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Volume 9
Issue 12
10.3390/vaccines9121452
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Review

Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials

by
Katrine Pedersbæk Hansen
1,
Christine Stabell Benn
1,2,3,*,
Thomas Aamand
1,4,
Martin Buus
1,4,
Isaquel da Silva
3,
Peter Aaby
1,3,
Ane Bærent Fisker
1,3 and
Sanne Marie Thysen
1,3
1
Bandim Health Project, OPEN, Department of Clinical Research, Odense University Hospital/University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
2
Danish Institute of Advanced Science, University of Southern Denmark, Fioniavej 34, 5230 Odense, Denmark
3
Bandim Health Project, Indepth Network, Apartado 861, Bissau 1004, Guinea-Bissau
4
Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark
*
Author to whom correspondence should be addressed.
Vaccines 2021, 9(12), 1452; https://doi.org/10.3390/vaccines9121452
Submission received: 25 October 2021 / Revised: 6 December 2021 / Accepted: 6 December 2021 / Published: 8 December 2021
(This article belongs to the Special Issue Non-specific Protections in Response to Vaccination and Other Stimulations of the Immune System)
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Abstract

The recommendation to provide inactivated influenza vaccine (IIV) to pregnant women is based on observed protection against influenza-related morbidity in mother and infant. Non-live vaccines may have non-specific effects (NSEs), increasing the risk of non-targeted infections in females. We reviewed the evidence from available randomised controlled trials (RCTs) of IIV to pregnant women, to assess whether IIV may have NSEs. Four RCTs, all conducted in low- and middle-income settings, were identified. We extracted information on all-cause and infectious mortality and adverse events in women and their infants. We conducted meta-analyses providing risk ratios (RR). The meta-analysis for maternal all-cause mortality provided a RR of 1.48 (95% CI = 0.52–4.16). The estimates for miscarriage/stillbirth and infant all-cause mortality up to 6 months of age were 1.06 (0.78–1.44) and 1.11 (0.87–1.41), respectively. IIV was associated with a higher risk of non-influenza infectious adverse events, with meta-estimates of 2.01 (1.15–3.50) in women and 1.36 (1.12–1.67) in infants up to 6 months of age. Thus, following a pattern seen for other non-live vaccines, IIV was associated with a higher risk of non-influenza infectious adverse events. To ensure that scarce resources are used well, and no harm is inflicted, further RCTs are warranted.
Keywords: non-specific effects; vaccination; immune system; influenza vaccine; pregnancy; all-cause mortality non-specific effects; vaccination; immune system; influenza vaccine; pregnancy; all-cause mortality

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MDPI and ACS Style

Hansen, K.P.; Benn, C.S.; Aamand, T.; Buus, M.; da Silva, I.; Aaby, P.; Fisker, A.B.; Thysen, S.M. Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Vaccines 2021, 9, 1452. https://doi.org/10.3390/vaccines9121452

AMA Style

Hansen KP, Benn CS, Aamand T, Buus M, da Silva I, Aaby P, Fisker AB, Thysen SM. Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Vaccines. 2021; 9(12):1452. https://doi.org/10.3390/vaccines9121452

Chicago/Turabian Style

Hansen, Katrine Pedersbæk, Christine Stabell Benn, Thomas Aamand, Martin Buus, Isaquel da Silva, Peter Aaby, Ane Bærent Fisker, and Sanne Marie Thysen. 2021. "Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials" Vaccines 9, no. 12: 1452. https://doi.org/10.3390/vaccines9121452

APA Style

Hansen, K. P., Benn, C. S., Aamand, T., Buus, M., da Silva, I., Aaby, P., Fisker, A. B., & Thysen, S. M. (2021). Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Vaccines, 9(12), 1452. https://doi.org/10.3390/vaccines9121452

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