Efectiveness of influenza vaccines in Asthma: A systematic review and meta-analysis

Eleftheria Vasileiou* (Corresponding Author), Aziz Sheikh, Chris Butler, Karim El Ferkh, Beatrix Von Wissmann, Jim McMenamin, Lewis Ritchie, Jürgen Schwarze, Nikolaos G. Papadopoulos, Sebastian L. Johnston, Lilly Tian, Colin R. Simpson

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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There is uncertainty about the effectiveness of influenza vaccination in persons with asthma and its impact on asthma outcomes, which may contribute to the suboptimal vaccination rates in persons with asthma. This systematic review and meta-analysis involved searching 12 international databases for randomized controlled trials (RCTs) and high-quality quasi-experimental and epidemiological studies (1970-2016). The risk of bias was low for 3 included RCTs. The quality of 3 included observational studies was moderate. The quality of evidence was very low for all study outcomes. Pooled vaccine effectiveness in 1825 persons with asthma from 2 test-negative design case-control studies was 45% (95% confidence interval [CI], 31%-56%) for laboratory-confirmed influenza. Pooled eficacy of live vaccines in reducing influenza was 81% (95% CI, 33%-94%). Live vaccine reduced febrile illness by 72% (95% CI, 20%-90%). Influenza vaccine prevented 59%-78% of asthma attacks leading to emergency visits and/or hospitalizations. For persons with asthma, influenza vaccination may be effective in both reducing influenza infection and asthma attacks.

Original languageEnglish
Pages (from-to)1388-1395
Number of pages8
JournalClinical Infectious Diseases
Issue number8
Publication statusPublished - 15 Oct 2017

Bibliographical note

The work was funded by the Chief Scientist Office of the Scottish Government under the grant (AUKCAR/14/03). This work is carried out with the support of the Asthma UK Centre for Applied Research (AUK-AC-2012-01).


  • Asthma
  • Immunization
  • Influenza
  • Laboratory confirmed influenza
  • Vaccination


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