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Occupational Medicine 52:255-258 (2002)
Copyright © 2002 Society of Occupational Medicine

Influenza vaccines in adults

T. Jefferson *,{dagger} , E. Bianco {ddagger} and V. Demicheli {dagger}

*Health Reviews Ltd, Via Adige 28a, 00061 Anguillara Sabazia, Rome; {dagger}Cochrane Vaccines Field, Servizio Sovrazonale di Epidemiologia, ASL 20, Via Venezia 6, 15100 Alessandria; and {ddagger}Istituto Superiore di Sanità, Reparto Epidemiologia Clinica, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Rome, Italy

Correspondence to: Tom Jefferson, Health Reviews Ltd, Via Adige 28a, 00061 Anguillara Sabazia, Rome, Italy. e-mail: toj1{at}aol.com

Abstract

Available influenza vaccines contain inactivated viruses, either whole or in parts, and are administered parenterally or intranasally. Their composition varies yearly because of viral antigenic shifts and drifts. Vaccines with a composition matching yearly World Health Organization recommendations are 72% [95% confidence interval (CI) = 54–83%] efficacious (prevention of influenza cases caused by influenza viruses A and B). Their effectiveness [capacity to prevent clinical influenza, or influenza-like illness (ILI)] is lower, at 37% (95% CI = 18–52%). A decision to vaccinate an adult population has to take into account the efficacy of the vaccines and their effectiveness (the likely proportion of ILI caused by influenza A and B viruses, amenable to prevention by vaccination), as well as costs and likely compliance. As the yearly levels of circulating A and B viruses are difficult to predict during the decision time for a vaccination campaign, there is a considerable element of uncertainty regarding the likely effectiveness of ‘this year's’ vaccine.

Keywords      Burden of influenza; Cochrane reviews; decision making; effectiveness and efficacy; healthy adults; influenza vaccines; prevention


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