TY - JOUR
T1 - Comparison of immunogenicity and safety of licensed Japanese encephalitis vaccines
T2 - A systematic review and network meta-analysis
AU - Furuya-Kanamori, Luis
AU - Xu, Chang
AU - Doi, Suhail A R
AU - Clark, Justin
AU - Wangdi, Kinley
AU - Mills, Deborah J
AU - Lau, Colleen L
N1 - Copyright © 2021 Elsevier Ltd. All rights reserved.
Funding Information:
LFK was supported by Australian National Health and Medical Research Council Early Career Fellowship (APP1158469).
Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2021/7/22
Y1 - 2021/7/22
N2 - INTRODUCTION: Annually more than 100,000 Japanese encephalitis (JE) cases and 25,000 deaths worldwide are caused by JE virus infection. More than 15 JE vaccines are currently in use worldwide. It is unknown whether any of the vaccines is superior to the others in terms of immunogenicity and safety.METHODS: Four databases were systematically searched for randomised controlled trials that compared two or more types of JE vaccines. Vaccines were classified into four classes: inactivated mouse brain-derived (oldest class), inactivated Vero cell, live chimeric, and live attenuated. Network meta-analysis was used to generate mixed effect estimates against inactivated mouse brain-derived vaccines for seroconversion, and against placebo for adverse event (AE) and severe adverse event (SAE).RESULTS: 23 studies (38,496 participants) were included. All newer vaccine classes had better immunogenicity, the difference was statistically significant for inactivated Vero cell (OR = 2.98; 95 %CI: 1.02-8.65) and live chimeric (OR = 5.93; 95 %CI: 1.73-20.32) vaccines. Inactivated mouse-derived vaccines had the highest odds for AEs (OR = 2.27; 95 %CI: 1.59-3.23), the odds of AE of newer vaccines was not different to placebo. There was no difference in SAEs across vaccine classes.CONCLUSIONS: All newer JE vaccines have comparable safety profiles, live chimeric and inactivated Vero cell vaccines are the most immunogenic among the newer vaccine classes.
AB - INTRODUCTION: Annually more than 100,000 Japanese encephalitis (JE) cases and 25,000 deaths worldwide are caused by JE virus infection. More than 15 JE vaccines are currently in use worldwide. It is unknown whether any of the vaccines is superior to the others in terms of immunogenicity and safety.METHODS: Four databases were systematically searched for randomised controlled trials that compared two or more types of JE vaccines. Vaccines were classified into four classes: inactivated mouse brain-derived (oldest class), inactivated Vero cell, live chimeric, and live attenuated. Network meta-analysis was used to generate mixed effect estimates against inactivated mouse brain-derived vaccines for seroconversion, and against placebo for adverse event (AE) and severe adverse event (SAE).RESULTS: 23 studies (38,496 participants) were included. All newer vaccine classes had better immunogenicity, the difference was statistically significant for inactivated Vero cell (OR = 2.98; 95 %CI: 1.02-8.65) and live chimeric (OR = 5.93; 95 %CI: 1.73-20.32) vaccines. Inactivated mouse-derived vaccines had the highest odds for AEs (OR = 2.27; 95 %CI: 1.59-3.23), the odds of AE of newer vaccines was not different to placebo. There was no difference in SAEs across vaccine classes.CONCLUSIONS: All newer JE vaccines have comparable safety profiles, live chimeric and inactivated Vero cell vaccines are the most immunogenic among the newer vaccine classes.
KW - Animals
KW - Antibodies, Viral
KW - Encephalitis Virus, Japanese
KW - Encephalitis, Japanese/prevention & control
KW - Japanese Encephalitis Vaccines/adverse effects
KW - Mice
KW - Network Meta-Analysis
KW - Vaccination
KW - Vaccines, Attenuated/adverse effects
KW - Vaccines, Inactivated/adverse effects
KW - Efficacy
KW - Seroconversion
KW - Adverse events
KW - Severe
KW - Japanese encephalitis
UR - http://www.scopus.com/inward/record.url?scp=85108540613&partnerID=8YFLogxK
U2 - 10.1016/j.vaccine.2021.06.023
DO - 10.1016/j.vaccine.2021.06.023
M3 - Review article
C2 - 34175128
SN - 0264-410X
VL - 39
SP - 4429
EP - 4436
JO - Vaccine
JF - Vaccine
IS - 32
ER -
