Abstract
Influenza virus infection is a major global public health problem, and the efficacy of influenza vaccination is not satisfactory. Vitamin D is involved in many immune-mediated inflammatory processes. The impact of vitamin D levels on the immunogenic response to influenza vaccination is not clear. We performed a comprehensive literature search and systematic review of studies that investigated vitamin D and influenza vaccination. Data pertaining to study population, vaccine components, vitamin D levels, and immunogenic response were analyzed. Nine studies, with a combined study population of 2367 patients, were included in the systematic review. Four studies were included in the meta-analysis to investigate the influence of vitamin D deficiency (VDD) on the seroprotection (SP) rates and seroconversion (SC) rates following influenza vaccination. We found no significant association between vitamin D level and the immunogenic response to influenza vaccination. However, strain-specific differences may exist. We observed lower SP rates of influenza A virus subtype H3N2 (A/H3N2) and B strain in VDD patients than patients with normal vitamin D levels (A/H3N2: 71.8% vs. 80.1%, odds ratio (OR): 0.63, 95% confidence interval (CI): 0.43–0.91, p = 0.01; B strain: 69.6% vs. 76.4%, OR: 0.68, 95% CI: 0.5–0.93, p = 0.01). However, the SP rates of A/H1N1 and SC rates of all three strains were not significantly different in VDD and control groups. In conclusion, no association was observed between VDD and immunogenic response to influenza vaccination.
Highlights
Influenza is an important infectious disease and a major contributor to the global disease burden
Two trials conducted during different influenza seasons with different patient numbers, vaccine components, and years of study were published in the same article and regarded as two independent studies [37]
Further studies are warranted to elucidate the influence of vitamin D deficiency (VDD) on individual vaccine strains and the impact of vitamin D supplementation
Summary
Influenza is an important infectious disease and a major contributor to the global disease burden. Nutrients 2018, 10, 409 elderly [1]. Influenza vaccination is widely used to prevent influenza infection; the vaccine efficacy is unsatisfactory. The pooled efficacy in adults aged 18–65 years was 59% in a meta-analysis published in 2012; there was no evidence of protection observed in the elderly group [2]. Protection by influenza vaccine is inadequate, and breakthrough infection is common, which results in influenza-related morbidity and mortality. Refinement has been made to enhance the immune response to influenza vaccines, such as by providing additional adjuvant supplements, nutritional interventions or by increasing the vaccine dose [3,4]. The composition of the influenza vaccine usually contains split virions with two A strains
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