Effect of a booster dose of influenza vaccine in patients with hemodialysis, peritoneal dialysis and renal transplant recipients: A systematic literature review and meta-analysis

Booster influenza vaccination has been recommended for patients with chronic renal disease in order to enhance the immune response to the influenza vaccine; however, the efficacy of a booster influenza vaccination is a matter of controversy. Therefore, we made a meta-analysis to determine the efficacy in patients with hemodialysis (HD), peritoneal dialysis (PD) and renal transplant recipient (RT). The sero-protection rate was used as a serologic parameter to describe the immune response to the vaccine. Statistical analysis was performed to calculate the pooled rate difference (RD) and 95% confidence interval (CI). The pooled RD for the H1N1, H3N2 and B influenza vaccines was 0.02 (95% CI: −0.02–0.06), 0.05 (95% CI: −0.01–0.11), 0.04 (95% CI: −0.02–0.10), respectively. We concluded that a booster dose of the influenza vaccine did not effectively enhance immunogenicity. Therefore, a booster dose of vaccine is not recommended for patients with hemodialysis, peritoneal dialysis and renal transplant recipients.Natural Science Foundation of Guangdong Province, Chin

Immunogenicity and Safety of Influenza Vaccination in Systemic Lupus Erythematosus Patients Compared with Healthy Controls: A Meta-Analysis.

OBJECTIVE:To assess the immunogenicity and safety of influenza vaccine in patients with systemic lupus erythematosus (SLE). METHODS:Relevant articles were retrieved from electronic databases. Seroprotection rate, seroconversion rate and factors that increase antibody geometric mean titer (GMT) were used as indices to measure the immunogenicity. The safety of vaccine was assessed through monitoring adverse events, which included side effects and SLE exacerbations. We performed a meta-analysis of influenza vaccine seroprotection, seroconversion and adverse effects. SLE exacerbation after vaccination was comprehensively described. We used the Committee for Proprietary Medicinal Products (CPMP) guidelines to determine whether influenza can induce adequate immunogenicity in patients with SLE. RESULTS:Eighteen studies with 1966 subjects met the inclusion criteria. At least 565 of the subjects were patients with low-to-moderate SLE Disease Activity Index (SLEDAI) score or stable SLE disease. Compared with the general population, seroprotection rate in SLE patients was significantly decreased in patients with H1N1 [odds ratio (OR) = 0.36, 95% confidence interval (CI): 0.27-0.50] and H3N2 vaccination (OR = 0.48, 95% CI: 0.24-0.93), but not influenza B vaccination (OR = 0.55, 95% CI: 0.24-1.25). Seroconversion rate also significantly decreased in patients with H1N1 (OR = 0.39, 95% CI: 0.27-0.57) and influenza B (OR = 0.47, 95% CI: 0.29-0.76) vaccination, but not H3N2 vaccination (OR = 0.62, 95% CI: 0.21-1.79). However, the immunogenicity of influenza vaccine in SLE patients almost reached that of the CPMP guidelines. The OR for side effects (patients versus healthy controls) was 3.24 (95% CI: 0.62-16.76). Among 1966 patients with SLE, 32 experienced mild exacerbation of SLE and five had serious side effects for other reasons. CONCLUSION:Influenza vaccine has moderate effect on protecting patients with SLE. The side effects of influenza vaccine are not serious and are manageable. With consideration of a higher risk of SLE exacerbation and a more severe course of infection among SLE patients, influenza vaccination should be promoted among SLE patients with a low-to-moderate SLEDAI score or stable disease

Forest plot of seroprotection rate of influenza B vaccination in SLE patients compared with healthy controls.

<p>Forest plot of seroprotection rate of influenza B vaccination in SLE patients compared with healthy controls.</p

Flow Chart of Study Selection.

<p>Flow Chart of Study Selection.</p

Forest plot of seroconversion rate of H1N1 vaccination in SLE patients compared with healthy controls.

<p>Forest plot of seroconversion rate of H1N1 vaccination in SLE patients compared with healthy controls.</p

Forest plot of seroprotection rate of H3N2 vaccination in SLE patients compared with healthy controls.

<p>Forest plot of seroprotection rate of H3N2 vaccination in SLE patients compared with healthy controls.</p

Forest plot of seroprotection rate of H1N1 vaccination in SLE patients compared with healthy controls.

<p>Forest plot of seroprotection rate of H1N1 vaccination in SLE patients compared with healthy controls.</p

Forest plot of seroconversion rate of influenza B vaccination in SLE patients compared with healthy controls.

<p>Forest plot of seroconversion rate of influenza B vaccination in SLE patients compared with healthy controls.</p

Measurement of the 181 ^{181} 181 Ta( n,γn,\gamma n , γ ) cross sections up to stellar s-process temperatures at the CSNS Back-n

Abstract The neutron capture cross section of $$^{181}$$ 181 Ta is relevant to s-process of nuclear astrophysics, extraterrestrial samples analysis in planetary geology and new generation nuclear energy system design. The $$^{181}$$ 181 Ta( $$n,\gamma$$ n , γ ) cross section had been measured between 1 eV and 800 keV at the back-streaming white neutron facility (Back-n) of China spallation neutron source(CSNS) using the time-of-flight (TOF) technique and $$\hbox {C}_{6}\,\hbox {D}_{6}$$ C 6 D 6 liquid scintillator detectors. The experimental results are compared with the data of several evaluated libraries and previous experiments in the resolved and unresolved resonance region. Resonance parameters are extracted using the R-Matrix code SAMMY in the 1–700 eV region. The astrophysical Maxwell average cross section(MACS) from kT = 5 to 100 keV is calculated over a sufficiently wide range of neutron energies. For the characteristic thermal energy of an astrophysical site, at kT = 30keV the MACS value of $$^{181}$$ 181 Ta is 834 ± 75 mb, which shows an obvious discrepancy with the Karlsruhe Astrophysical Database of Nucleosynthesis in Stars (KADoNiS) recommended value 766 ± 15 mb. The new measurements strongly constrain the MACS of $$^{181}$$ 181 Ta( $$n,\gamma$$ n , γ ) reaction in the stellar s-process temperatures