PMID- 36177017
OWN - NLM
STAT- MEDLINE
DCOM- 20221003
LR  - 20231213
IS  - 1664-3224 (Electronic)
IS  - 1664-3224 (Linking)
VI  - 13
DP  - 2022
TI  - Efficacy, immunogenicity and safety of COVID-19 vaccines in older adults: a 
      systematic review and meta-analysis.
PG  - 965971
LID - 10.3389/fimmu.2022.965971 [doi]
LID - 965971
AB  - BACKGROUND: Older adults are more susceptible to severe health outcomes for 
      coronavirus disease 2019 (COVID-19). Universal vaccination has become a trend, 
      but there are still doubts and research gaps regarding the COVID-19 vaccination 
      in the elderly. This study aimed to investigate the efficacy, immunogenicity, and 
      safety of COVID-19 vaccines in older people aged >/= 55 years and their influencing 
      factors. METHODS: Randomized controlled trials from inception to April 9, 2022, 
      were systematically searched in PubMed, EMBASE, the Cochrane Library, and Web of 
      Science. We estimated summary relative risk (RR), rates, or standardized mean 
      difference (SMD) with 95% confidence interval (CI) using random-effects 
      meta-analysis. This study was registered with PROSPERO (CRD42022314456). RESULTS: 
      Of the 32 eligible studies, 9, 21, and 25 were analyzed for efficacy, 
      immunogenicity, and safety, respectively. In older adults, vaccination was 
      efficacious against COVID-19 (79.49%, 95% CI: 60.55-89.34), with excellent 
      seroconversion rate (92.64%, 95% CI: 86.77-96.91) and geometric mean titer (GMT) 
      (SMD 3.56, 95% CI: 2.80-4.31) of neutralizing antibodies, and provided a 
      significant protection rate against severe disease (87.01%, 50.80-96.57). 
      Subgroup and meta-regression analyses consistently found vaccine types and the 
      number of doses to be primary influencing factors for efficacy and 
      immunogenicity. Specifically, mRNA vaccines showed the best efficacy (90.72%, 95% 
      CI: 86.82-93.46), consistent with its highest seroconversion rate (98.52%, 95% 
      CI: 93.45-99.98) and GMT (SMD 6.20, 95% CI: 2.02-10.39). Compared to the control 
      groups, vaccination significantly increased the incidence of total adverse events 
      (AEs) (RR 1.59, 95% CI: 1.38-1.83), including most local and systemic AEs, such 
      as pain, fever, chill, etc. For inactivated and DNA vaccines, the incidence of 
      any AEs was similar between vaccination and control groups (p > 0.1), while mRNA 
      vaccines had the highest risk of most AEs (RR range from 1.74 to 7.22). 
      CONCLUSION: COVID-19 vaccines showed acceptable efficacy, immunogenicity and 
      safety in older people, especially providing a high protection rate against 
      severe disease. The mRNA vaccine was the most efficacious, but it is worth 
      surveillance for some AEs it caused. Increased booster coverage in older adults 
      is warranted, and additional studies are urgently required for longer follow-up 
      periods and variant strains.
CI  - Copyright (c) 2022 Li, Liu, Li, Li, Li, Peng, Li, He and Liu.
FAU - Li, Zejun
AU  - Li Z
AD  - National Clinical Research Center for Mental Disorders, Department of Psychiatry, 
      The Second Xiangya Hospital of Central South University, Changsha, China.
FAU - Liu, Shouhuan
AU  - Liu S
AD  - Department of Psychiatry, First Affiliated Hospital of Kunming Medical 
      University, Kunming, China.
FAU - Li, Fengming
AU  - Li F
AD  - Ministry of Education Key Laboratory of Child Development and Disorders, 
      Children's Hospital of Chongqing Medical University, Chongqing, China.
FAU - Li, Yifeng
AU  - Li Y
AD  - College of Pediatrics, Chongqing Medical University, Chongqing, China.
FAU - Li, Yilin
AU  - Li Y
AD  - College of Pediatrics, Chongqing Medical University, Chongqing, China.
FAU - Peng, Pu
AU  - Peng P
AD  - National Clinical Research Center for Mental Disorders, Department of Psychiatry, 
      The Second Xiangya Hospital of Central South University, Changsha, China.
FAU - Li, Sai
AU  - Li S
AD  - College of Pediatrics, Chongqing Medical University, Chongqing, China.
FAU - He, Li
AU  - He L
AD  - National Clinical Research Center for Mental Disorders, Department of Psychiatry, 
      The Second Xiangya Hospital of Central South University, Changsha, China.
FAU - Liu, Tieqiao
AU  - Liu T
AD  - National Clinical Research Center for Mental Disorders, Department of Psychiatry, 
      The Second Xiangya Hospital of Central South University, Changsha, China.
LA  - eng
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20220913
PL  - Switzerland
TA  - Front Immunol
JT  - Frontiers in immunology
JID - 101560960
RN  - 0 (Antibodies, Neutralizing)
RN  - 0 (COVID-19 Vaccines)
RN  - 0 (Vaccines, DNA)
RN  - 0 (Vaccines, Synthetic)
RN  - 0 (mRNA Vaccines)
SB  - IM
MH  - Aged
MH  - Antibodies, Neutralizing
MH  - *COVID-19/prevention & control
MH  - *COVID-19 Vaccines/adverse effects
MH  - Humans
MH  - *Vaccines, DNA
MH  - Vaccines, Synthetic
MH  - mRNA Vaccines
PMC - PMC9513208
OTO - NOTNLM
OT  - COVID-19 vaccines
OT  - efficacy
OT  - immunogenicity
OT  - meta-analysis
OT  - older adults
OT  - randomized controlled trials (RCTs)
OT  - safety
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/10/01 06:00
MHDA- 2022/10/04 06:00
PMCR- 2022/09/13
CRDT- 2022/09/30 02:40
PHST- 2022/06/10 00:00 [received]
PHST- 2022/08/24 00:00 [accepted]
PHST- 2022/09/30 02:40 [entrez]
PHST- 2022/10/01 06:00 [pubmed]
PHST- 2022/10/04 06:00 [medline]
PHST- 2022/09/13 00:00 [pmc-release]
AID - 10.3389/fimmu.2022.965971 [doi]
PST - epublish
SO  - Front Immunol. 2022 Sep 13;13:965971. doi: 10.3389/fimmu.2022.965971. eCollection 
      2022.