Table 1.
Characteristics of included RCTs on intradermal versus intramuscular administration of influenza vaccine
| Authors | Country | Interventions | Units of treatment ID/IM | Immunogenicity | Reported reactions | Population | Quality score | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Seroprotection | Seroconversion | Injection sitea | Systemicb | Jadad scale | Chalmers scale | ||||||||||
| A/H1N1 | A/H3N2 | B | A/H1N1 | A/H3N2 | B | ||||||||||
| ID | IM | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | ||||||
| ID/IM | ID/IM | ID/IM | ID/IM | ID/IM | ID/IM | ID/IM | ID/IM | ||||||||
| L Gelinck et al. 2009 [14] | Netherlands | TIV SU | TIV SU | 77/79 | 49(63.6)/60(75.9) | 60(77.9)/58(73.4) | 50(64.9)/55(69.6) | NA | NA | NA | Total reactionsc | Immuno-compromized patients | 3/5 | 0.54 | |
| 3 μg HA/strain | 15 μg HA/strain | 52 % ID group/30 % IM group | |||||||||||||
| Y Jo et al. 2009 [15] | Korea | TIV SPL | TIV SPL | 52/55 | 50(96.1)/52(94.5) | 50(90.1)/54(98.1) | 41(78.8)/ 45(81.8) | 38(73)/41(74.5) | 28(53.8)/24(43.6) | 28(53.8)/37(67.3) | 10 (19)/3(5.5)d | 1 (1.9)/2 (3.6)e | Patients with solid cancer | 2/5 | 0.32 |
| 7.5 μg HA/strain | 15 μg HA/strain | ||||||||||||||
| E Morelon et al. 2010 [16] | France | TIV SPL | TIV SPL | 31/31 | 22(71)/16(52) | 16(52)/11(36) | 22(71)/19(61) | 11(35)/6(19) | 11(35)/6(19) | 6(19)/6(19) | 25 (80.6)/ 15 (48.4) | 17 (54.8)/16 (51.6) | Renal transplant patients | 3/5 | 0.45 |
| 15 μg HA/strain | 15 μg HA/strain | ||||||||||||||
| O Manuel et al. 2011 [17] | Multicentricf | TIV SPL | TIV SPL | 41/43 | 16(39)/ 12(28) | 34(83)/ 42(98) | 12(29)/ 25(58) | 3(7.3)/ 3(7) | 2(4.9)/3(7) | 3(7.3)/5(11.6) | 17 (41.5)/11 (25) | 3 (7.3)/7 (15.9) | Lung transplant patients | 3/5 | 0.67 |
| 6h μg HA/strain | 15 μg HA/strain | ||||||||||||||
| F Ansaldi et al. 2012 [18] | Italy | TIV SPL | TIV SPL | 28/24 | 22(79)/19(80) | 23(82)/19(80) | 21(75)/18(76) | 14(50)/15(64) | 15(54)/14(60) | 11(36)/ 8(32) | 18 (64.3)/5 (20.8) | 6 (21.4)/3 (12.5)g | HIV-infected patients | 3/5 | 0.71 |
| 9 μg HA/strain | 15 μg HA/strain | ||||||||||||||
| A Baluch et al. 2013 [19] | Canada | TIV SPL | TIV SPL | 107/105 | 76(71)/74(70.5) | 75(70.1)/67(63.8) | 68(63.6)/55(52.4) | 40(37.4)/36(34.3) | 31(29)/32(30.5) | 23(21.5)/18(17.1) | NA | Transplant patients | 3/5 | 0.75 | |
| 9i μg HA/strain | 15 μg HA/strain | ||||||||||||||
ID: Intradermal; IM: Intramuscular; TIV: trivalent inactivated vaccine; HA: hemagglutinin; SPL: split vaccine; SU: subunit vaccine
aPain at injection site, erythema, swelling, pruritus, induration and ecchymosis
bFever, myalgia, headache, malaise and shivering
cFrequency of local and systemic adverse reactions calculated on 125 participants that recorded whether or not they had suffered adverse reactions
dReferred to swelling that was the most frequent symptom suffered both in ID and IM groups
eReferred to fever or myalgia
fCanada and Switzerland
gReferred to shivering that was the most frequent symptom suffered both in ID and IM groups
hTwo doses of ID vaccine were delivered for a cumulative dose of 12 μg antigen per strain
iTwo doses of ID vaccine were delivered for a cumulative dose of 18 μg antigen per strain