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Peer reviewedCOVID-19InfluenzaH5N1

A systematic meta-analytic comparative evaluation of seasonal influenza vaccine effectiveness from test-negative design studies in the Northern Hemisphere pre/post COVID-19 pandemic

Vaccine·

George N. Okoli, Sheena G. Sullivan, Diane M. Harper, Tim K. Tsang, Benjamin J. Cowling

DOI
10.1016/j.vaccine.2026.128956
PMID
42486051
PMCID
OpenAlex
W7170036910
Study type
Systematic review
Publisher
Elsevier BV
Article type
journal-article
Integrity
current

Why this research matters now

The findings provide comparative context for interpreting seasonal influenza vaccine-effectiveness estimates across periods and age groups. The abstract indicates that factors other than population immunity could account for the observed differences, so the results do not establish a single explanation.

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Structured evidence summary

Research question

The study evaluates whether pooled seasonal influenza vaccine-effectiveness estimates differed between pre-pandemic and post-pandemic periods in Northern Hemisphere test-negative studies.

Study design

This was a systematic review and meta-analysis of published peer-reviewed test-negative design studies. The analysis used inverse-variance random-effects models and compared pooled estimates across defined pre-pandemic and post-pandemic periods.

Population and setting

The evidence comprised 85 publications examining medically attended, laboratory-confirmed seasonal influenza in Northern Hemisphere settings. Estimates were grouped by influenza subtype and by ages 6 months–17 years, 18–64 years, and 65 years or older.

Main findings

Post-pandemic vaccine effectiveness against A(H3N2) was higher than pre-pandemic estimates among people aged 6 months–17 years and 18–64 years. Effectiveness against influenza B was also higher in those two age groups, while A(H1N1)pdm09 effectiveness was lower among 18–64-year-olds; no significant differences were reported for adults aged 65 years or older, and B/Victoria evidence was limited.

Public-health relevance

The findings provide comparative context for interpreting seasonal influenza vaccine-effectiveness estimates across periods and age groups. The abstract indicates that factors other than population immunity could account for the observed differences, so the results do not establish a single explanation.

Important limitations

The abstract identifies limited B/Victoria data and notes that factors other than population immunity may explain the observed differences. This summary is additionally limited to the supplied single-article abstract and metadata; the original paper is required for decision-grade assessment of study heterogeneity, bias, and analytic details.

GIDS interpretation

The article is discoverable as evidence concerning influenza vaccination and vaccine effectiveness, with COVID-19 appearing as a study-period context. It provides literature context only and does not confirm, measure, or explain any live surveillance signal.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 13 auditable classifier relationships to diseases, places, topics, and study design.

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