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Updated: Mar 1, 2026

Use of an Influenza Antigen Microarray to Measure the Breadth of Serum Antibodies Across Virus Subtypes

Use of an Influenza Antigen Microarray to Measure the Breadth of Serum Antibodies Across Virus Subtypes

Published on: July 26, 2019

Indirect Influenza Vaccine Effectiveness Under Randomized Conditions: A Systematic Review and Meta-Analysis.

Andrew C Gilmore¹, Yuanyuan Liang¹, Ian M Galbreath¹

¹Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685 W. Baltimore St., Baltimore, Maryland, 20201, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America

|February 28, 2026

Summary

This summary is machine-generated.

High-quality influenza indirect vaccine effectiveness (IVE) evidence is limited. This systematic review found that while direct vaccine effectiveness was moderate, indirect vaccine effectiveness was low, suggesting individual vaccination is most reliable for influenza prevention.

Keywords:

Influenza vaccine Meta-analysis indirect vaccine effectiveness randomized controlled trial vaccine effectiveness

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Area of Science:

Epidemiology
Public Health
Infectious Diseases

Background:

Indirect vaccine effectiveness (IVE) estimates are prone to bias, with limited high-quality evidence for influenza.
Randomized controlled trials (RCTs) offer a robust method for assessing IVE.

Purpose of the Study:

To systematically review and meta-analyze RCTs to estimate influenza IVE.
To provide a rigorous benchmark for measurable IVE under randomized conditions.

Main Methods:

Systematic review and meta-analysis of RCTs published up to December 9, 2025.
Searched MEDLINE and EMBASE for English-language RCTs in non-institutional settings.
Included trials comparing RT-PCR-confirmed influenza illness in vaccinated versus unvaccinated households or communities.

Main Results:

Twelve RCTs (ten cluster-randomized, two individual-randomized) with low risk of bias were included.
Pooled direct vaccine effectiveness (DVE) was 44.1% (95% CI: 29.6%, 55.6%).
Pooled IVE was 13.7% (95% CI: 1.5%, 24.5%), with most trials not showing statistically significant indirect effects.

Conclusions:

This review establishes a methodologically sound benchmark for influenza IVE.
Pooled IVE was significantly lower than DVE, indicating limited community protection from vaccination.
Individual vaccination remains the most dependable strategy for preventing influenza, rather than relying on community-level effects.