MD, PhD, MAE, FMedSci, FRCP, FRCPEd.

Changes in the vaccine advisory process in the United States have disrupted immunization guidance, which reinforces the need for independent evidence review to inform decisions regarding immunization for respiratory viruses during the 2025-2026 season.

The researchers conducted a systematic review of U.S.-licensed immunizations against coronavirus disease 2019 (Covid-19), respiratory syncytial virus (RSV), and influenza. They searched databases on PubMed/MEDLINE, Embase, and Web of Science for updates of the most recent review by the Advisory Committee on Immunization Practices (ACIP) Evidence-to-Recommendations for each disease, which was performed during the 2023-2024 period. Outcomes included vaccine efficacy and effectiveness against hospitalization, other clinical end points, and safety.

Of 17,263 identified references, 511 studies met the inclusion criteria. Covid-19 mRNA vaccines against the XBB.1.5 subvariant had pooled vaccine effectiveness against hospitalization of 46% (95% confidence interval [CI], 34 to 55; from cohort studies) and 50% (95% CI, 43 to 57; from case-control studies) among adults and 37% (95% CI, 29 to 44) among immunocompromised adults. In a case-control study, vaccines against the KP.2 subvariant showed an effectiveness of 68% (95% CI, 42 to 82). Maternal RSV vaccination (for infant protection), nirsevimab for infants, and RSV vaccines in adults who were 60 years of age or older showed vaccine effectiveness of 68% or more against hospitalization. Influenza vaccination had a pooled vaccine effectiveness of 48% (95% CI, 39 to 55) in adults between the ages of 18 and 64 years and 67% (95% CI, 58 to 75) in children against hospitalization. Safety profiles were consistent with previous evaluations. The diagnosis of myocarditis associated with Covid-19 vaccines occurred at rates of 1.3 to 3.1 per 100,000 doses in male adolescents, with lower risk associated with longer dosing intervals. The RSVPreF vaccine was associated with 18.2 excess cases of Guillain-Barré syndrome per million doses in older adults; a significant association with preterm birth was not observed when the vaccine was administered at 32 to 36 weeks’ gestation.

The authors concluded that the evidence supports the safety and effectiveness of immunizations against Covid-19, RSV, and influenza during the 2025-2026 season.

On this blog, we have a surprising amount of commentators who seem unconvinced about the benefits of vaccinations, particularly the COVID vaccinations. Therefore, I thought that this recent article might help these confused people to better understand the current evidence.

In contrast to the self-appointed ‘experts’ claiming that vaccinations do more harm than good, the authors of this excellent paper come from the most reputable institutions in the US:

  • 1Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA.
  • 2Department of Medicine, Division of Infectious Diseases, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY.
  • 3Department of Pediatrics, Mass General Brigham for Children and Harvard Medical School, Boston.
  • 4Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston.
  • 5Department of Medicine (Infectious Diseases), University of Pennsylvania Perelman School of Medicine, Philadelphia.
  • 6Center for Infectious Disease Research and Policy, University of Minnesota, Minneapolis.
  • 7Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, WI.
  • 8Harvard Medical School, Boston.
  • 9Massachusetts General Hospital, Boston.
  • 10Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, McGill University, Montreal.
  • 11Division of Infectious Diseases, Brown University Health and Warren Alpert Medical School of Brown University, Providence, RI.
  • 12Division of General Internal Medicine and Infectious Disease, Massachusetts General Hospital, Harvard Medical School, Boston.
  • 13Division of Infectious Diseases, Massachusetts General Hospital, Boston.

Will this new paper convince many anti-vaxers? I sure hope so but somehow I also have my doubts.

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