Climate Adaptation Through Combined Vaccination: A Meta-Analysis on the Immunogenicity and Safety of Coadministering COVID-19 and Influenza Vaccines
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Abstract
Introduction: Climate change has been linked to worsening infections and increased vulnerability to diseases such as SARS-CoV-2 and influenza, through increased pollution and changing seasonal patterns. Coadministration of COVID-19 and influenza vaccines emerges as a proactive approach to enhance immunization coverage and streamline preventive measures against climate-induced risks. However, concerns over safety and efficacy remain a major barrier with current guidelines being largely based on individual studies and lacking conclusive data on its immunogenicity and safety. This meta-analysis aims to evaluate the immunogenicity and safety of coadministering COVID-19 vaccines with influenza vaccines.
Methods: Following PRISMA guidelines, we searched PubMed, EMBASE, and Cochrane Library for studies published up to September 1, 2024. Statistical analyses were conducted in R studio, with sensitivity analysis using Begg’s modified funnel plot. The Cochrane Risk of Bias Tool and ROBINS-I were used to assess study quality for RCTs and non-RCTs, respectively. Relative risk (RR) and standardized mean difference (SMD) were estimated with 95% confidence intervals (CI) using random or fixed effect models, with significance set at p<0.05.
Results: Twenty studies involving 11,671 participants were included in this meta-analysis. Coadministration of COVID-19 and influenza vaccines yielded comparable seroconversion rates to those in the non-coadministration group (RR = 0.99, 95% CI = 0.98–1.00). While a slight reduction in geometric mean titer (SMD = -1.06, 95% CI = -2.14–0.03) of neutralizing antibodies was noted in the coadministration group, the results remained within the non-inferiority margin, supporting adequate immunogenicity. Mild to moderate systemic adverse events were more frequent in the coadministration group (RR = 1.09, 95% CI = 1.05–1.14), with fatigue and myalgia being the most common. Severe adverse events were rare across both groups (RR = 1.04, 95% CI = 0.83–1.30), suggesting the overall safety of coadministration.
Conclusion: Coadministration of COVID-19 and influenza vaccines offers comparable immunogenicity and safety to non-coadministration. However, further studies are needed to assess long-term efficacy and cellular immune responses to better understand the full impact of coadministration compared to non-coadministration.
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