Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a Cochrane Clinical Answer that focuses on the above important clinical question.
Confidence in the evidence is moderate or low to moderate where GRADE has been performed and there is a trade off between benefits and harms of the intervention.
Population: Healthy adults (18 to 64 years old)
Intervention: Inactivated parenteral vaccine ᵃ
Comparison: Placebo or ‘do nothing’ ᵃ
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Influenza‐like illness (tested over a single influenza season) | Favours intervention | Moderate |
Influenza (tested over a single influenza season) | Favours intervention | Moderate |
Working days lost (tested over a single influenza season) | No statistically significant difference | Low |
Hospitalisations (tested over a single influenza season) | No statistically significant difference | Low |
Complications: Pneumonia, bronchitis, otitis | - | No RCTs were identified which assessed this outcome |
Local harms (tested over a single influenza season) Subgroups: tenderness/soreness; local - erythema; induration; combined endpoint (any or highest symptom) | Occurs more commonly with inactivated parenteral vaccine compared with placebo or ‘do nothing’ (favours comparison) | GRADE assessment not performed for this outcome |
Local harms (tested over a single influenza season) Subgroups: arm stiffness | No statistically significant difference | GRADE assessment not performed for this outcome |
Systemic harms (tested over a single influenza season) Subgroups: myalgia; fatigue or indisposition | Occurs more commonly with inactivated parenteral vaccine compared with placebo or ‘do nothing’ (favours comparison) | GRADE assessment not performed for this outcome |
Systemic harms (tested over a single influenza season) Subgroups: fever | Occurs more commonly with inactivated parenteral vaccine compared with placebo or ‘do nothing’ (favours comparison) | High |
Systemic harms (tested over a single influenza season) Subgroups: headache; combined endpoint (any or highest symptom) | No statistically significant difference | GRADE assessment not performed for this outcome |
Systemic harms (tested over a single influenza season) Subgroups: nausea/vomiting | No statistically significant difference | Low |
Note ᵃ This evidence table summarises the findings for the comparison of inactivated parenteral vaccine versus placebo or ‘do nothing’, which is the main comparison as stated in the Cochrane review Summary of Findings table. See the full Cochrane Clinical Answer (CCA) for information on other comparisons (live aerosol vaccine versus placebo or ‘do nothing’ and inactivated aerosol vaccine versus placebo or ‘do nothing’).
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
- How do provider‐ or system‐based interventions impact the uptake of influenza vaccination in people aged 60 or older?
- How do interventions aimed at increasing community demand impact the uptake of influenza vaccination in people aged 60 or older?
- In healthy adults, what are the benefits and harms of vaccines for preventing influenza?
- In healthy children, what are the benefits and harms of vaccines for preventing influenza?
- Does randomized controlled trial evidence support the use of vaccines to prevent influenza in the elderly?
- What are the benefits and harms of neuraminidase inhibitors for the treatment of influenza in otherwise healthy adults?
- In children with clinically or serologically confirmed influenza A, do amantadine and rimantadine improve outcomes?
- If there is an outbreak of influenza A in the community, do amantadine and rimantadine given prophylactically prevent the development of influenza in children?
- If there is an outbreak of influenza A in the community, do amantadine and rimantadine given prophylactically prevent the development of influenza in the elderly?
- What are the benefits and harms of neuraminidase inhibitors for the prevention of influenza in adults?
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