ABSTRACT

Introduction

Psychological and behavioural may enhance vaccine effectiveness. We conducted a systematic review and network meta-analysis (NMA) to examine the effects of non-pharmacological adjuvants on vaccine effectiveness, as measured by antibody responses to vaccination.

Areas covered

Electronic databases (EMBASE, Medline, PsychINFO, CINAHL) were searched from inception to 6th February 2018. This yielded 100 eligible papers, reporting 106 trials: 79 interventions associated with diet and/or nutrition; 12 physical activity interventions and 9 psychological interventions.Over half (58/106) of trials reported evidence of an enhanced antibody response to vaccination across one or more outcomes. The NMA considered the comparative effects between all intervention types, control and placebo for antibody titres (48 studies), seroconversion (25 studies) and seroprotection (23 studies) separately. The NMA provided weak evidence in support of nutritional formulae and probiotics in increasing antibody titres.

Expert opinion

This review offers a comprehensive summary of the literature on non-pharmacological interventions as vaccine adjuvants. The evidence is characterised by considerable heterogeneity but provides early evidence in support of nutritional formulae and probiotic interventions. Psychological and exercise-based interventions were characterised by limited and unreliable evidence. Large, well-designed studies including consistent core outcomes and measures of intervention adherence and fidelity are required.

中文翻译：

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非药物干预作为疫苗佐剂对人类的影响：系统评价和网络荟萃分析

摘要

介绍

心理和行为可能会提高疫苗的有效性。我们进行了系统评价和网络荟萃分析 (NMA)，以检查非药物佐剂对疫苗有效性的影响，通过对疫苗接种的抗体反应来衡量。

涵盖的领域

从开始到 2018 年 2 月 6 日，对电子数据库（EMBASE、Medline、PsychINFO、CINAHL）进行了检索。这产生了 100 篇符合条件的论文，报告了 106 项试验：79 项与饮食和/或营养相关的干预措施；12 项身体活动干预和 9 项心理干预。超过一半 (58/106) 的试验报告了在一项或多项结果中增强了对疫苗接种的抗体反应的证据。NMA 分别考虑了所有干预类型、对照和安慰剂对抗体滴度（48 项研究）、血清转化（25 项研究）和血清保护（23 项研究）的比较效果。NMA 提供了微弱的证据来支持营养配方和益生菌增加抗体滴度。

专家意见

本综述全面总结了关于非药物干预作为疫苗佐剂的文献。证据的特点是相当大的异质性，但提供了支持营养配方和益生菌干预的早期证据。以心理和运动为基础的干预措施的特点是证据有限且不可靠。需要设计良好的大型研究，包括一致的核心结果以及干预依从性和保真度的测量。