Immunogenicity and safety of the domestic and imported live-attenuated varicella vaccine in healthy Chinese populations: a systematic review and meta-analysis.

OBJECTIVES

This study aimed to synthesize existing evidence to compare the immunogenicity and safety of domestic and imported live-attenuated varicella vaccine (VarV) in healthy Chinese populations.

METHODS

We searched PubMed, Web of Science, Embase, China National Knowledge Internet (CNKI), Wan Fang Database, and Chinese Biomedical Literature Service System (SinoMed) using predefined search terms to identify relevant studies. Retrieve all language articles up to March 15, 2024. Articles reported varicella vaccination in healthy Chinese populations were included. We calculated the pooled rates of seroconversions and adverse events using the random effects model and assessed the quality of each study using the modified Jadad Scale and Newcastle Ottawa Scale (NOS). Publication bias was evaluated using Egger's regression test.

RESULTS

In our immunogenicity analysis, which included 16,655 Chinese individuals from 21 studies, the pooled seroconversion rate was 89% (95%CI: 86-91%) for domestic VarV and 93% (95%CI: 88-98%) for imported Varv, with no statistically significant difference. In our safety analysis, which included 29,696 Chinese individuals from 25 studies, the pooled rate of systemic reactions was higher for domestic Varv (11%, 95%CI: 10-13%) than for imported Varv (8%, 95%CI: 6-10%; P < 0.001), while the results for local reactions were the opposite (domestic Varv: 3%, 95%CI: 2-3%; imported Varv: 7%, 95%CI: 3-10%; P = 0.020). The results are based on pooled proportions rather than direct comparison. Egger's test suggested that publication bias was not negligible.

CONCLUSIONS

Both domestic and imported varicella vaccines appear to be generally immunogenic and safe in healthy Chinese populations. However, due to limited and heterogeneous data on imported vaccines, further high-quality studies are needed to validate these comparative findings.