Vaccines for preventing the common cold in healthy people

The common cold is a self limiting viral infection of the upper respiratory tract, characterised by a runny nose, nasal congestion, sneezing, cough, malaise, with or without sore throat, and a slightly elevated temperature. Treatment is symptomatic. Vaccines for preventing the common cold have been difficult to produce because the sources and antigens of the virus vary greatly. Globally, the common cold causes widespread morbidity. The efficacy and safety of interventions for preventing the common cold in healthy people are still uncertain.

This Cochrane review identified only one randomised controlled trial (RCT) involving 2307 healthy people. The trial compared adenovirus vaccines with a placebo to prevent the common cold in healthy people. No statistically significant difference in common cold incidence was found. This RCT report no adverse events related to the live vaccine. The trial had a high risk of bias. The existing evidence does not support adenovirus vaccines to prevent the common cold in healthy people. How far virus vaccines can reduce the incidence of the common cold still remains to be investigated.

Authors' conclusions: 

This Cochrane review has found a lack of evidence on the effects of vaccines for the common cold in healthy people. Only one RCT was found and this did not show differences between comparison groups; it also had a high risk of bias. There are no conclusive data to support the use of vaccines for preventing the common cold in healthy people. We identified the need for well-designed, adequately powered RCTs to investigate vaccines for the common cold in healthy people. Unless RCTs provide evidence of a treatment effect and the trade-off between potential benefits and harms is established, policy-makers, clinicians and academics should not recommend the use of vaccines for preventing the common cold in healthy people. Any future trials on medical treatments for preventing the common cold should assess a variety of virus vaccines for this condition. Outcome measures should include common cold incidence, vaccine safety and mortality related to the vaccine.

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Background: 

The common cold is a spontaneously remitting infection of the upper respiratory tract, characterised by a runny nose, nasal congestion, sneezing, cough, malaise, sore throat and fever (usually < 37.8˚C). The widespread morbidity it causes worldwide is related to its ubiquitousness rather than its severity. The development of vaccines for the common cold has been difficult because of antigenic variability of the common cold virus and the indistinguishable multiple other viruses and even bacteria acting as infective agents. There is uncertainty regarding the efficacy and safety of interventions for preventing the common cold in healthy people.

Objectives: 

To assess the clinical effectiveness and safety of vaccines for preventing the common cold in healthy people.

Search strategy: 

We searched CENTRAL (2012, Issue 12), MEDLINE (1948 to January week 1, 2013), EMBASE (1974 to January 2013), CINAHL (1981 to January 2013) and LILACS (1982 to January 2013).

Selection criteria: 

Randomised controlled trials (RCTs) of any virus vaccines to prevent the common cold in healthy people.

Data collection and analysis: 

Two review authors independently evaluated methodological quality and extracted trial data. Disagreements were resolved by discussion or by consulting a third review author.

Main results: 

This review included one RCT with 2307 healthy participants; all of them were analysed. This trial compared the effect of an adenovirus vaccine against a placebo. No statistically significant difference in common cold incidence was found: there were 13 events in 1139 participants in the vaccines group and 14 events in 1168 participants in the placebo group; risk ratio (RR) 0.95, 95% confidence interval (CI) 0.45 to 2.02, P = 0.90). No adverse events related to the live vaccine were reported.

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