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流感疫苗接种效果评估(作者译)

[Assessment of the efficiency of vaccination against influenza (author's transl)].

作者信息

Ambrosch F, Wiedermann G

出版信息

Immun Infekt. 1976 Aug;4(4):174-81.

PMID:1017849
Abstract

The efficiency of the vaccination against influenza resp. its assessment depends on methodological factors, on the vaccine in use and on the epidemiological situation. According to serological tests protection rates (p) may be found of 0,8-0,9; a combined clinical and serological evaluation leads to a value of p=0,7 and after clinical estimation p=0,5. For statistical evaluation it is important to know whether the groups of persons to be compared were randomized or selected. Vaccination groups consisting of volunteers were selected in as much as the vaccines apparently exhibited a higher premorbidity than the control groups. Further on the protection rate is influenced by the number of vaccinations performed. Another very important factor is the composition of the vaccine in use, which should be in accordance with the recommendations of the WHO. Concentration of antigen and addition of adiuvant also influences the efficiency of inactivated vaccines. The antigenic composition is also relevant in live attenuated vaccines. Epidemiological factors are of importance in as much as the efficiency of the vaccination rises with the morbidity of the population. However, even in interepidemic periods the vaccination offers a certain degree of clinically observable protection (0,3). The indication for vaccination against influenza is influenced by age. In older persons the vaccination depresses morbidity and mortality rates, in middle aged working people lower morbidity and a drop in days of absence resulted as consequence of a vaccination campaign, whereas in children shedding of virus is prevented by the vaccination.

摘要

流感疫苗接种的效率及其评估取决于方法学因素、所用疫苗以及流行病学情况。根据血清学检测,保护率(p)可能为0.8 - 0.9;临床与血清学联合评估得出的p值为0.7,临床评估后p值为0.5。对于统计评估而言,了解待比较人群组是随机分组还是经过挑选非常重要。由于疫苗接种组的志愿者明显比对照组有更高的发病率,所以疫苗接种组是经过挑选的。此外,保护率还受接种次数的影响。另一个非常重要的因素是所用疫苗的成分,其应符合世界卫生组织的建议。抗原浓度和佐剂的添加也会影响灭活疫苗的效率。抗原组成在减毒活疫苗中也很重要。流行病学因素很重要,因为疫苗接种的效率会随着人群发病率的上升而提高。然而,即使在流行间期,疫苗接种也能提供一定程度的临床可观察到的保护(0.3)。流感疫苗接种的适应证受年龄影响。在老年人中,疫苗接种可降低发病率和死亡率;在中年在职人员中,疫苗接种降低了发病率,并且由于开展了疫苗接种活动,缺勤天数减少;而在儿童中,疫苗接种可预防病毒传播。

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