Fedson David S
Pasteur Mérieux MSD, Sergy Haut, France.
Pediatr Infect Dis J. 2004 Jan;23(1 Suppl):S74-7. doi: 10.1097/01.inf.0000108195.12141.cc.
The demand for influenza vaccine is driven by recognition of its health and economic benefits. Vaccine reduces all cause mortality in the elderly by 30 to 50% and prevents > or =30% of hospital admissions for influenza-related respiratory disease, heart disease and stroke. However, because most influenza vaccine (85%) is produced in only eight countries, adequate production and equitable distribution of vaccine throughout the world will pose a serious challenge when the next influenza pandemic appears.
This article reviews a six point agenda for pandemic vaccination that should be undertaken during interpandemic years. The agenda includes preparing vaccine seed strains using reverse genetics, determining the characteristics of a pandemic vaccine and vaccination schedule, considering global registration of pandemic vaccines, increasing vaccination in interpandemic years, documenting the epidemiology of vaccine use and addressing political issues that will affect the global supply of pandemic vaccines.
Planning for pandemic vaccination must begin during the interpandemic period to ensure a vaccine supply that will be adequate to meet demand in all countries. This will require the skills not only of experts in virology, epidemiology and public health but also those in politics, economics and law. The task will be complex, but its promised benefits will be immense.
对流感疫苗的需求源于对其健康和经济效益的认识。疫苗可使老年人的全因死亡率降低30%至50%，并预防≥30%的因流感相关呼吸道疾病、心脏病和中风导致的住院治疗。然而，由于大多数流感疫苗（85%）仅在八个国家生产，当下一次流感大流行出现时，在全球范围内实现疫苗的充足生产和公平分配将是一项严峻挑战。
本文回顾了在流感大流行间隔年应开展的六点大流行疫苗接种议程。该议程包括利用反向遗传学制备疫苗种子毒株、确定大流行疫苗的特性和接种计划、考虑大流行疫苗的全球注册、在大流行间隔年增加疫苗接种、记录疫苗使用的流行病学情况以及解决会影响大流行疫苗全球供应的政治问题。
大流行疫苗接种规划必须在大流行间隔期开始，以确保有足够的疫苗供应来满足所有国家的需求。这不仅需要病毒学、流行病学和公共卫生专家的技能，还需要政治、经济和法律方面的专家技能。这项任务将很复杂，但其预期效益将是巨大的。
