Zangwill Kenneth M, Belshe Robert B
School of Medicine, UCLA Harbor-UCLA Medical Center, Torrance, CA, USA.
Pediatr Infect Dis J. 2004 Mar;23(3):189-97. doi: 10.1097/01.inf.0000116292.46143.d6.
Increasing use of influenza vaccine in children is expected as this important virus becomes more widely recognized as a major cause of morbidity in young children. Clinicians and third party payers must consider the implications of national vaccine use recommendations, with their current focus on young children, on their practices and on the community at large. Two influenza vaccines are available in the United States, an inactivated, trivalent intramuscular formulation (TIV) which is approved for use among children > or =6 months of age; and a live, attenuated intranasal trivalent preparation (LAIV) indicated for healthy persons 5 to 49 years of age. This review summarizes available data regarding the safety and efficacy of TIV, in comparison with LAIV, with particular attention to children <9 years of age, the population for whom two doses of vaccine are recommended for first time vaccination. It is apparent that relatively few data are available on the safety of TIV in young children, that important age-specific differences in TIV vaccine efficacy exist and that LAIV appears similar to TIV with regard to safety and efficacy in younger children, but no head-to-head comparison of these two licensed products is available.
随着这种重要病毒作为幼儿发病的主要原因而得到更广泛认可，预计儿童流感疫苗的使用将会增加。临床医生和第三方支付者必须考虑国家疫苗使用建议（目前重点关注幼儿）对其医疗实践以及整个社区的影响。美国有两种流感疫苗，一种是灭活三价肌肉注射制剂（TIV），已获批用于6个月及以上儿童；另一种是减毒活鼻内三价制剂（LAIV），适用于5至49岁的健康人群。本综述总结了与LAIV相比，TIV安全性和有效性的现有数据，特别关注9岁以下儿童，这一人群首次接种疫苗时建议接种两剂。显然，关于幼儿TIV安全性的可用数据相对较少，TIV疫苗效力存在重要的年龄特异性差异，并且在年幼儿童中，LAIV在安全性和有效性方面似乎与TIV相似，但尚无这两种获批产品的直接对比。
