Neuzil Kathleen M, Jackson Lisa A, Nelson Jennifer, Klimov Alexander, Cox Nancy, Bridges Carolyn B, Dunn John, DeStefano Frank, Shay David
Program for Appropriate Technology in Health, School of Medicine, University of Washington, Seattle, Seattle, WA 98107, USA.
J Infect Dis. 2006 Oct 15;194(8):1032-9. doi: 10.1086/507309. Epub 2006 Sep 11.
Two doses of trivalent inactivated influenza vaccine (TIV) are recommended for children <9 years old receiving vaccine for the first time, but compliance is suboptimal. This study assessed the need for a second dose of TIV in this age group.
In this prospective, open-label study, 232 influenza vaccine-naive 5-8-year-olds enrolled in a health maintenance organization received 2 doses of TIV in fall 2004. Serum for antibody titer measurement was obtained at 3 time points (n = 222). Parents completed diaries for 5 days.
Both doses of vaccine were well tolerated. The strongest predictor of a protective antibody response (> or =1 : 40) after 1 dose of TIV was baseline seropositive status. In multivariate analysis adjusting for age, sex, and baseline serostatus, the proportion of children with protective antibody responses was significantly higher after 2 doses than after 1 dose of TIV for each antigen (P < .001, for A/H1N1; P = .01, for A/H3N2; P < .001, for B). Age and sex were not independently predictive of a protective antibody response. Over one-third of children had antibody responses <1:40 for the type B vaccine component, even after 2 doses.
The present study supports the need for 2 doses of TIV in 5-8-year-olds receiving TIV for the first time. Efforts to increase compliance with the 2-dose recommendation are warranted.
对于首次接种疫苗的9岁以下儿童，推荐接种两剂三价灭活流感疫苗（TIV），但依从性欠佳。本研究评估了该年龄组接种第二剂TIV的必要性。
在这项前瞻性、开放标签研究中，232名加入健康维护组织且未接种过流感疫苗的5至8岁儿童于2004年秋季接种了两剂TIV。在3个时间点采集血清用于测量抗体滴度（n = 222）。家长记录了5天的日记。
两剂疫苗耐受性均良好。一剂TIV后产生保护性抗体反应（≥1:40）的最强预测因素是基线血清学阳性状态。在对年龄、性别和基线血清状态进行校正的多变量分析中，每种抗原接种两剂TIV后产生保护性抗体反应的儿童比例显著高于接种一剂后（A/H1N1，P <.001；A/H3N2，P =.01；B，P <.001）。年龄和性别并非保护性抗体反应的独立预测因素。即使接种两剂后，超过三分之一的儿童针对B型疫苗成分的抗体反应<1:40。
本研究支持首次接种TIV的5至8岁儿童需要接种两剂TIV。有必要努力提高对两剂接种推荐的依从性。
