Cook Ian F, Pond Dimity, Hartel Gunter
University of Newcastle, Callaghan, NSW, Australia.
Vaccine. 2007 Jun 15;25(25):4767-74. doi: 10.1016/j.vaccine.2007.04.017. Epub 2007 Apr 26.
23 Valent pneumococcal vaccine is provided to the elderly through public health programs in many countries. However there is no clear recommendation regarding its route of administration (subcutaneous or intramuscular). In a randomised, observer blind study of 254 elderly subjects, the immunogenicity of a 23 valent pneumococcal vaccine was not influenced by its route of administration. A low rate of systemic adverse reactions was observed with the vaccine (subcutaneous and intramuscular both 6.3%). Local adverse reaction rates were; intramuscular 7.1% and subcutaneous 18.9% and these were predicted by: * Pre-vaccination antibody titres>1 microg/ml, odds ratio 22.4 (8.06-74.84) compared with pre-vaccination antibody titre<1 microg/ml. * Female gender, odds ratio 5.0 (1.85-14.83) compared with male gender. * Subcutaneous injection route, odds ratio 3.20 (1.13-9.13) compared with intramuscular injection route. * Female gender subcutaneous injection route, odds ratio 2.99 (1.10-8.70) compared with female gender intramuscular injection route. These data support the intramuscular injection of 23 valent pneumococcal vaccine, especially in elderly females.
许多国家通过公共卫生项目为老年人提供23价肺炎球菌疫苗。然而，关于其给药途径（皮下或肌肉注射）尚无明确建议。在一项对254名老年受试者进行的随机、观察者盲法研究中，23价肺炎球菌疫苗的免疫原性不受给药途径的影响。观察到该疫苗的全身不良反应发生率较低（皮下和肌肉注射均为6.3%）。局部不良反应发生率分别为：肌肉注射7.1%，皮下注射18.9%，以下因素可预测局部不良反应：* 接种疫苗前抗体滴度>1微克/毫升，与接种疫苗前抗体滴度<1微克/毫升相比，比值比为22.4（8.06 - 74.84）。* 女性，与男性相比，比值比为5.0（1.85 - 14.83）。* 皮下注射途径，与肌肉注射途径相比，比值比为3.20（1.13 - 9.13）。* 女性皮下注射途径，与女性肌肉注射途径相比，比值比为2.99（1.10 - 8.70）。这些数据支持23价肺炎球菌疫苗采用肌肉注射，尤其是老年女性。
