Palache Bram
Solvay Biologicals BV, P.O. Box 900, 1380 DA Weesp, The Netherlands.
Vaccine. 2008 Nov 18;26(49):6232-6. doi: 10.1016/j.vaccine.2008.07.022. Epub 2008 Jul 30.
Inactivated influenza vaccines have been available since the late 1940s for the prevention of influenza disease. Based on the available scientific evidence, many public health authorities, including the World Health Organization, recommend annual use of these vaccines for specific populations, including the elderly. Despite these recommendations, actual vaccination uptake rates are very limited in many countries. Influenza vaccine research is confounded by the variable nature of the influenza viruses and annual influenza epidemics and by non-specific clinical diagnostic criteria. These confounding factors complicate evaluation not only of overall vaccine effectiveness, but also of the relative efficacy and effectiveness of different vaccine formulations. This paper summarizes recent advances in the development of seasonal and (pre-)pandemic vaccines, discusses the methodologic constraints on influenza vaccine research, and proposes measures to reduce the level of potential bias and confounding in influenza vaccine research.
自20世纪40年代末以来，灭活流感疫苗一直用于预防流感疾病。根据现有科学证据，包括世界卫生组织在内的许多公共卫生当局建议特定人群（包括老年人）每年接种这些疫苗。尽管有这些建议，但在许多国家，实际疫苗接种率非常有限。流感病毒的多变性、每年的流感流行以及非特异性临床诊断标准使流感疫苗研究变得复杂。这些混杂因素不仅使评估总体疫苗效力变得复杂，也使评估不同疫苗配方的相对疗效和效力变得复杂。本文总结了季节性和（大流行前）大流行疫苗开发的最新进展，讨论了流感疫苗研究的方法学限制，并提出了减少流感疫苗研究中潜在偏倚和混杂水平的措施。
