Leroux-Roels Isabel, Leroux-Roels Geert
Center for Vaccinology, Ghent University and Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
Expert Rev Vaccines. 2009 Apr;8(4):401-23. doi: 10.1586/erv.09.15.
H5N1 viruses are widely considered to be a probable cause of the next influenza pandemic. Influenza vaccines are considered to form the main prophylactic measure against pandemic influenza. The world's population is expected to have no pre-existing immunity against the pandemic virus strain and will need two vaccine doses to acquire protective immunity. A pandemic outbreak will spread much faster than it will take for pandemic vaccines to be produced and distributed. Therefore, increasing efforts are being made to develop prepandemic vaccines that can induce broad cross-protective responses and that can be administered as soon as a pandemic is declared or even before, in order to successfully prime the immune system and allow for a rapid and protective antibody response with one dose of the pandemic vaccine. Several vaccine manufacturers have developed candidate pandemic and prepandemic vaccines, predominantly based on reverse-genetics reference strains and have improved the immunogenicity by formulating these vaccines with different adjuvants. Clinical studies with inactivated split-virion or whole-virion vaccines based on H5N1 indicate that two immunizations appear necessary to elicit the level of immunity required to meet licensure criteria. A detailed overview is given of the most successful candidate vaccines developed by seven vaccine manufacturers.
H5N1病毒被广泛认为是下一次流感大流行的可能病因。流感疫苗被视为预防大流行性流感的主要措施。预计全球人口对大流行病毒株没有预先存在的免疫力，需要接种两剂疫苗才能获得保护性免疫。大流行疫情的传播速度将远远快于大流行疫苗的生产和分发速度。因此，人们正在加大努力开发大流行前疫苗，这种疫苗能够诱导广泛的交叉保护反应，并且在宣布大流行时甚至在此之前就能接种，以便成功地启动免疫系统，并在接种一剂大流行疫苗后产生快速的保护性抗体反应。几家疫苗制造商已经开发出候选大流行疫苗和大流行前疫苗，主要基于反向遗传学参考毒株，并通过用不同佐剂配制这些疫苗提高了免疫原性。基于H5N1的灭活裂解病毒或全病毒疫苗的临床研究表明，似乎需要进行两次免疫接种才能引发达到许可标准所需的免疫水平。本文详细概述了七家疫苗制造商开发的最成功的候选疫苗。
