University of Washington, Seattle, Washington, USA.
Clin Infect Dis. 2010 May 15;50(10):1331-8. doi: 10.1086/652144.
Influenza vaccine immunogenicity is suboptimal in older persons. Intradermal (ID) vaccination may be a promising alternative to intramuscular (IM) vaccination.
This randomized trial compared the immunogenicity of 60% dose ID influenza vaccination to standard IM vaccination of full-dose or 60% dose vaccine. Pre- and postvaccination measurements in the hemagglutination inhibition antibody titer were compared. Participants who received reduced-dose vaccine were revaccinated with full-dose IM vaccine.
257 healthy adults aged 65 years received 1 of the following trivalent inactivated influenza vaccines: standard-dose (15 microg each of 3 hemagglutinin vaccine antigens in 0.5 mL) IM injection, reduced-dose (9 microg, 0.3 mL) IM injection, reduced-dose (9 microg, 0.3 mL) ID injection, or 2 reduced-dose (4.5 microg, 0.15 mL) ID injections. Respective seroprotection rates were 65.6%, 57.8%, 68.9%, and 67.2% against A/H1N1; 76.6%, 75.0%, 75.4%, and 75.0% against A/H3N2; and 26.6%, 17.2%, 16.4%, and 25.0% against influenza B. Subsequent full-dose IM vaccination of participants randomized to reduced-dose vaccine by either IM or ID routes did not improve seroprotection rates. Local reactions of redness, swelling, and itching were significantly more frequent among recipients of ID injections.
Influenza vaccine at 60% dose by either IM or ID route elicited antibody responses generally similar to full-dose IM vaccination among healthy elderly persons (ClinicalTrials.gov identifier: NCT00504231).
流感疫苗在老年人中的免疫原性并不理想。皮内（ID）接种可能是肌肉内（IM）接种的一种有前途的替代方法。
这项随机试验比较了 60%剂量 ID 流感疫苗接种与全剂量或 60%剂量疫苗的标准 IM 疫苗接种的免疫原性。比较了血凝抑制抗体滴度的预接种和接种后测量值。接受低剂量疫苗的参与者用全剂量 IM 疫苗进行了再接种。
257 名年龄在 65 岁的健康成年人接受了以下三种单价灭活流感疫苗中的一种：标准剂量（0.5 毫升中每 3 种血凝素疫苗抗原各 15 微克）IM 注射、低剂量（9 微克，0.3 毫升）IM 注射、低剂量（9 微克，0.3 毫升）ID 注射或 2 次低剂量（4.5 微克，0.15 毫升）ID 注射。针对 A/H1N1 的相应血清保护率分别为 65.6%、57.8%、68.9%和 67.2%；针对 A/H3N2 的分别为 76.6%、75.0%、75.4%和 75.0%；针对 B 型流感的分别为 26.6%、17.2%、16.4%和 25.0%。随后对通过 IM 或 ID 途径接受低剂量疫苗的参与者进行了全剂量 IM 疫苗接种，但并未提高血清保护率。接受 ID 注射的人出现红斑、肿胀和瘙痒等局部反应的频率明显更高。
在健康老年人中，通过 IM 或 ID 途径给予 60%剂量的流感疫苗，其抗体反应通常与全剂量 IM 疫苗接种相似（临床试验注册号：NCT00504231）。
