Department of Maternal and Pediatric Sciences, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Nephrol Dial Transplant. 2011 Jun;26(6):2018-24. doi: 10.1093/ndt/gfq657. Epub 2010 Oct 25.
The aim of this study was to investigate the immunogenicity, safety and tolerability of the 2009 A/H1N1 MF59-adjuvanted influenza vaccine, administered sequentially or simultaneously with the seasonal 2009-10 virosomal-adjuvanted influenza vaccine, to paediatric kidney transplant recipients.
Thirty-two children and adolescents with transplanted kidneys and 32 age- and gender-matched healthy controls were randomized 1:1 to receive the pandemic vaccine upon enrolment and the seasonal vaccine 1 month later (16 transplant recipients and 16 healthy controls), or to receive the two vaccines simultaneously upon enrolment (16 transplant recipients and 16 healthy controls).
When the pandemic vaccine was administered sequentially to the seasonal vaccine, it was significantly less immunogenic in the patients than in the controls (P < 0.05); when it was administered together with the seasonal vaccine, the immune response of both patients (P < 0.05) and controls (P < 0.05) was significantly greater than when it was administered sequentially. Seroconversion rates and the geometric mean titres of all of the seasonal antigens were significantly lower in the patients, regardless of the type of vaccine administration (P < 0.05). Simultaneous administration was associated with a better immune response against A/H1N1 and A/H3N2 antigens in both patients and controls, and did not increase the mild local and systemic reactions. No impact on renal function was observed.
Paediatric kidney transplant recipients have a lower immune response to the pandemic influenza A/H1N1 MF59-adjuvanted and seasonal virosomal-adjuvanted influenza vaccines than healthy controls. The simultaneous administration of the two vaccines seems to increase immune response to both pandemic and seasonal A/H1N1 and A/H3N2 antigens, and has the same safety profile as that of the pandemic vaccine administered sequentially to the seasonal vaccine.
本研究旨在探讨 MF59 佐剂 2009 年 A/H1N1 流感疫苗在先后或同时接种季节性 2009-10 年病毒样流感疫苗时，对儿科肾移植受者的免疫原性、安全性和耐受性。
32 名肾移植儿童和青少年及 32 名年龄和性别匹配的健康对照者按 1:1 随机分为两组，一组在入组时接种大流行疫苗，1 个月后接种季节性疫苗（16 例移植受者和 16 例健康对照者），另一组在入组时同时接种两种疫苗（16 例移植受者和 16 例健康对照者）。
当大流行疫苗先后接种于季节性疫苗时，患者的免疫原性明显低于对照组（P < 0.05）；当与季节性疫苗同时接种时，患者（P < 0.05）和对照组（P < 0.05）的免疫反应均显著大于先后接种的情况。无论接种何种疫苗，患者的季节性抗原血清转化率和几何平均滴度均明显低于对照组（P < 0.05）。
同时接种与患者和对照组对 A/H1N1 和 A/H3N2 抗原产生更好的免疫反应相关，且不会增加轻微的局部和全身反应。未观察到对肾功能的影响。
儿科肾移植受者对大流行流感 A/H1N1 MF59 佐剂和季节性病毒样佐剂流感疫苗的免疫反应低于健康对照者。同时接种两种疫苗似乎可以增加对大流行和季节性 A/H1N1 和 A/H3N2 抗原的免疫反应，且与大流行疫苗先后接种于季节性疫苗的安全性相似。
