Infectious Disease Epidemiology Group, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Clin Infect Dis. 2010 Dec 15;51(12):1370-9. doi: 10.1086/657311. Epub 2010 Nov 10.
The relationship between seasonal influenza vaccine and susceptibility to 2009 pandemic A/H1N1 virus infection is not fully understood.
One child 6-15 years of age from each of 119 households was randomized to receive 1 dose of inactivated trivalent seasonal influenza vaccine (TIV) or saline placebo in November 2008. Serum samples were collected from study subjects and their household contacts before and 1 month after vaccination (December 2008), after winter (April 2009) and summer influenza (September-October 2009) seasons. Seasonal and pandemic influenza were confirmed by serum hemagglutinination inhibition, viral neutralization titers, and reverse-transcription polymerase chain reaction performed on nasal and throat swab samples collected during illness episodes.
TIV recipients had lower rates of serologically confirmed seasonal A/H1N1 infection (TIV group, 8%; placebo group, 21%; P=.10) and A/H3N2 infection (7% vs 12%; P=A9), but higher rates of pandemic A/H1N1 infection (32% vs 17%; [Formula: see text]). In multivariable analysis, those infected with seasonal influenza A during the study had a lower risk of laboratory-confirmed pandemic A/H1N1 infection (adjusted odds ratio [OR], 0.35; 95% confidence interval [CI], 0.14-0.87), and receipt of seasonal TIV was unassociated with risk of pandemic A/H1N1 infection (adjusted OR, 1.11; 95% CI, 0.54-2.26).
TIV protected against strain-matched infection in children. Seasonal influenza infection appeared to confer cross-protection against pandemic influenza. Whether prior seasonal influenza vaccination affects the risk of infection with the pandemic strain requires additional study.
ClinicalTrials.gov number NCT00792051 .
季节性流感疫苗与感染 2009 年大流行 A/H1N1 病毒的易感性之间的关系尚未完全阐明。
2008 年 11 月，从 119 户家庭中随机选择每个家庭的 1 名 6-15 岁的儿童，接受 1 剂灭活三价季节性流感疫苗（TIV）或生理盐水安慰剂。在接种疫苗前（2008 年 12 月）和冬季（2009 年 4 月）及夏季流感（2009 年 9-10 月）后，收集研究对象及其家庭接触者的血清样本。通过血清血凝抑制、病毒中和滴度和鼻、咽拭子样本的逆转录聚合酶链反应确认季节性和大流行性流感。
TIV 组血清学确诊的季节性 A/H1N1 感染率（8%）低于安慰剂组（21%）（P=0.10），A/H3N2 感染率（7%对 12%）（P=0.10），但大流行性 A/H1N1 感染率（32%对 17%）（P=0.006）较高。多变量分析显示，研究期间感染季节性流感 A 的患者实验室确诊的大流行性 A/H1N1 感染风险较低（校正比值比[OR]，0.35；95%置信区间[CI]，0.14-0.87），接种季节性 TIV 与大流行性 A/H1N1 感染风险无关（校正 OR，1.11；95% CI，0.54-2.26）。
TIV 可预防儿童感染与疫苗株匹配的病毒。季节性流感感染似乎对大流行性流感具有交叉保护作用。季节性流感疫苗接种是否会影响感染大流行株的风险，还需要进一步研究。
ClinicalTrials.gov 编号 NCT00792051。
