Beijing Centre for Disease Control and Prevention, China.
Vaccine. 2011 Jan 29;29(5):1009-16. doi: 10.1016/j.vaccine.2010.11.058. Epub 2010 Dec 2.
A randomized clinical trial was conducted to assess whether the immunogenicity of seasonal and pandemic (H1N1/09) influenza vaccines is affected by the order of vaccine administration. 151 healthy adult volunteers were randomized into three groups. All groups received one dose (15 μg haemagglutinin) each of a pandemic H1N1 vaccine and a seasonal trivalent vaccine. Group 1 received the pandemic H1N1 vaccine first, followed by the seasonal vaccine 21 days later. Group 2 received vaccinations in vice versa and Group 3 received both vaccines simultaneously. Post-vaccination blood samples were collected to determine the immunogenicity by hemagglutination-inhibition (HI), microneutralization (MN), and B cell ELISPOT assays. All three vaccination strategies were well-tolerated and generated specific immune responses. However, we found a significant difference in magnitude of antibody responses to pandemic H1N1 between the three groups. Pre- or co-vaccination with the seasonal flu vaccine led to a significant reduction by 50% in HI titre to pandemic H1N1 virus after pandemic vaccination. Pre- or co-vaccination of pandemic H1N1 vaccine had no effect on seasonal flu vaccination. MN and ELISPOT assays showed a similar effect. Vaccination with pandemic H1N1 vaccine first is recommended to avoid an associated inhibitory effect by the seasonal trivalent flu vaccine.
一项随机临床试验评估了季节性和大流行性（H1N1/09）流感疫苗的免疫原性是否受到疫苗接种顺序的影响。151 名健康成年志愿者被随机分为三组。所有组均接种一剂（15 μg 血凝素）大流行性 H1N1 疫苗和季节性三价疫苗。第 1 组先接种大流行性 H1N1 疫苗，21 天后再接种季节性疫苗。第 2 组接种顺序相反，第 3 组同时接种两种疫苗。接种后采集血样，通过血凝抑制（HI）、微量中和（MN）和 B 细胞 ELISPOT 测定来评估免疫原性。所有三种接种策略均耐受良好并产生了特异性免疫反应。然而，我们发现三种组之间对大流行性 H1N1 的抗体反应幅度存在显著差异。在大流行性流感疫苗接种前或同时接种季节性流感疫苗后，大流行性 H1N1 病毒的 HI 滴度显著降低 50%。大流行性 H1N1 疫苗的预接种或同时接种对季节性流感疫苗接种没有影响。MN 和 ELISPOT 测定显示出相似的效果。建议首先接种大流行性 H1N1 疫苗，以避免季节性三价流感疫苗的相关抑制作用。
