Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
Pediatr Infect Dis J. 2011 Jun;30(6):491-4. doi: 10.1097/INF.0b013e31820b7c22.
Data on the immunogenicity of the influenza vaccine in children after liver transplantation are sparse. Our study aims to evaluate the response of such patients to the trivalent influenza vaccine, administered by different protocols in 2 influenza seasons.
Children attending the Liver Transplantation Unit of a tertiary care medical center were prospectively recruited and immunized with the inactivated subvirion influenza vaccine during the influenza seasons of 2004/2005 (1 dose, n = 18) and 2005/2006 (2 doses 4-6 weeks apart, n = 32). Antibodies were measured by hemagglutination inhibition assay. Immunity was defined as a titer of ≥1:40, and response was defined as a ≥4-fold increase in antibody titer from baseline.
In 2004/2005, the proportions of patients with protective antibodies were similar before and after 1 dose of vaccine. We found significant difference after the first dose for the A/H3N2 Wisconsin strain (43.2% vs. 70.3%, P = 0.003) and B/Malaysia strains (8.1% vs. 35.1%, P = 0.003) and for A/H1N1 New Caledonia strain (48.6% vs. 64.9% vs. 75%, P = 0.08, 0.005, respectively) after the second dose in 2005/2006 season. In 2004/2005, geometric mean titers rose significantly (P = 0.03) for the A/H3N2 New York strain; in 2005/2006, geometric mean titers for A/H3N2 New York and B/Malaysia increased after the first dose and for A/H1N1 New Caledonia after the second dose. Antibody titers were unrelated to age at transplantation, time from transplantation, and number of immunosuppressive drugs used. No serious vaccine-related events were documented.
Liver-transplanted children respond to influenza vaccination. For some strains, the response is similar to that reported for healthy children. A second vaccine dose yielded no statistically significant benefit.
关于儿童肝移植后流感疫苗免疫原性的数据很少。我们的研究旨在评估这些患者对两种流感季节中不同方案接种三价流感疫苗的反应。
前瞻性招募在三级医疗中心肝移植科就诊的儿童，并在 2004/2005 流感季节（1 剂，n = 18）和 2005/2006 流感季节（2 剂，间隔 4-6 周，n = 32）接受灭活亚单位流感疫苗免疫。通过血凝抑制试验测量抗体。将效价≥1:40 定义为免疫，将抗体滴度较基线升高≥4 倍定义为有反应。
在 2004/2005 年，1 剂疫苗后，具有保护抗体的患者比例在疫苗接种前后相似。我们发现首次接种后 A/H3N2 威斯康星州株（43.2%对 70.3%，P = 0.003）和 B/马来西亚株（8.1%对 35.1%，P = 0.003）以及 A/H1N1 新喀里多尼亚株（48.6%对 64.9%对 75%，P = 0.08，0.005）有显著差异，而在 2005/2006 年接种第二剂后。2004/2005 年，A/H3N2 纽约株的几何平均滴度显著升高（P = 0.03）；2005/2006 年，A/H3N2 纽约株和 B/马来西亚株的几何平均滴度在首次接种后增加，A/H1N1 新喀里多尼亚株在第二次接种后增加。抗体滴度与移植时年龄、移植后时间和使用的免疫抑制剂数量无关。未记录到与疫苗相关的严重不良事件。
肝移植儿童对流感疫苗有反应。对于某些菌株，反应与健康儿童报告的反应相似。接种第二剂疫苗并没有带来统计学上的显著获益。
