School of Paediatrics & Child Health, University of Western Australia, Perth, WA, Australia.
Vaccine. 2011 Jul 18;29(32):5107-13. doi: 10.1016/j.vaccine.2011.05.054. Epub 2011 Jun 1.
Increased numbers of children presenting with febrile adverse events following trivalent influenza vaccine (TIV) were noted in Australia in 2010. We describe the epidemiology and clinical features of the adverse events and explore the biological basis for the adverse events using an in vitro model.
Children presenting to a tertiary paediatric hospital in 2010 with adverse events within 72 h of TIV were retrospectively reviewed. Demographics, clinical features, physiological variables and outcomes were examined. Plasma cytokine and chemokine levels were examined in a subgroup of children with vaccine-related febrile convulsions. Peripheral blood mononuclear cells of age-matched children were stimulated with different TIV preparations. Inflammatory cytokine and chemokine analysis was performed on cultured supernatants.
Vaccine-related febrile adverse events were identified in 190 children. Most occurred in healthy children (median age: 1.5 years) within 12 h of vaccination. Twenty-eight (14.7%) required hospital admission. High temperature ≥39.0 °C (101/190; 53%), vomiting (120/190; 63%) and convulsions (38/190; 20%) were common. All children presenting had received Fluvax(®) or Fluvax Junior(®). In the in vitro model, IFN-α, IL-1β, IL-6, IL-10, IP-10 and MIP-1α levels were significantly higher when measured at 6 and 24 h in cultures stimulated with Fluvax(®) compared with alternative 2010 TIV preparations.
Numerous febrile adverse events (including febrile seizures) were observed following Fluvax(®) or Fluvax Junior(®) in 2010. Clear differences in cytokine production were observed when peripheral blood mononuclear cells were stimulated with Fluvax(®) compared with alternate TIV preparations. Increased awareness of these potential adverse events is required to ensure earlier detection and prevention in the future.
2010 年，澳大利亚注意到接种三价流感疫苗（TIV）后出现发热不良事件的儿童人数增加。我们描述了不良事件的流行病学和临床特征，并使用体外模型探索了不良事件的生物学基础。
回顾性分析 2010 年在一家三级儿科医院就诊的 72 小时内发生 TIV 相关不良事件的儿童。检查了人口统计学、临床特征、生理变量和结局。对与疫苗相关的热性惊厥儿童的亚组检查了血浆细胞因子和趋化因子水平。用不同的 TIV 制剂刺激年龄匹配的儿童的外周血单核细胞。对培养上清液进行炎症细胞因子和趋化因子分析。
在 190 名儿童中发现了与疫苗相关的发热不良事件。大多数发生在健康儿童（中位数年龄：1.5 岁）接种疫苗后 12 小时内。28 名（14.7%）需要住院治疗。高热≥39.0°C（190 例中有 101 例；53%）、呕吐（190 例中有 120 例；63%）和惊厥（190 例中有 38 例；20%）很常见。所有就诊的儿童均接种了 Fluvax（®）或 Fluvax Junior（®）。在体外模型中，与其他 2010 年 TIV 制剂相比，Fluvax（®）刺激的培养物中在 6 小时和 24 小时测量时 IFN-α、IL-1β、IL-6、IL-10、IP-10 和 MIP-1α 水平明显更高。
2010 年，Fluvax（®）或 Fluvax Junior（®）接种后观察到大量发热不良事件（包括热性惊厥）。当用 Fluvax（®）刺激外周血单核细胞时，与其他 TIV 制剂相比，细胞因子的产生有明显差异。需要提高对这些潜在不良事件的认识，以便在未来更早地发现和预防。
