Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Vaccine. 2011 Oct 19;29(45):7975-81. doi: 10.1016/j.vaccine.2011.08.068. Epub 2011 Aug 30.
Excellent immune responses following 1 or 2 doses of the monovalent inactivated pandemic H1N1 vaccines have been documented, but the effectiveness of these vaccines against laboratory-confirmed H1N1 infections in the general population is not clear. We evaluated the effectiveness of the pandemic H1N1 and seasonal trivalent influenza vaccines (TIV) used during the 2009 mass vaccination campaign in Manitoba (Canada) in preventing laboratory-confirmed H1N1 infections.
A population-based case-control study using data from Cadham Provincial Laboratory (CPL) and the Manitoba Immunization Monitoring System (MIMS). All Manitoba residents ≥6 months of age who had a respiratory specimen tested at CPL for H1N1 were included in the study. Cases were individuals who tested positive for pandemic H1N1 influenza A by reverse transcriptase-PCR (N=1435). Controls were individuals who tested negative for both influenza A and B (N=2309). Information on receipt of TIV or H1N1 vaccine was obtained by record linkage with MIMS, the population-based province-wide immunization registry.
Overall, the adjuvanted H1N1 vaccine was 86% (95%CI 75-93%) effective in preventing laboratory-confirmed H1N1 infections when vaccination occurred ≥14 days before testing. Effectiveness seemed lower among older (≥50 years) individuals [51% (-51 to 84%)] and among those with immunocompromising conditions [67% (-13 to 90%)]. There was also evidence that the H1N1 vaccine might be less effective among those who had received the 2009/10 TIV.
The adjuvanted H1N1 vaccine used during Manitoba's H1N1 mass vaccination campaign was highly effective against laboratory-confirmed pandemic H1N1 infection, especially among children and younger adults.
有研究证明，接种一剂或两剂单价季节性流感疫苗（TIV）后可产生良好的免疫应答，但人群中接种这些疫苗对确诊甲型 H1N1 流感的效果尚不清楚。我们评估了 2009 年曼尼托巴省（加拿大）大规模疫苗接种运动期间使用的甲型 H1N1 大流行疫苗和 TIV 预防实验室确诊甲型 H1N1 感染的效果。
采用基于人群的病例对照研究，数据来自 Cadham 省级实验室（CPL）和曼尼托巴免疫监测系统（MIMS）。所有在 CPL 进行甲型 H1N1 呼吸道标本检测的曼尼托巴省≥6 月龄居民均纳入研究。病例为经逆转录-聚合酶链反应（RT-PCR）检测甲型 H1N1 流感病毒阳性的个体（N=1435）。对照为甲型和乙型流感病毒检测均为阴性的个体（N=2309）。通过与 MIMS 的记录链接获得 TIV 或 H1N1 疫苗接种信息，MIMS 是基于人群的全省免疫登记系统。
总体而言，当接种疫苗距检测时间≥14 天时，含佐剂的 H1N1 疫苗预防实验室确诊甲型 H1N1 感染的效果为 86%（95%CI 75-93%）。在年龄较大（≥50 岁）人群[51%（-51 至 84%）]和免疫功能低下人群[67%（-13 至 90%）]中，效果似乎较低。也有证据表明，在接种过 2009/10 年 TIV 的人群中，H1N1 疫苗的效果可能较低。
曼尼托巴省 H1N1 大规模疫苗接种运动中使用的含佐剂 H1N1 疫苗对实验室确诊的甲型 H1N1 感染高度有效，尤其是在儿童和年轻成年人中。
