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大流行 H1N1 疫苗对儿童流感相关住院的有效性。

Effectiveness of pandemic H1N1 vaccine against influenza-related hospitalization in children.

机构信息

Institut National de Santé Publique du Québec, Quebec City, Quebec, Canada.

出版信息

Pediatrics. 2011 Nov;128(5):e1084-91. doi: 10.1542/peds.2010-3492. Epub 2011 Oct 10.

Abstract

OBJECTIVE

Young children are generally considered immunologically naive with respect to influenza exposure opportunities; thus, a 2-dose schedule is recommended when a child is first immunized with conventional influenza vaccine lacking adjuvant. We estimated the effectiveness of a single pediatric dose of AS03-adjuvanted vaccine against hospitalization for confirmed pandemic influenza A/H1N1 (pH1N1) infection in children aged 6 months to 9 years during the fall 2009 vaccination campaign.

METHODS

In a matched case-control design, case subjects were children hospitalized for pH1N1 infection in the Fall of 2009, in Quebec, Canada. Controls were nonhospitalized children, matched by age and region of residence. Vaccination status in case subjects and controls was ascertained in relation to the case subject's date of illness onset. Vaccine effectiveness was estimated through conditional logistic regression.

RESULTS

The overall effectiveness of a single pediatric dose of vaccine administered ≥14 days before illness onset was 85% (95% confidence interval [CI]: 61% to 94%), varying according to age category but with wide and overlapping CIs: 92% (95% CI: 51% to 99%) in 6-23 month-old children, 89% (95% CI: 34% to 98%) in 2-4 year-olds, and 79% (95% CI: -31% to 96%) in 5-9 year-olds. Overall vaccine effectiveness for immunization ≥10 days before illness onset was slightly lower at 80% (95% CI: 60% to 90%), with similar variation according to age.

CONCLUSION

In children aged 6 months to 9 years, a single pediatric dose of the AS03-adjuvanted pH1N1 vaccine was highly protective against hospitalization beginning at 10 and 14 days after vaccination.

摘要

目的

年幼的儿童通常被认为在接触流感的机会方面具有免疫原性幼稚;因此,当儿童首次接种无佐剂的常规流感疫苗时,建议使用 2 剂方案。我们估计了在 2009 年秋季疫苗接种运动期间,6 个月至 9 岁儿童接种 AS03 佐剂疫苗对确诊的大流行性流感 A/H1N1(pH1N1)感染住院的效果。

方法

在匹配的病例对照设计中,病例组为 2009 年秋季在加拿大魁北克省因 pH1N1 感染住院的儿童。对照组为未住院的儿童,按年龄和居住地相匹配。病例组和对照组的疫苗接种情况是根据病例组发病日期确定的。通过条件逻辑回归估计疫苗的有效性。

结果

在发病前 14 天以上接种一剂小儿疫苗的总体有效性为 85%(95%置信区间:61%至 94%),按年龄类别有所不同,但置信区间较宽且重叠:6-23 个月龄儿童为 92%(95%置信区间:51%至 99%),2-4 岁儿童为 89%(95%置信区间:34%至 98%),5-9 岁儿童为 79%(95%置信区间:-31%至 96%)。在发病前 10 天以上进行免疫接种的总体疫苗有效性略低,为 80%(95%置信区间:60%至 90%),且按年龄变化相似。

结论

在 6 个月至 9 岁的儿童中,一剂 AS03 佐剂 pH1N1 疫苗对发病后 10 天和 14 天开始的住院治疗具有高度保护作用。

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