Lai Yi-Chun, Yang Kuen-Cheh, Hsieh Szu-Min, Yao Chien-An, Lee Long-Teng, Huang Kuo-Chin
Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Clin Vaccine Immunol. 2012 Mar;19(3):429-35. doi: 10.1128/CVI.05528-11. Epub 2012 Jan 18.
After WHO declared H1N1 pandemic, global vaccination was carried out immediately after much research. However, the data on long-term immunogenicity were lacking. We aimed to investigate the long-term immunogenicity of different H1N1 vaccine dosage groups 24 weeks after vaccination by a randomized clinical trial. A total of 218 participants were stratified into adult (≤60 years old) and elderly (>60 years old) groups. The adults were randomized in a 1:1:1 ratio. The first group received a single dose of vaccine with 15 μg hemagglutination antigen (HA). The other two groups received two doses with 15 μg or 30 μg HA triweekly. The elderly were randomized 1:1 for two doses of 15 or 30 μg HA. We evaluated serologic responses at prevaccination and weeks 3, 6, and 24. We also examined possible associated factors of immunogenicity by multivariate logistic regression analyses. At week 24, seroprotection (anti-HA antibody level ≥ 1:40) remained at 76.8% and 46.2% in the adult and elderly groups, respectively. The adult group had a higher seroprotection rate (odds ratio of 2.98, 95% confidence interval [CI]: 1.21 to 7.36) than the elderly group. There was no statistical difference in seroprotection and seroconversion rates between different adult and elderly dosage groups. Lower immunogenicity in the elderly than in the adults 24 weeks after the vaccination was observed. However, there was no statistically significant difference among different dose groups. Therefore, we suggest only a single vaccination dose of 15 μg HA for adults and two doses of 15 μg HA for the elderly in the future.
在世界卫生组织宣布甲型H1N1流感大流行后,经过大量研究,全球立即开展了疫苗接种。然而,缺乏长期免疫原性的数据。我们旨在通过一项随机临床试验,研究接种疫苗24周后不同甲型H1N1疫苗剂量组的长期免疫原性。总共218名参与者被分为成人(≤60岁)组和老年人(>60岁)组。成人按1:1:1的比例随机分组。第一组接受一剂含15μg血凝素抗原(HA)的疫苗。另外两组每三周接受两剂含15μg或30μg HA的疫苗。老年人按1:1随机接受两剂15μg或30μg HA的疫苗。我们在接种前以及第3、6和24周评估血清学反应。我们还通过多因素逻辑回归分析检查免疫原性的可能相关因素。在第24周时,成人组和老年人组的血清保护率(抗HA抗体水平≥1:40)分别保持在76.8%和46.2%。成人组的血清保护率高于老年人组(优势比为2.98,95%置信区间[CI]:1.21至7.36)。不同成人和老年人剂量组之间的血清保护率和血清转化率没有统计学差异。观察到接种疫苗24周后老年人的免疫原性低于成人。然而,不同剂量组之间没有统计学上的显著差异。因此,我们建议未来成人接种一剂15μg HA,老年人接种两剂15μg HA。