Adis, Auckland, New Zealand.
Drugs. 2012 Jul 30;72(11):1543-57. doi: 10.2165/11209650-000000000-00000.
The influenza A subtype H5N1 virus is a likely causative agent for the next human influenza pandemic. Pandemic influenza vaccine production can begin only after a novel pandemic virus emerges. Cell-based vaccine production has advantages over conventional egg-based methods, allowing more rapid large-scale vaccine production. A reliable Vero cell culture system is available for pandemic and prepandemic influenza vaccine production. Prepandemic influenza vaccines are an important component of influenza pandemic preparedness plans, as their targeted use in the pandemic alert period or early in a pandemic is likely to mitigate the consequences of an influenza outbreak. Vepacel® is a prepandemic influenza vaccine (whole virion, Vero cell-derived, inactivated) containing antigen of H5N1 strain A/Vietnam/1203/2004 and is approved for use in the EU. Clinical immunogenicity studies with the vaccine have demonstrated good rates of functional neutralizing antibody responses against the vaccine strain (A/Vietnam/1203/2004), meeting established immunogenicity criteria for seasonal influenza vaccines, and cross-reactivity against H5N1 strains from other clades. In phase I/II and III studies, a heterologous (A/Indonesia/05/2005) booster vaccine administered to healthy adult and elderly volunteers 6-24 months after the two-dose priming vaccine (A/Vietnam/1203/2004) regimen induced good immunogenic responses against both H5N1 strains, demonstrating strong immunological memory. Broadly similar, albeit less robust, responses were observed in two special risk cohorts of immunocompromised and chronically ill patients. In general, adverse events observed in clinical immunogenicity studies with H5N1 vaccine (A/Vietnam/1203/2004) were similar to those reported with non-adjuvanted, inactivated, seasonal influenza vaccines.
甲型 H5N1 亚型流感病毒可能是下一次人类流感大流行的病原体。只有在出现新型大流行病毒后,才能开始生产大流行流感疫苗。基于细胞的疫苗生产相对于传统的基于鸡蛋的方法具有优势,能够更快速地大规模生产疫苗。一种可靠的 Vero 细胞培养系统可用于大流行和大流行前流感疫苗的生产。大流行前流感疫苗是流感大流行防范计划的重要组成部分,因为在大流行警戒期或大流行早期有针对性地使用它们可能会减轻流感爆发的后果。Vepacel®是一种大流行前流感疫苗(全病毒,Vero 细胞衍生,灭活),包含 H5N1 株 A/Vietnam/1203/2004 的抗原,已在欧盟获得批准使用。该疫苗的临床免疫原性研究表明,针对疫苗株(A/Vietnam/1203/2004)的功能性中和抗体反应率良好,符合季节性流感疫苗的既定免疫原性标准,并且对来自其他谱系的 H5N1 株具有交叉反应性。在 I/II 期和 III 期研究中,在两剂基础疫苗(A/Vietnam/1203/2004)方案 6-24 个月后,向健康成年和老年志愿者接种异源(A/Indonesia/05/2005)加强疫苗,可诱导针对两种 H5N1 株的良好免疫应答,证明具有强大的免疫记忆。在免疫功能低下和慢性病患者这两个特殊风险队列中,观察到的反应大致相似,尽管不如前者强烈。一般来说,在 Vepacel®(A/Vietnam/1203/2004)的临床免疫原性研究中观察到的不良事件与非佐剂、灭活、季节性流感疫苗报告的不良事件相似。