Karolinska Institutet, Department of Medicine, Unit of Infectious Diseases, Karolinska Solna, Sweden.
Vaccine. 2012 Aug 24;30(39):5699-702. doi: 10.1016/j.vaccine.2012.07.009. Epub 2012 Jul 20.
We studied the effectiveness of the AS03-adjuvanted monovalent vaccine (Pandemrix(®)) for the prevention of severe pandemic influenza A(H1N1)pdm09 in children, in 2009. All children hospitalized for influenza-like illness in Stockholm County during the peak of the pandemic were included. We compared the frequency of vaccinated children between influenza A(H1N1)pdm09 PCR positive cases and PCR negative controls in a retrospective case-control study. 95 cases and 177 controls were identified. About half of the children in both groups were between 6 months and 2 years of age. Only 1/95 (1%) cases had been vaccinated more than 14 days prior to admission, compared to 23/177 controls (13%), corresponding to a vaccine effectiveness, adjusted for co-morbid conditions, of 91% (95% confidence interval [CI] 30-99). In contrast, the risk for being a case was significantly higher among children vaccinated between 1 and 14 days prior to hospitalization, than among those who were non-vaccinated 13/95 vs. 7/177 (OR 3.6, 95% CI 1.4-9.5). We conclude that a single dose of adjuvanted vaccine was highly protective against hospitalization for influenza A(H1N1)pdm09 in children 6 month to 17 years. The reason for the increased rate of hospitalizations with confirmed influenza in children just following immunization is unclear and should be studied further.
我们研究了 2009 年 AS03 佐剂单价疫苗（Pandemrix(®)）对儿童预防严重大流行性流感 A(H1N1)pdm09 的效果。所有在流感大流行高峰期因流感样疾病住院的斯德哥尔摩县儿童均纳入本研究。我们在一项回顾性病例对照研究中比较了 PCR 阳性流感 A(H1N1)pdm09 病例组和 PCR 阴性对照组中接种疫苗儿童的频率。确定了 95 例病例和 177 例对照。两组中约一半的儿童年龄在 6 个月至 2 岁之间。仅 1/95（1%）例病例在入院前 14 天以上接种过疫苗，而 23/177 例对照（13%），经合并症调整后的疫苗有效性为 91%（95%置信区间 [CI] 30-99）。相比之下，在入院前 1-14 天接种疫苗的儿童患病例的风险明显高于未接种疫苗的儿童，13/95 例 vs. 7/177 例（OR 3.6，95%CI 1.4-9.5）。我们的结论是，6 个月至 17 岁儿童接种一剂佐剂疫苗对预防 A(H1N1)pdm09 型流感住院具有高度保护作用。接种疫苗后儿童因确诊流感而住院率增加的原因尚不清楚，应进一步研究。
