Internistische Gemeinschaftspraxis, Sülmerstraße 32, D74072, Heilbronn, Germany.
Vaccine. 2013 Mar 1;31(11):1496-502. doi: 10.1016/j.vaccine.2012.12.081. Epub 2013 Jan 10.
Annual influenza vaccination provides an opportunity to administer a booster dose of diphtheria, tetanus, acellular pertussis and inactivated poliomyelitis vaccine (Tdap-IPV) to the elderly. This study evaluated immune responses to and safety of the two vaccines administered concomitantly or sequentially to elderly individuals in France and Germany.
Individuals aged ≥60 years who had received a diphtheria/tetanus booster within 5-15 years were randomised (1:1) to receive either Tdap-IPV and an inactivated influenza vaccine concomitantly (Group 1) or inactivated influenza vaccine then Tdap-IPV 28-35 days later (Group 2). Antibody titres were measured before and 28-35 days after each vaccination.
The mean age of randomised individuals (n=954) was 68.8 years. Post-vaccination seroprotection rates (≥0.1 IU/mL for diphtheria/tetanus and ≥8 1/dilution for polio) for Group 1 were non-inferior to Group 2 for diphtheria (85.4% vs. 87.5%), tetanus (both 100%), polio type 1 (99.8% vs. 100%), polio type 2 (both 100%) and polio type 3 (99.3% vs. 99.8%). Similarly, percentages of individuals with pertussis antibodies ≥5 EU/mL for Group 1 were non-inferior to Group 2: pertussis toxin (94.3% vs. 98.1%), filamentous haemagglutinin (99.8% vs. 100%), pertactin (97.3% vs. 96.0%), fimbriae 2 and 3 (91.7% vs. 89.5%). Post-vaccination geometric mean titres of anti-influenza haemagglutinin antibodies for Group 1 were non-inferior to Group 2. Adverse events following administration of Tdap-IPV were similar in both study groups, with no vaccine-related serious adverse events.
Tdap-IPV and inactivated influenza vaccine can be administered concomitantly in the elderly without impairing tolerability or the immune response to either vaccine.
每年接种流感疫苗为老年人提供了接种白喉、破伤风、无细胞百日咳和灭活脊髓灰质炎疫苗（Tdap-IPV）加强针的机会。本研究评估了在法国和德国，同时或序贯接种这两种疫苗对老年人的免疫反应和安全性。
年龄≥60 岁且在 5-15 年内接受过白喉/破伤风加强针的个体按 1:1 随机（随机分组）接受 Tdap-IPV 和灭活流感疫苗同时接种（第 1 组）或先接种灭活流感疫苗，28-35 天后再接种 Tdap-IPV（第 2 组）。在每次接种前后测量抗体滴度。
随机分组的个体（n=954）的平均年龄为 68.8 岁。第 1 组的疫苗接种后血清保护率（白喉/破伤风≥0.1 IU/mL 和脊髓灰质炎≥8 1/稀释度）不劣于第 2 组：白喉（85.4% vs. 87.5%）、破伤风（均为 100%）、脊髓灰质炎 1 型（99.8% vs. 100%）、脊髓灰质炎 2 型（均为 100%）和脊髓灰质炎 3 型（99.3% vs. 99.8%）。同样，第 1 组的百日咳抗体≥5 EU/mL 的个体百分比不劣于第 2 组：百日咳毒素（94.3% vs. 98.1%）、丝状血凝素（99.8% vs. 100%）、 pertactin（97.3% vs. 96.0%）、fimbriae 2 和 3（91.7% vs. 89.5%）。第 1 组接种 Tdap-IPV 后的抗流感血凝素抗体几何平均滴度不劣于第 2 组。两组研究中 Tdap-IPV 接种后的不良事件相似，均无与疫苗相关的严重不良事件。
Tdap-IPV 和灭活流感疫苗可同时用于老年人，不会影响耐受性或对任何一种疫苗的免疫反应。
