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比较 7 价肺炎球菌结合疫苗在儿童中的效果与 13 价疫苗在成人中的效果。

Compared effectiveness of the 7-valent pneumococcal conjugate vaccine in children with the 13-valent vaccine in adults.

机构信息

Service des maladies infectieuses, infectiologie, centre hospitalier de la région d'Annecy, 1, avenue de l'Hôpital-Metz-Tessy, BP 90074, 74374 Pringy cedex, France.

出版信息

Med Mal Infect. 2013 Jun;43(6):215-21. doi: 10.1016/j.medmal.2013.04.005. Epub 2013 Jun 13.

Abstract

13-valent-pneumococcal conjugated vaccine was recently approved in the USA and Europe for adults 50 years of age or more. But this approval was followed by recommendations limiting its use to immunocompromised and asplenic patients. The extension of indications to adults was based on the well-demonstrated clinical effectiveness in infants less than 2 years of age, and on a better immune response either quantitatively or qualitatively with conjugated vaccines compared to the immunogenicity of plain polysaccharide vaccines. Nevertheless, the issue was to know whether results observed with the 7-valent pneumococcal conjugate vaccine in children are reproducible in adults with the 13-valent. The answer was given by comparing the epidemiological and physiopathological data, and the immunological response of the two populations. Very few clinical effectiveness studies in adults are available. We had for aim to assess these various issues in infants and adults. A lot of questions remain, such as the unknown impact of serotype replacement with the 13-valent pneumococcal conjugated vaccine on the clinical epidemiology and emergent Streptococcus pneumoniae pathogenicity, while waiting for the CAPITA study results expected in 2014.

摘要

13 价肺炎球菌结合疫苗最近在美国和欧洲获得批准,可用于 50 岁或以上的成年人。但这一批准后紧接着的是建议将其使用限制在免疫功能低下和无脾患者中。将适应证扩展到成年人是基于在 2 岁以下婴儿中已充分证明的临床疗效,以及与多糖疫苗的免疫原性相比,结合疫苗在数量或质量上具有更好的免疫反应。然而,问题是要知道在儿童中观察到的 7 价肺炎球菌结合疫苗的结果是否可以在成人中复制。通过比较两种人群的流行病学和生理病理学数据以及免疫反应,给出了答案。只有很少的关于成年人的临床有效性研究。我们的目的是评估婴儿和成年人的这些不同问题。仍有许多问题悬而未决,例如,在等待预计于 2014 年公布的 CAPITA 研究结果的同时,13 价肺炎球菌结合疫苗的血清型替代对临床流行病学和新兴肺炎链球菌致病性的未知影响。

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