Division of Infectious Diseases, Memorial Sloan Kettering Cancer Cente, New York, New York 10065, USA.
Curr Opin Infect Dis. 2013 Aug;26(4):366-77. doi: 10.1097/QCO.0b013e3283630ee5.
Healthcare personnel (HCP) are at risk for exposure to and transmission of potentially life-threatening vaccine preventable diseases to patients and colleagues. The Centers for Disease Control and Advisory Committee on Immunization Practices (ACIP) recommend routine influenza immunization and maintenance of immunity to hepatitis B and pertussis, among others. In this article, we aim to review recently approved influenza vaccines, as well as address some of the issues regarding hepatitis B and pertussis vaccinations in HCP.
Several new formulations of influenza vaccines are now available, including quadrivalent vaccines and non-egg-based vaccines; their use in HCP requires further study. An alarming rise in pertussis rates has led to a revision of ACIP guidelines recommending vaccination for women during each pregnancy. Persistent lack of immunity to hepatitis B after vaccine series remains a problem for many HCP.
Inactivated trivalent influenza vaccines remain the safest and most widely studied influenza vaccinations for healthcare workers. A pertussis booster in the form of Tdap is now recommended for most HCP. More studies are needed regarding the issue of nonresponders in HCP who receive the three-dose hepatitis B vaccine series, as there are some promising strategies available that may boost immune responses.
医护人员(HCP)面临着将潜在危及生命的疫苗可预防疾病暴露给患者和同事的风险。疾病控制和预防中心及免疫实践咨询委员会(ACIP)建议对流感进行常规免疫接种,并保持对乙型肝炎和百日咳等疾病的免疫力。本文旨在综述最近批准的流感疫苗,并探讨 HCP 乙型肝炎和百日咳疫苗接种的一些问题。
目前有几种新的流感疫苗配方,包括四价疫苗和非卵基疫苗;它们在 HCP 中的应用需要进一步研究。百日咳发病率的惊人上升导致 ACIP 指南修订,建议在每次妊娠期间为妇女接种疫苗。许多 HCP 仍存在乙型肝炎疫苗系列接种后持续缺乏免疫力的问题。
灭活三价流感疫苗仍然是最安全和研究最广泛的医护人员流感疫苗。现在建议大多数 HCP 接种 Tdap 作为百日咳加强针。对于接受三剂乙型肝炎疫苗系列接种的 HCP 中无应答者的问题,需要进行更多的研究,因为有一些有前途的策略可能会增强免疫反应。