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两剂无佐剂甲型H1N1/2009流感疫苗在年轻自身免疫性风湿病患者中的免疫原性和安全性

Immunogenicity and safety of two doses of a non-adjuvanted influenza A H1N1/2009 vaccine in young autoimmune rheumatic diseases patients.

作者信息

Aikawa N E, Trudes G, Campos L M A, Pereira R M R, Moraes J C B, Ribeiro A C, Miraglia J, Timenetsky M do Carmo S, Bonfa E, Silva Ca

机构信息

1Pediatric Rheumatology Unit.

出版信息

Lupus. 2013 Nov;22(13):1394-8. doi: 10.1177/0961203313505926. Epub 2013 Sep 27.

DOI:10.1177/0961203313505926
PMID:24076765
Abstract

OBJECTIVES

The aim of this study was to evaluate the immunogenicity and safety of the influenza A H1N1/2009 vaccine in children under 9 years old with autoimmune rheumatic diseases (ARD).

METHODS

Thirty-eight ARD patients and 11 healthy children received two doses of non-adjuvanted influenza A/California/7/2009 (H1N1) virus-like vaccine. Subjects were evaluated before and 21 days after vaccination. Seroprotection (SP) and seroconversion (SC) rates, geometric mean titers (GMT) and factor increases (FI) in GMT were calculated.

RESULTS

Mean ages were comparable between patients and controls. Pre-vaccination SP and GMT were similar in patients and controls (p > 0.05). Three weeks after immunization, SP (81.6% vs. 81.8%, p = 1.0), SC (81.6% vs. 90.9%, p = 0.66), GMT (151.5 vs. 282.1, p = 0.26) and the FI in GMT (16.7 vs. 36.3, p = 0.23) were similar in patients and controls, with both groups achieving an adequate response, according to the European Medicines Agency and Food and Drug Administration standards. Analysis of the possible factors influencing SC showed no difference in demographic data, leukocyte/lymphocyte counts or immunosuppressant use between seroconverted and non-seroconverted patients (p > 0.05). The vaccine demonstrated a satisfactory safety profile in this population.

CONCLUSIONS

Two doses of influenza A H1N1/2009 vaccination induced an effective antibody response and caused adverse events in rare instances, suggesting this vaccine is appropriate and can be recommended for this age group.

摘要

目的

本研究旨在评估甲型H1N1/2009流感疫苗在9岁以下自身免疫性风湿性疾病(ARD)儿童中的免疫原性和安全性。

方法

38例ARD患者和11名健康儿童接种了两剂无佐剂的甲型/加利福尼亚/7/2009(H1N1)病毒样疫苗。在接种疫苗前和接种后21天对受试者进行评估。计算血清保护(SP)率、血清转化(SC)率、几何平均滴度(GMT)和GMT的倍数增长(FI)。

结果

患者和对照组的平均年龄相当。接种疫苗前患者和对照组的SP和GMT相似(p>0.05)。免疫接种三周后,患者和对照组的SP(81.6%对81.8%,p=1.0)、SC(81.6%对90.9%,p=0.66)、GMT(151.5对282.1,p=0.26)和GMT的FI(16.7对36.3,p=0.23)相似,根据欧洲药品管理局和美国食品药品监督管理局的标准,两组均获得了充分的反应。对影响SC的可能因素进行分析,血清转化和未血清转化的患者在人口统计学数据、白细胞/淋巴细胞计数或免疫抑制剂使用方面无差异(p>0.05)。该疫苗在这一人群中显示出令人满意的安全性。

结论

两剂甲型H1N1/2009流感疫苗接种可诱导有效的抗体反应,且罕见不良事件发生,表明该疫苗适用于该年龄组,可予以推荐。

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