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一项观察者盲法、随机、多中心试验,评估 AS03 佐剂或未佐剂 H1N1/2009 流感疫苗在 10-17 岁儿童中的长期安全性和免疫原性。

An observer-blind, randomized, multi-center trial assessing long-term safety and immunogenicity of AS03-adjuvanted or unadjuvanted H1N1/2009 influenza vaccines in children 10-17 years of age.

机构信息

Tartu University Clinics Foundation, Raja 31, Tartu, Estonia.

Pediatric Department, Faculty Hospital, Trenčín University AD, Trenčín, Slovakia.

出版信息

Vaccine. 2014 Feb 19;32(9):1121-9. doi: 10.1016/j.vaccine.2013.11.031. Epub 2013 Nov 16.

Abstract

BACKGROUND

Vaccination is an effective strategy to prevent influenza. This observer-blind, randomized study in children 10-17 years of age assessed whether the hemagglutination inhibition (HI) antibody responses elicited by H1N1/2009 vaccines adjuvanted with AS03 (an adjuvant system containing α-tocopherol and squalene in an oil-in-water emulsion) or without adjuvant, met the European regulatory immunogenicity criteria at Days 21 and 182.

METHODS

Three hundred and ten healthy children were randomized (3:3:3:5) to receive one dose of 3.75 μg hemagglutinin (HA) AS03A-adjuvanted vaccine, one or two doses of 1.9 μg HA AS03B-adjuvanted vaccine, or one dose of 15 μg HA pandemic vaccine. All children received a booster dose of the allocated vaccine at Day 182. Serum samples were tested for HI antibody response at Days 21, 42, 182 and 189.

RESULTS

All vaccination regimens elicited HI antibody responses that met the European regulatory criteria at Days 21 and 42. HI antibody responses fulfilling European regulatory criteria were still observed six months after the first vaccine dose in all study vaccines groups. Two doses of 1.9 μg HA AS03B-adjuvanted vaccine elicited the strongest HI antibody response throughout the study. The non-adjuvanted 15 μg HA vaccine elicited a lower HI antibody response than the AS03-adjuvanted vaccines. At Day 189, the European regulatory criteria were met for all vaccines with baseline HI antibody titers as reference. An anamnestic response for all vaccines was suggested at Day 189, based on the rapid increase in HI antibody geometric mean titers (1.5-2.5-fold increase). Injection site reactogenicity was higher following the AS03-adjuvanted vaccines compared with the non-adjuvanted vaccine. No safety concerns were identified for any study vaccine.

CONCLUSION

All study vaccines elicited HI antibody responses that persisted at purported protective levels through six months after vaccination and fulfilled the European regulatory criteria.

摘要

背景

接种疫苗是预防流感的有效策略。本项在 10-17 岁儿童中进行的、观察者设盲、随机研究评估了含有 α-生育酚和角鲨烯的油包水乳剂佐剂系统(AS03)佐剂或无佐剂的 H1N1/2009 疫苗能否在接种后第 21 天和第 182 天产生符合欧洲监管免疫原性标准的血凝抑制(HI)抗体应答。

方法

310 名健康儿童按 3:3:3:5 的比例随机分组,分别接受 3.75 μg 血凝素(HA)AS03A 佐剂疫苗、1 或 2 剂 1.9 μg HA AS03B 佐剂疫苗或 15 μg 大流行疫苗接种。所有儿童在第 182 天接种加强剂。在第 21、42、182 和 189 天检测血清样本中的 HI 抗体应答。

结果

所有疫苗接种方案均在第 21 和 42 天产生符合欧洲监管标准的 HI 抗体应答。在所有研究疫苗组中,在首剂疫苗接种后 6 个月仍观察到符合欧洲监管标准的 HI 抗体应答。2 剂 1.9 μg HA AS03B 佐剂疫苗在整个研究期间产生的 HI 抗体应答最强。无佐剂的 15 μg HA 疫苗产生的 HI 抗体应答低于 AS03 佐剂疫苗。在第 189 天,以基线 HI 抗体滴度为参考,所有疫苗均符合欧洲监管标准。基于 HI 抗体几何平均滴度(增加 1.5-2.5 倍)的快速增加,提示所有疫苗在第 189 天出现回忆应答。与无佐剂疫苗相比,AS03 佐剂疫苗接种后的注射部位反应更常见。任何研究疫苗均未发现安全性问题。

结论

所有研究疫苗均产生 HI 抗体应答,在接种后 6 个月内持续保持假定的保护水平,并符合欧洲监管标准。

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