Macias Alejandro E, Precioso Alexander R, Falsey Ann R
Department of Medicine, University of Guanajuato, Leon, Mexico.
Division of Clinical Trials and Pharmacovigilance, Instituto Butantan, São Paulo, Brazil.
Influenza Other Respir Viruses. 2015 Aug;9 Suppl 1(Suppl 1):31-7. doi: 10.1111/irv.12320.
There is a heavy disease burden due to seasonal influenza in pregnant women, their fetuses, and their newborns. The main aim of this study was to review and analyze current evidence on safety, immunogenicity, and clinical benefits of the inactivated influenza vaccine (IIV) in pregnant women. Current evidence shows that in pregnant women, the seasonal and pandemic IIVs are safe and well tolerated. After vaccination, pregnant women have protective concentrations of anti-influenza antibodies, conferring immunogenicity in newborns. The best evidence, to date, suggests that influenza vaccination confers clinical benefits in both pregnant women and their newborns. Vaccination with either the seasonal or pandemic vaccine has been shown to be cost-effective in pregnancy. There are scarce data from randomized clinical trials; fortunately, new phase 3 clinical trials are under way. In the Northern and Southern Hemispheres, data suggest that the greatest clinical benefit for infants occurs if the IIV is administered within the first weeks of availability of the vaccine, at the beginning of the influenza season, regardless of the pregnancy trimester. The optimal timing to vaccinate pregnant women who live in tropical regions is unclear. Based on evaluation of the evidence, the Global Influenza Initiative (GII) recommends that to prevent seasonal influenza morbidity and mortality in infants and their mothers, all pregnant women, regardless of trimester, should be vaccinated with the IIV. For countries where vaccination against influenza is starting or expanding, the GII recommends that pregnant women have the highest priority.
孕妇、胎儿及新生儿因季节性流感承受着沉重的疾病负担。本研究的主要目的是回顾和分析目前关于孕妇接种灭活流感疫苗（IIV）的安全性、免疫原性及临床益处的证据。现有证据表明，对于孕妇而言，季节性流感疫苗和大流行性流感疫苗都是安全且耐受性良好的。接种疫苗后，孕妇体内会产生具有保护性浓度的抗流感抗体，从而使新生儿具有免疫原性。迄今为止，最佳证据表明流感疫苗接种对孕妇及其新生儿均有临床益处。接种季节性流感疫苗或大流行性流感疫苗在孕期已被证明具有成本效益。随机临床试验的数据较少；幸运的是，新的3期临床试验正在进行中。在北半球和南半球，数据表明，如果在流感季节开始时，疫苗上市后的头几周内接种IIV，对婴儿的临床益处最大，无论处于孕期的哪个阶段。居住在热带地区的孕妇的最佳接种时机尚不清楚。基于对证据的评估，全球流感行动计划（GII）建议，为预防婴儿及其母亲的季节性流感发病和死亡，所有孕妇，无论处于孕期的哪个阶段，均应接种IIV。对于刚开始或正在扩大流感疫苗接种的国家，GII建议孕妇具有最高优先级。
