Alfelali Mohammad, Khandaker Gulam, Booy Robert, Rashid Harunor
a National Center for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead and the University of Sydney ; Sydney , NSW , Australia.
b Department of Family and Community Medicine ; Faculty of Medicine in Rabigh, King Abdulaziz University ; Jeddah , Saudi Arabia.
Hum Vaccin Immunother. 2016 Mar 3;12(3):709-15. doi: 10.1080/21645515.2015.1085144.
The trivalent seasonal influenza vaccine is expected to provide optimum protection if the vaccine strains match the circulating strains. The effect of worldwide mismatch between the vaccine strains and extant strains on travelers attending Hajj pilgrimage is not known. Annually 2-3 million Muslims coming from north and south hemispheres congregate at Hajj in Mecca, Saudi Arabia, where intense congestion amplifies the risk of respiratory infection up to eight fold. In order to estimate, to what extent mismatching increases the risk of vaccine failure in Hajj pilgrims, we have examined the global data on influenza epidemiology since 2003, in light of the available data from Hajj. These data demonstrate that globally mismatching between circulating and vaccine strains has occurred frequently over the last 12 years, and the mismatch seems to have affected the Hajj pilgrims, however, influenza virus characteristics were studied only in a limited number of Hajj seasons. When the vaccines are different, dual vaccination of travelers by vaccines for southern and northern hemispheres should be considered for Hajj pilgrims whenever logistically feasible. Consideration should also be given to the use of vaccines with broader coverage, i.e., quadrivalent, or higher immunogenicity. Continuous surveillance of influenza at Hajj is important.
如果疫苗毒株与流行毒株匹配，三价季节性流感疫苗有望提供最佳保护。目前尚不清楚疫苗毒株与现存毒株在全球范围内不匹配对参加朝觐的旅行者会产生何种影响。每年有200万至300万来自北半球和南半球的穆斯林聚集在沙特阿拉伯麦加进行朝觐，那里的高度拥挤使呼吸道感染风险增加至八倍。为了评估不匹配在多大程度上会增加朝觐者疫苗接种失败的风险，我们根据朝觐的现有数据，研究了自2003年以来全球流感流行病学数据。这些数据表明，在过去12年中，全球范围内流行毒株与疫苗毒株之间经常出现不匹配情况，而且这种不匹配似乎对朝觐者产生了影响，不过，仅在少数朝觐季节对流感病毒特征进行了研究。当疫苗不同时，只要在后勤上可行，对于朝觐者，应考虑为旅行者接种南半球和北半球的疫苗进行双重接种。还应考虑使用覆盖范围更广的疫苗，即四价疫苗，或免疫原性更高的疫苗。对朝觐期间的流感进行持续监测很重要。
