Camacho-Lovillo M S, Bulnes-Ramos A, Goycochea-Valdivia W, Fernández-Silveira L, Núñez-Cuadros E, Neth O, Pérez-Romero P
Unidad de Enfermedades Infecciosas e Inmunopatologías Pediátrica, Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain.
Instituto de Biomedicina de Sevilla (IBIS), University Hospital Virgen del Rocío/CSIC/University of Sevilla, Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Sevilla, Spain.
Pediatr Rheumatol Online J. 2017 Aug 7;15(1):62. doi: 10.1186/s12969-017-0190-0.
Seasonal influenza virus vaccination should be considered in all pediatric patients with rheumatic diseases. Few studies have addressed influenza vaccination safety and efficacy in this group. We aim to prospectively evaluate immunogenicity and safety of the trivalent inactivated influenza vaccine including A/H1N1, A/H3N2 and B strains in children with juvenile idiopathic arthritis (JIA) receiving biological therapy.
Thirty-five children diagnosed with JIA and 6 healthy siblings were included. Serum samples were collected prior to, 4-8 weeks and one year after vaccination. Microneutralization assays were used to determine neutralizing antibody titers. The type and duration of therapy were analyzed to determine its effect on vaccine response. Clinical data of the participants were collected throughout the study including severe adverse events (SAE) and adverse events following immunization (AEFI).
Twenty-five patients (74.3%) received biological treatment for JIA; anti TNF-α was prescribed in 15, anti IL-1 receptor in 4 and anti IL-6 receptor therapy in 6 children. The seroprotection rate 4-8 weeks after vaccination in the JIA group was 96% for influenza A/(H1N1)pdm and influenza A/H3N2, and 88% for influenza B. No differences were found in GMT, seroprotection and seroconversion rates for the three influenza strains between the control group and patients receiving biological therapy. Furthermore, long-term seroprotection at 12 months after vaccination was similar in patients receiving either biological or non-biological treatments. No SAEs were observed.
In this study, influenza vaccination was safe and immunogenic in children with JIA receiving biological therapy.
所有患有风湿性疾病的儿科患者均应考虑接种季节性流感病毒疫苗。很少有研究涉及该群体流感疫苗接种的安全性和有效性。我们旨在前瞻性评估三价灭活流感疫苗（包括甲型H1N1、甲型H3N2和乙型毒株）在接受生物治疗的幼年特发性关节炎（JIA）儿童中的免疫原性和安全性。
纳入35例诊断为JIA的儿童和6名健康同胞。在接种疫苗前、接种后4 - 8周和1年后采集血清样本。采用微量中和试验测定中和抗体滴度。分析治疗类型和持续时间以确定其对疫苗反应的影响。在整个研究过程中收集参与者的临床数据，包括严重不良事件（SAE）和免疫接种后不良事件（AEFI）。
25例患者（74.3%）接受了JIA生物治疗；15例使用抗TNF-α，4例使用抗IL-1受体，6例儿童使用抗IL-6受体治疗。JIA组接种疫苗后4 - 8周，甲型H1N1pdm流感和甲型H3N2流感的血清保护率为96%，乙型流感为88%。对照组与接受生物治疗患者之间，三种流感毒株的几何平均滴度（GMT）、血清保护率和血清转化率无差异。此外，接种疫苗12个月后的长期血清保护在接受生物治疗或非生物治疗的患者中相似。未观察到严重不良事件。
在本研究中，流感疫苗接种在接受生物治疗的JIA儿童中是安全且具有免疫原性的。
