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带状疱疹疫苗与四价流感病毒疫苗联合接种的免疫原性和安全性。

Immunogenicity and safety of zoster vaccine live administered with quadrivalent influenza virus vaccine.

机构信息

University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

Merck & Co., Inc., Kenilworth, NJ, USA.

出版信息

Vaccine. 2018 Jan 2;36(1):179-185. doi: 10.1016/j.vaccine.2017.08.029. Epub 2017 Aug 19.

Abstract

OBJECTIVES

Randomized, blinded, placebo-controlled trial to evaluate the safety and immunogenicity of ZOSTAVAX™ (ZV) administered concomitantly with quadrivalent inactivated influenza vaccine (IIV4) in adults≥50years of age (NCT02519855).

METHODS

Overall, 440 participants were randomized into the Concomitant Group (CG) and 442 into the Sequential Group (SG). The CG received ZV and IIV4 at separate injection sites on Day 1 and matching placebo at Week 4. The SG received placebo and IIV4 (2015-2016 influenza season) at separate injection sites on Day 1 and ZV at Week 4.

IMMUNOGENICITY ENDPOINTS

Varicella-zoster virus (VZV) antibody geometric mean titer (GMT) and geometric mean fold-rise (GMFR) from baseline to 4weeks postvaccination, measured by glycoprotein enzyme-linked immunosorbent assay (gpELISA) and adjusted for age and prevaccination titer. Influenza strain-specific GMT at baseline and 4weeks postvaccination was measured by hemagglutination inhibition (HAI) assay.

SAFETY ENDPOINTS

Injection-site and systemic adverse experiences (AEs) within 28days following any vaccination and serious AEs throughout the study.

RESULTS

The adjusted VZV antibody GMT ratio (CG/SG) was 0.87 (95%CI: 0.80, 0.95), meeting the prespecified noninferiority criterion. The VZV antibody GMFR in the CG was 1.9 (95%CI: 1.76, 2.05), meeting the acceptability criterion. Influenza antibody GMT ratios for A/H1N1, A/H3N2, B/Yamagata and B/Victoria were 1.02 (95%CI: 0.88, 1.18), 1.10 (95%CI: 0.94, 1.29), 1.00 (95%CI: 0.88, 1.14), and 0.99 (95%CI: 0.87, 1.13), respectively. The frequency of vaccine-related injection-site and systemic AEs was comparable between groups. No vaccine-related serious AE was observed.

CONCLUSION

The concomitant administration of ZV and IIV4 to adults≥50years of age induced VZV-specific and influenza-specific antibody responses that were comparable to those following administration of either vaccine alone, and was generally well tolerated.

摘要

目的

评价带状疱疹疫苗(ZV)与四价灭活流感疫苗(IIV4)同时接种在 50 岁及以上成人中的安全性和免疫原性的随机、双盲、安慰剂对照试验(NCT02519855)。

方法

总体上,440 名参与者被随机分配到联合组(CG)和 442 名到序贯组(SG)。CG 在第 1 天在不同的注射部位接种 ZV 和 IIV4,并在第 4 周接种匹配的安慰剂。SG 在第 1 天在不同的注射部位接种安慰剂和 IIV4(2015-2016 流感季节),并在第 4 周接种 ZV。

免疫原性终点

接种后 4 周时,通过糖蛋白酶联免疫吸附试验(gpELISA)测量水痘带状疱疹病毒(VZV)抗体几何平均滴度(GMT)和几何平均倍数升高(GMFR),并根据年龄和接种前滴度进行调整。接种前和接种后 4 周时通过血凝抑制(HAI)试验测量流感株特异性 GMT。

安全性终点

接种任何疫苗后 28 天内的注射部位和全身不良事件(AE)以及整个研究期间的严重 AE。

结果

调整后的 VZV 抗体 GMT 比值(CG/SG)为 0.87(95%CI:0.80,0.95),符合预设的非劣效性标准。CG 中的 VZV 抗体 GMFR 为 1.9(95%CI:1.76,2.05),符合可接受性标准。A/H1N1、A/H3N2、B/Yamagata 和 B/Victoria 的流感抗体 GMT 比值分别为 1.02(95%CI:0.88,1.18)、1.10(95%CI:0.94,1.29)、1.00(95%CI:0.88,1.14)和 0.99(95%CI:0.87,1.13)。两组之间疫苗相关的注射部位和全身 AE 的频率相当。未观察到与疫苗相关的严重 AE。

结论

50 岁及以上成人同时接种 ZV 和 IIV4 可诱导 VZV 特异性和流感特异性抗体应答,与单独接种任一疫苗相当,且通常具有良好的耐受性。

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