a Department of Leprosy , Wuhan Institute of Dermatology and Venereology , Wuhan , China.
b Department of Immunization , Jianghan Center for Disease Prevention and Control , Wuhan , China.
Hum Vaccin Immunother. 2018 Mar 4;14(3):671-677. doi: 10.1080/21645515.2017.1390638. Epub 2017 Dec 14.
Leprosy is an infectious disease caused by the bacterium Mycobacterium leprae. Influenza vaccine is an important influenza prevention strategy and the preparations used display good safety and tolerability profiles. But the safety of applying influenza vaccine on the clinical cured leprosy patients is unclear.
We conducted an observational clinical study, in Wuhan between November 15, 2016 and March 1, 2017. Two groups of participants ≥50 years of age received a 0.5 ml dose of the inactivated split-virion trivalent influenza vaccine and a follow-up 28 days observation of any solicited and unsolicited adverse events.
A total of 134 subjects were included in the study. The total rate of reactogenicity was 5.4% [2/37] in leprosy group and 15.5% [15/ 97] in control group, the difference of reactogenicity between two groups was not significant (p = 0.1522). For solicited injection-sites adverse events (AEs), 12.4% [12/ 97] participants in the control group reported of itching, pain, erythema, swelling or induration, and no participants in leprosy group reported of any solicited injection-sites AEs. For solicited systemic AEs, 7.2% [7 / 97] participants in the control group reported of fever, malaise or headache, and 2.7% [1 / 37] participants in the leprosy group reported of fever, statistic result showed that the difference was not significant (p = 0.4438). Unsolicited AEs was reported by one male aged 76, 4 hours after vaccination administration, his plantar ulcer area began bleeding. All AEs were grade 1 or grade 2, and no recurrence of lepra reaction, AEs leading to early withdrawal from the study, or deaths were reported in this study.
To our knowledge, the present study is the first clinical study to evaluate the safety of influenza vaccine in clinically cured leprosy patients. We concluded that clinically cured leprosy patients are relatively safe for influenza vaccine. More importantly, our study make a positive and scientific efforts to eradicate discrimination on leprosy. In our study, we described a patient with plantar ulcer undergoing bleeding for 4 hours after vaccine administration. Based on evidence we have, we interpret that this adverse event may probably associated with vaccine, and patients with ulcer and leprosy need intensive attention after vaccines administration.
麻风病是一种由麻风分枝杆菌引起的传染病。流感疫苗是一种重要的流感预防策略,其制剂具有良好的安全性和耐受性。然而,在临床治愈的麻风病患者中应用流感疫苗的安全性尚不清楚。
我们在 2016 年 11 月 15 日至 2017 年 3 月 1 日期间在武汉进行了一项观察性临床研究。两组年龄均≥50 岁的参与者接受了 0.5 毫升剂量的灭活分裂病毒三价流感疫苗,并在接种后 28 天观察任何应征和未应征的不良事件。
共有 134 名患者纳入研究。麻风病组总反应率为 5.4%[2/37],对照组为 15.5%[15/97],两组反应率差异无统计学意义(p=0.1522)。对于应征注射部位不良事件(AE),对照组 12.4%[97/97]的参与者报告瘙痒、疼痛、红斑、肿胀或硬结,麻风病组无参与者报告任何应征注射部位 AE。对于应征全身 AE,对照组 7.2%[97/97]的参与者报告发热、不适或头痛,麻风病组 2.7%[37/37]的参与者报告发热,统计学结果显示差异无统计学意义(p=0.4438)。接种后 4 小时,一名 76 岁男性报告了一起非应征 AE,其足底溃疡面积开始出血。所有 AE 均为 1 级或 2 级,本研究未报告出现麻风反应复发、AE 导致提前退出研究或死亡。
据我们所知,本研究是第一项评估临床治愈麻风病患者接种流感疫苗安全性的临床研究。我们的结论是,临床治愈的麻风病患者接种流感疫苗相对安全。更重要的是,我们的研究为消除麻风病歧视做出了积极和科学的努力。在我们的研究中,我们描述了一名足底溃疡患者在接种疫苗后 4 小时发生出血。根据我们现有的证据,我们认为这种不良事件可能与疫苗有关,溃疡和麻风病患者在接种疫苗后需要密切关注。