Division of Infectious Diseases, Department of Medicine, University of Texas Southwestern Medical Center, Dallas.
Health Sciences Library.
Clin Infect Dis. 2018 May 17;66(11):1802-1811. doi: 10.1093/cid/cix1081.
Immunogenicity from seasonal inactivated influenza vaccine (IIV) remains suboptimal in solid organ transplant recipients (SOTRs). We conducted a systematic review that compared the safety and immunogenicity of nonstandard influenza vaccination strategies with single-dose IIV in SOTRs. Booster doses and possibly high-dose (HD) influenza vaccination strategies seem to hold promise for improving vaccination immunogenicity in SOTRs. Administration of intradermal and MF59-adjuvanted trivalent IIV (IIV3) did not improve vaccine immunogenicity compared with single-dose intramuscular IIV. Alternative vaccine strategies were generally well tolerated; SOTRs who received HD, intradermal or adjuvanted IIV3 had a higher frequency of infection site reactions, while systemic adverse events were more frequent in SOTRs who received HD IIV3. Allograft rejection rates were similar in both groups. SOTRs should continue to receive standard-dose IIV annually in accordance with current recommendations, pending future studies to determine the optimal timing, frequency, and dosage of IIV using the booster-dose strategy.
季节性灭活流感疫苗（IIV）在实体器官移植受者（SOTR）中的免疫原性仍然不理想。我们进行了一项系统评价，比较了非标准流感疫苗接种策略与 SOTR 中单剂量 IIV 的安全性和免疫原性。加强剂量和可能的高剂量（HD）流感疫苗接种策略似乎有望提高 SOTR 中的疫苗免疫原性。与单剂量肌内 IIV 相比，皮内和 MF59 佐剂三价 IIV（IIV3）的给药并未改善疫苗的免疫原性。替代疫苗策略通常具有良好的耐受性；接受高剂量、皮内或佐剂 IIV3 的 SOTR 更频繁地出现接种部位反应，而接受高剂量 IIV3 的 SOTR 更频繁地出现全身不良事件。两组同种异体移植排斥率相似。在等待未来使用加强剂量策略确定 IIV 的最佳时间、频率和剂量的研究结果之前，SOTR 应继续按照当前建议每年接受标准剂量 IIV。
