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疫苗干扰情况下季节性流感疫苗接种的影响。

Impact of seasonal influenza vaccination in the presence of vaccine interference.

机构信息

Department of Mathematics, Soongsil University, Sangdo-ro 369, Dongjak-gu, Seoul 156-743 Republic of Korea.

University of Pittsburgh School of Medicine, 200 Meyran Ave, Suite 200, Pittsburgh, PA 15213, USA.

出版信息

Vaccine. 2018 Feb 1;36(6):853-858. doi: 10.1016/j.vaccine.2017.12.067. Epub 2018 Jan 9.

Abstract

BACKGROUND

Annual influenza vaccination is a key to preventing widespread influenza infections. Recent reports of influenza vaccine effectiveness (VE) indicate that vaccination in prior years may reduce VE in the current season, suggesting vaccine interference. The purpose of this study is to evaluate the potential effect of repeat influenza vaccinations in the presence of vaccine interference.

METHODS

Using literature-based parameters, an age-structured influenza equation-based transmission model was used to determine the optimal vaccination strategy, while considering the effect of varying levels of interference.

RESULTS

The model shows that, even in the presence of vaccine interference, revaccination reduces the influenza attack rate and provides individual benefits. Specifically, annual vaccination is a favored strategy over vaccination in alternate years, as long as the level of residual protection is less than 58% or vaccine interference effect is minimal. Furthermore, the negative impact of vaccine interference may be offset by increased vaccine coverage levels.

CONCLUSIONS

Even in the presence of potential vaccine interference, our work provides a population-level perspective on the potential merits of repeated influenza vaccination. This is because repeat vaccination groups had lower attack rates than groups that omitted the second vaccination unless vaccine interference was at very high, perhaps implausible, levels.

摘要

背景

每年接种流感疫苗是预防广泛流感感染的关键。最近关于流感疫苗有效性(VE)的报告表明,前几年的接种可能会降低当前季节的 VE,表明存在疫苗干扰。本研究旨在评估在存在疫苗干扰的情况下重复接种流感疫苗的潜在影响。

方法

使用基于文献参数的年龄结构流感方程传播模型来确定最佳接种策略,同时考虑不同程度干扰的影响。

结果

该模型表明,即使存在疫苗干扰,再次接种也会降低流感发病率并为个体带来益处。具体来说,只要剩余保护率低于 58%或疫苗干扰效应最小,那么与隔年接种相比,每年接种是更优的策略。此外,增加疫苗覆盖率水平可以抵消疫苗干扰的负面影响。

结论

即使存在潜在的疫苗干扰,我们的工作也从人群角度提供了对重复接种流感疫苗潜在益处的看法。这是因为重复接种组的发病率低于省略第二次接种的组,除非疫苗干扰处于非常高的水平,也许是不太可能的水平。

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Repeated flu shots may blunt effectiveness.
CMAJ. 2015 Apr 7;187(6):E180. doi: 10.1503/cmaj.109-5000. Epub 2015 Mar 2.

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