a Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network , Toronto , Ontario , Canada.
Hum Vaccin Immunother. 2018 Jun 3;14(6):1311-1322. doi: 10.1080/21645515.2018.1445446. Epub 2018 Mar 21.
Immunocompromised persons are at high risk of complications from influenza infection. This population includes those with solid organ transplants, hematopoietic stem cell transplants, solid cancers and hematologic malignancy as well as those with autoimmune conditions receiving biologic therapies. In this review, we discuss the impact of influenza infection and evidence for vaccine effectiveness and immunogenicity. Overall, lower respiratory disease from influenza is common; however, vaccine immunogenicity is low. Despite this, in some populations, influenza vaccine has demonstrated effectiveness in reducing severe disease. Various strategies to improve influenza vaccine immunogenicity have been attempted including two vaccine doses in the same influenza season, intradermal, adjuvanted, and high-dose vaccines. The timing of influenza vaccine is also important to achieve optimal immunogenicity. Given the suboptimal immunogenicity, family members and healthcare professionals involved in the care of these populations should be vaccinated. Health care professional recommendation for vaccination is an important factor in vaccine coverage.
免疫功能低下者患流感感染并发症的风险很高。该人群包括实体器官移植、造血干细胞移植、实体癌和血液恶性肿瘤患者以及接受生物疗法的自身免疫性疾病患者。在这篇综述中，我们讨论了流感感染的影响以及疫苗有效性和免疫原性的证据。总的来说，流感引起的下呼吸道疾病很常见；然而，疫苗的免疫原性较低。尽管如此，在某些人群中，流感疫苗已被证明可有效减少重症疾病。为了提高流感疫苗的免疫原性，已经尝试了各种策略，包括在同一流感季节接种两剂疫苗、皮内、佐剂和高剂量疫苗。流感疫苗的接种时间也很重要，以达到最佳的免疫原性。鉴于免疫原性不理想，应接种这些人群的家庭成员和医护人员。医护人员对疫苗接种的推荐是疫苗接种覆盖率的一个重要因素。
