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老年人季节性流感的有效免疫接种。

Effective Immunization of Older Adults Against Seasonal Influenza.

机构信息

Department of Health Policy and Division of Infectious Diseases, School of Medicine, Vanderbilt University, Nashville, Tenn.

Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore.

出版信息

Am J Med. 2018 Aug;131(8):865-873. doi: 10.1016/j.amjmed.2018.02.019. Epub 2018 Mar 12.

Abstract

The 2017-2018 influenza season reminds us that it is important for health care professionals to be prepared for the annual onslaught of this contagious respiratory disease associated with potentially serious complications. Vaccination is by far the best method to prevent and control influenza, reducing illness, hospitalizations, and mortality. The highest rates of influenza-associated morbidity and mortality are observed in older adults. The immune function of older adults decreases with increasing age, a phenomenon termed immunosenescence. Immunosenescence not only confers increased susceptibility to influenza disease, but also renders vaccination less effective. To address the need for improved vaccines that provide enhanced protection to this high-risk group, 2 formulations-a high-dose vaccine and an adjuvanted vaccine-have been approved in recent years specifically for people aged 65 years and over. Here we discuss: the challenges of influenza immunization in those 65 years and older; the recent advancements in vaccines targeted at this age group; and the latest influenza vaccine recommendations for the 2017-2018 influenza season in the United States.

摘要

2017-2018 年流感季提醒我们,医疗卫生专业人员做好准备应对传染性呼吸道疾病年度流行至关重要,这种疾病可能导致严重并发症。疫苗接种是预防和控制流感的最佳方法,可以减少疾病、住院和死亡。与流感相关发病率和死亡率最高的是老年人。老年人的免疫功能随年龄增长而下降,这种现象称为免疫衰老。免疫衰老不仅使人更容易感染流感疾病,而且使疫苗的效果降低。为了满足高危人群对改进疫苗的需求,提供更好的保护,近年来专门批准了 2 种配方疫苗,即高剂量疫苗和佐剂疫苗,适用于 65 岁及以上人群。本文讨论了:65 岁及以上人群流感免疫接种的挑战;针对该年龄组疫苗的最新进展;以及美国 2017-2018 年流感季的最新流感疫苗建议。

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