Kostinov Mikhail P, Cherdantsev Alexander P, Akhmatova Nelli K, Praulova Daria A, Kostinova Aristitsa M, Akhmatova Elina A, Demina Evgeniia O
Mechnikov Research Institute of Vaccines and Sera, Moscow, Russia.
Sechenov First Moscow State Medical University, Moscow, Russia.
ERJ Open Res. 2018 Apr 9;4(2). doi: 10.1183/23120541.00060-2017. eCollection 2018 Apr.
Pregnancy is a condition of modulated immune suppression, so this group of patients has increased risk of infectious diseases. Trivalent subunit vaccines, unadjusted Agrippal S1 (group I) and immunoadjuvant Grippol Plus (group II), containing 5 μg of actual influenza virus strains, were administered respectively to 37 and 42 women in the second and third trimester of physiological pregnancy. The administration of subunit influenza vaccines was accompanied by the development of local reactions in no more than 10% of patients, compared with 4.9% of the 41 pregnant women in the placebo group (group III). Systemic reactions were of a general somatic nature, did not differ between vaccinated and placebo groups, and were not associated with vaccination. Physiological births in groups I, II and III were 94.6%, 92.9% and 85.4%, respectively, and the birth rates of children without pathologies were 91.9%, 90.5% and 80.5%, respectively, and were comparable between groups. Vaccination stimulated the production of protective antibodies against influenza virus strains in 64.8-94.5% of patients after immunisation with an unadjusted vaccine and in 72.5-90.0% of patients after the administration of an immunoadjuvant vaccine. After 9 months, antibody levels were recorded in 51.3-72.9% in group I and 54.2-74.2% in group II. Immunisation against influenza in pregnant women provided a high level of seroprotection and seroconversion. Nevertheless, the level of seroprotection against the influenza strain A(H3N2, Victoria) was slightly lower in the group immunised with an unadjusted vaccine compared to those vaccinated with the immunoadjuvant vaccine.
妊娠是一种免疫抑制受到调节的状态，因此这类患者感染性疾病的风险增加。分别将含5μg实际流感病毒株的三价亚单位疫苗、未调整的Agrippal S1（第一组）和免疫佐剂Grippol Plus（第二组），给予37名和42名处于生理性妊娠中晚期的妇女。亚单位流感疫苗接种后，不超过10%的患者出现局部反应，而安慰剂组（第三组）的41名孕妇中这一比例为4.9%。全身反应具有一般躯体性质，接种组和安慰剂组之间无差异，且与接种无关。第一组、第二组和第三组的生理性分娩率分别为94.6%、92.9%和85.4%，无病理情况的儿童出生率分别为91.9%、90.5%和80.5%，各组之间具有可比性。接种疫苗后，未调整疫苗免疫的患者中有64.8 - 94.5%、免疫佐剂疫苗接种的患者中有72.5 - 90.0%产生了针对流感病毒株的保护性抗体。9个月后，第一组抗体水平记录为51.3 - 72.9%，第二组为54.2 - 74.2%。孕妇接种流感疫苗可提供高水平的血清保护和血清转化。然而，与接种免疫佐剂疫苗的组相比，未调整疫苗免疫组对A(H3N2, Victoria)流感毒株的血清保护水平略低。
