Gemmill I
Chair, NACI.
Kingston, Frontenac and Lennox & Addington Public Health, Kingston, ON.
Can Commun Dis Rep. 2015 Oct 1;41(10):227-232. doi: 10.14745/ccdr.v41i10a02.
The National Advisory Committee on Immunization (NACI) provides the Public Health Agency of Canada with ongoing and timely medical, scientific, and public health advice relating to immunization.
To summarize the update of the 2015-2016 recommendations by NACI regarding the use of seasonal influenza vaccines.
Annual influenza vaccine recommendations are developed by the Influenza Working Group for consideration by NACI, based on NACI's evidence-based process for developing recommendations, and includes: a consideration of the burden of influenza illness and the target populations for vaccination; efficacy and effectiveness, immunogenicity, and safety of influenza vaccines; vaccine schedules; and other aspects of influenza immunization.
NACI continues to recommend influenza vaccination for all individuals aged 6 months and older, with particular focus on people at high risk of influenza-related complications or hospitalization, people capable of transmitting influenza to those at high risk, and others as indicated. For the 2015-2016 influenza season, the Statement has been updated to identify children and adolescents with neurologic or neurodevelopment conditions as a group at high risk for influenza-related complications or hospitalization. Several changes to product availability in Canada have also been noted. A new adjuvanted, trivalent influenza vaccine (Fluad Pediatric™ [Novartis]) will be available for use in children aged 6 to <24 months. The recommended choice of product for this age group, however, is quadrivalent inactivated influenza vaccine (QIV), because children are more likely to be affected by influenza B, and the QIV provides broader protection against both lineages of influenza B. If QIV is not available, either unadjuvanted or adjuvanted trivalent inactivated influenza vaccine (TIV) should be used. Only the quadrivalent formulation of the live attenuated influenza vaccine (LAIV) (FluMist® Quadrivalent [AstraZeneca]) will be available, and the recommendation for preferential use of LAIV in children 2 to 17 years of age who do not have contraindications to this vaccine remains unchanged following a review of information pertaining to reports of decreased effectiveness of LAIV in the United States during the 2013-2014 season. Finally, the intradermal trivalent influenza vaccine (Intanza® [Sanofi Pasteur]) will no longer be available for use in Canada. Other updates to the Statement include additional information reaffirming the safety of LAIV use in children with cystic fibrosis who are not considered immunosuppressed or receiving immunosuppressive treatment, as well as a revised definition for oculo-respiratory syndrome which, when it occurs, should be reported as an adverse event following immunization (AEFI) to local public health officials.
Vaccination is the safest, longest lasting and most effective way to prevent influenza.
国家免疫咨询委员会（NACI）为加拿大公共卫生署提供与免疫相关的持续且及时的医学、科学及公共卫生建议。
总结NACI关于2015 - 2016年季节性流感疫苗使用建议的更新内容。
流感工作组根据NACI制定建议的循证流程制定年度流感疫苗建议，内容包括：考虑流感疾病负担及疫苗接种目标人群；流感疫苗的效力、效果、免疫原性和安全性；疫苗接种时间表；以及流感免疫的其他方面。
NACI继续建议对所有6个月及以上的个体接种流感疫苗，尤其关注有流感相关并发症或住院高风险的人群、能够将流感传播给高风险人群的人以及其他指明的人群。对于2015 - 2016年流感季节，声明已更新，将患有神经或神经发育疾病的儿童和青少年确定为有流感相关并发症或住院高风险的群体。还注意到加拿大疫苗产品供应的若干变化。一种新的佐剂三价流感疫苗（Fluad Pediatric™[诺华公司]）将可供6至<24个月的儿童使用。然而，该年龄组推荐的产品选择是四价灭活流感疫苗（QIV），因为儿童更易受B型流感影响，且QIV对B型流感的两个谱系提供更广泛的保护。如果没有QIV，应使用无佐剂或佐剂三价灭活流感疫苗（TIV）。仅活病毒减毒流感疫苗（LAIV）（FluMist®四价[阿斯利康公司]）的四价配方将可供使用，在审查了2013 - 2014年美国LAIV效力降低报告的相关信息后，对于2至17岁无该疫苗接种禁忌证儿童优先使用LAIV的建议保持不变。最后，皮内注射三价流感疫苗（Intanza®[赛诺菲巴斯德公司]）将不再在加拿大使用。声明的其他更新内容包括重申LAIV在未被视为免疫抑制或接受免疫抑制治疗的囊性纤维化儿童中使用的安全性的补充信息，以及眼 - 呼吸综合征的修订定义，该综合征发生时应作为免疫接种后不良事件（AEFI）向当地公共卫生官员报告。
接种疫苗是预防流感最安全、持续时间最长且最有效的方法。
