2018/2019 年度 55 岁及以上人群接种四价流感疫苗的抗体应答及影响因素分析。
Quadrivalent Influenza Vaccine-Induced Antibody Response and Influencing Determinants in Patients ≥ 55 Years of Age in the 2018/2019 Season.
机构信息
Department of Infectious Diseases, University of Zielona Góra, Zyty 28, 65-046 Zielona Góra, Poland.
Department of Epidemiology and Management. Pomeranian Medical University, Zolnierska 48, 71-210 Szczecin, Poland.
出版信息
Int J Environ Res Public Health. 2019 Nov 14;16(22):4489. doi: 10.3390/ijerph16224489.
UNLABELLED
The effects of immunization with subunit inactivated quadrivalent influenza vaccine (QIV) are not generally well assessed in the elderly Polish population. Therefore, this study evaluated vaccine-induced antibody response and its determinants.
METHODS
Consecutive patients ≥ 55 years old, attending a Primary Care Clinic in Gryfino, Poland, received QIV (A/Michigan/ 45/2015(H1N1)pdm09, A/Singapore/INFIMH-16-0019/2016 (H3N2), B/Colorado/06/2017, B/Phuket/ 3073/2013) between October-December 2018. Hemagglutination inhibition assays measured antibody response to vaccine strains from pre/postvaccination serum samples. Geometric mean titer ratio (GMTR), protection rate (PR) and seroconversion rate (SR) were also calculated.
RESULTS
For 108 patients (54.6% males, mean age: 66.7 years) the highest GMTR (61.5-fold) was observed for A/H3N2/, then B/Colorado/06/2017 (10.3-fold), A/H1N1/pdm09 (8.4-fold) and B/Phuket/ 3073/2013 (3.0-fold). Most patients had post-vaccination protection for A/H3N2/ and B/Phuket/3073/ 2013 (64.8% and 70.4%, respectively); lower PRs were observed for A/H1N1/pdm09 (41.8%) and B/Colorado/06/ 2017 (57.4%). The SRs for A/H3N2/, A/H1N1/pdm09, B Victoria and B Yamagata were 64.8%, 38.0%, 46.8%, and 48.2%, respectively. Patients who received QIV vaccination in the previous season presented lower ( < 0.001 and = 0.03, respectively) response to B Victoria and B Yamagata.
CONCLUSIONS
QIV was immunogenic against the additional B lineage strain (B Victoria) without significantly compromising the immunogenicity of the other three vaccine strains, therefore, adding a second B lineage strain in QIV could broaden protection against influenza B infection in this age group. As the QIV immunogenicity differed regarding the four antigens, formulation adjustments to increase the antigen concentration of the serotypes that have lower immunogenicity could increase effectiveness. Prior season vaccination was associated with lower antibody response to a new vaccine, although not consistent through the vaccine strains.
目的
评估接种四价流感亚单位灭活疫苗（QIV）后诱导的抗体反应及其决定因素。
方法
2018 年 10 月至 12 月，连续入组年龄≥55 岁、在波兰格里菲诺初级保健诊所就诊的患者，接种 QIV（A/Michigan/45/2015[H1N1]pdm09、A/Singapore/INFIMH-16-0019/2016[H3N2]、B/Colorado/06/2017、B/Phuket/3073/2013）。在接种前和接种后采集血清样本，用血凝抑制试验测量疫苗株抗体反应。还计算了几何平均滴度比（GMTR）、保护率（PR）和血清转化率（SR）。
结果
在 108 例患者（54.6%为男性，平均年龄：66.7 岁）中，A/H3N2/的 GMTR 最高（61.5 倍），其次是 B/Colorado/06/2017（10.3 倍）、A/H1N1/pdm09（8.4 倍）和 B/Phuket/3073/2013（3.0 倍）。大多数患者对 A/H3N2/和 B/Phuket/3073/2013 有接种后保护作用（分别为 64.8%和 70.4%）；A/H1N1/pdm09 和 B/Colorado/06/2017 的 PR 较低（分别为 41.8%和 57.4%）。A/H3N2/、A/H1N1/pdm09、B Victoria 和 B Yamagata 的 SR 分别为 64.8%、38.0%、46.8%和 48.2%。上一季接种 QIV 的患者对 B Victoria 和 B Yamagata 的反应较低（<0.001 和=0.03）。
结论
QIV 对额外的 B 谱系菌株（B Victoria）具有免疫原性，而不会显著降低其他三种疫苗株的免疫原性，因此，在 QIV 中添加第二种 B 谱系菌株可以扩大该年龄段对流感 B 感染的保护范围。由于 QIV 的免疫原性因四种抗原而异，因此可以调整制剂以增加免疫原性较低的血清型的抗原浓度，从而提高有效性。上一季的疫苗接种与对新疫苗的抗体反应较低有关，尽管通过疫苗株并不一致。
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