Zhonghua Liu Xing Bing Xue Za Zhi. 2019 Nov 10;40(11):1333-1349. doi: 10.3760/cma.j.issn.0254-6450.2019.11.002.
Influenza virus infection is a respiratory infectious disease that can seriously affect human health. Influenza viruses can have antigenic variation and changes frequently, which results in rapid and widespread transmission resulting in annual epidemics and outbreaks in population gathering places such as schools, kindergartens and nursing homes. WHO estimated that seasonal influenza epidemics could cause 3 to 5 million severe cases annually, and 290 000 to 650 000 deaths globally. Pregnant women, young children, the elderly, and persons with chronic illnesses are at high risk for severe illness and death associated with influenza virus infection. Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and complications from infection. Currently, China has licensed trivalent inactivated influenza vaccine (IIV3) which includes split-virus influenza vaccine and subunit vaccine, and quadrivalent inactivated influenza vaccine (IIV4) which is split. Except a few major cities, influenza vaccine is a category Ⅱ vaccine, which means influenza vaccination is voluntary, and recipients should pay for it. In 2018, China CDC issued the " (2018-2019)" (Guide 2018). In the past year, new research evidences have been published both in China and abroad, and new seasonal influenza vaccine has been licensed in China. To strengthen the technical guidance for prevention and control of influenza and operational research on influenza vaccination in China, the Influenza Vaccination Technical Working Group (TWG) of National Immunization Advisory Committee (NIAC) updated the Guide 2018 and compiled the " (2019-2020)" . Major updates include the following: First, new research evidences especially studies of China, including disease burden, effectiveness, vaccine-avoidable disease burden, vaccine safety monitoring, and cost-effectiveness and cost-benefit. Second, policies and measures for influenza prevention and control issued by National Health Commission (PRC) in the past year. Thirdly, new type seasonal influenza vaccine licensed and issued in 2019-2020 in China. Fourth, northern hemisphere influenza vaccination composition for the 2019-2020 season was updated for both IIV3 and IIV4. The recommendations include: Points of vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for one influenza vaccine product over another for persons whom can accept more than one licensed, recommended and appropriate products. To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups, the recommendations prioritize seasonal influenza vaccination for children aged 6 to 59 months, adults ≥60 years of age, persons with specific chronic diseases, healthcare workers, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to become pregnant during the influenza season. Children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. If they were vaccinated in 2018-2019 influenza season or prior, 1 dose is recommended. People ≥9 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as available. For the people unable to be vaccinated before the end of October, influenza vaccination will continue to be offered for the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for use by staff members of the CDCs at all levels who work on influenza control and prevention, PoVs staff members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and staff members of maternity and child care institutions at all levels. These guidelines will be updated periodically as new evidence becomes available.
流感病毒感染是一种可严重影响人类健康的呼吸道传染病。流感病毒会发生抗原变异且变异频繁,导致其迅速广泛传播,从而在学校、幼儿园和养老院等人群聚集场所每年引发流行和暴发。世界卫生组织估计,季节性流感流行每年可导致300万至500万重症病例,全球有29万至65万人死亡。孕妇、幼儿、老年人以及慢性病患者感染流感病毒后发生重症和死亡的风险较高。季节性流感疫苗接种是预防流感病毒感染及感染后并发症的最有效方法。目前,中国已批准三价灭活流感疫苗(IIV3),包括裂解流感疫苗和亚单位疫苗,以及四价灭活流感疫苗(IIV4),为裂解疫苗。除少数大城市外,流感疫苗属于二类疫苗,即流感疫苗接种为自愿行为,受种者需自费。2018年,中国疾病预防控制中心发布了《(2018 - 2019年)》(《2018年指南》)。过去一年,国内外均发表了新的研究证据,中国也批准了新的季节性流感疫苗。为加强中国流感防控技术指导及流感疫苗接种工作的操作研究,国家免疫咨询委员会(NIAC)流感疫苗接种技术工作组(TWG)更新了《2018年指南》,并编写了《(2019 - 2020年)》。主要更新内容如下:一是新的研究证据,尤其是中国的研究,包括疾病负担、有效性、疫苗可避免疾病负担、疫苗安全性监测以及成本效益和成本效益分析;二是国家卫生健康委员会(中国)过去一年发布的流感防控政策和措施;三是2019 - 2020年中国批准上市的新型季节性流感疫苗;四是更新了2019 - 2020年北半球IIV3和IIV4流感疫苗接种组分。建议如下:接种门诊应为所有愿意接种且无禁忌证的6月龄及以上人群提供流感疫苗接种服务。对于可接受多种已批准、推荐且合适产品的人群,不特别推荐某一种流感疫苗产品优于另一种。为降低高危人群因流感病毒感染导致重症感染和并发症的风险,建议优先为6至59月龄儿童、≥60岁成年人、特定慢性病患者、医护人员、<6月龄婴儿的家庭成员和照护者以及流感季节期间的孕妇或计划怀孕的女性接种季节性流感疫苗。6月龄至8岁儿童在首次接种流感疫苗季节需要接种2剂,间隔至少4周,以获得最佳保护。如果他们在2018 - 2019年流感季节或之前已接种,建议接种1剂。≥9岁人群需要接种1剂流感疫苗。建议人们在10月底前接种流感疫苗。只要有疫苗应尽早接种。对于10月底前无法接种的人群,整个流感季节都可继续接种。也建议孕妇在任何孕周接种流感疫苗。本指南供各级从事流感防控工作的疾病预防控制中心工作人员、接种门诊工作人员、儿科、内科和传染病科医护人员以及各级妇幼保健机构工作人员使用。随着新证据的出现,本指南将定期更新。