University of Zurich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Department of Public and Global Health, MilMedBiol Competence Centre, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland.
Division of Infectious Disease, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Travel Med Infect Dis. 2020 Sep-Oct;37:101876. doi: 10.1016/j.tmaid.2020.101876. Epub 2020 Sep 12.
Tick-borne encephalitis (TBE) is increasing in Europe. We aimed to evaluate the immunogenicity and safety of TBE-vaccination.
This systematic review was registered at PROSPERO (#CRD42020155737) and conducted in accordance with PRISMA guidelines. We searched CINAHL, Cochrane, Embase, PubMed, and Scopus using specific terms. Original articles, case reports and research abstracts in English, French, German and Italian were included for screening and extracting (JER; PS).
Of a total of 2464 records, 49 original research publications were evaluated for immunogenicity and safety. TBE-vaccines showed adequate immunogenicity, good safety and interchangeability in adults and children with some differences in long-term protection (Seropositivity in 90.6-100% after primary vaccination; 84.9%-99.4% at 5 year follow up). Primary conventional vaccination schedule (days 0, 28, and 300) demonstrated the best immunogenic results (99-100% of seropositivity). Mixed brand primary vaccination presented adequate safety and immunogenicity with some exceptions. After booster follow-ups, accelerated conventional and rapid vaccination schedules were shown to be comparable in terms of immunogenicity and safety. First booster vaccinations five years after primary vaccination were protective in adults aged <50 years, leading to protective antibody levels from at least 5 years up to 10 years after booster vaccination. In older vaccinees, > 50 years, lower protective antibody titers were found. Allergic individuals showed an adequate response and immunosuppressed individuals a diminished response to TBE-vaccination.
The TBE-vaccination is generally safe with rare serious adverse events. Schedules should, if possible, use the same vaccine brand (non-mixed). TBE-vaccines are immunogenic in terms of antibody response but less so when vaccination is started after the age of 50 years. Age at priming is a key factor in the duration of protection.
在欧洲，蜱传脑炎（TBE）的发病率正在上升。我们旨在评估 TBE 疫苗的免疫原性和安全性。
本系统评价在 PROSPERO（#CRD42020155737）中进行注册，并按照 PRISMA 指南进行。我们使用特定术语在 CINAHL、Cochrane、Embase、PubMed 和 Scopus 中进行了搜索。纳入了英文、法文、德文和意大利文的原始文章、病例报告和研究摘要进行筛选和提取（JER；PS）。
在总共 2464 条记录中，有 49 项原始研究出版物评估了免疫原性和安全性。TBE 疫苗在成人和儿童中具有足够的免疫原性、良好的安全性和可互换性，但其长期保护效果存在一些差异（初次接种后血清阳性率为 90.6%-100%；5 年随访时为 84.9%-99.4%）。初级常规接种方案（第 0、28 和 300 天）显示出最佳的免疫效果（血清阳性率为 99-100%）。混合品牌初级接种表现出足够的安全性和免疫原性，但也存在一些例外。加强针随访后，加速常规和快速接种方案在免疫原性和安全性方面表现相当。初次接种后 5 年进行首次加强接种可保护 50 岁以下成年人，使保护性抗体水平至少在加强接种后 5 年至 10 年保持不变。在年龄较大的疫苗接种者（>50 岁）中，保护性抗体滴度较低。过敏个体表现出足够的反应，而免疫抑制个体对 TBE 疫苗的反应减弱。
TBE 疫苗接种通常是安全的，只有少数严重不良事件。如果可能的话，接种方案应使用相同的疫苗品牌（非混合）。从抗体反应的角度来看，TBE 疫苗具有免疫原性，但在 50 岁以上开始接种时效果较差。初次接种年龄是保护持续时间的关键因素。
