既往流感疫苗接种对1至5岁儿童当前流感疫苗效力的影响。
Influence of Prior Influenza Vaccination on Current Influenza Vaccine Effectiveness in Children Aged 1 to 5 Years.
作者信息
Matsumoto Kazuhiro, Fukushima Wakaba, Morikawa Saeko, Fujioka Masashi, Matsushita Tohru, Kubota Megumi, Yagi Yoshina, Takasaki Yoshio, Shindo Shizuo, Yamashita Yuji, Yokoyama Takato, Kiyomatsu Yumi, Hiroi Satoshi, Nakata Keiko, Maeda Akiko, Kondo Kyoko, Ito Kazuya, Kase Tetsuo, Ohfuji Satoko, Hirota Yoshio
机构信息
Department of Public Health, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.
Research Center for Infectious Disease Sciences, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.
出版信息
Vaccines (Basel). 2021 Dec 7;9(12):1447. doi: 10.3390/vaccines9121447.
BACKGROUND
Although annual influenza vaccination is an important strategy used to prevent influenza-related morbidity and mortality, some studies have reported the negative influence of prior vaccination on vaccine effectiveness (VE) for current seasons. Currently, the influence of prior vaccination is not conclusive, especially in children.
METHODS
We evaluated the association between current-season VE and prior season vaccination using a test-negative design in children aged 1-5 years presenting at nine outpatient clinics in Japan during the 2016/17 and 2017/18 influenza seasons. Children with influenza-like illness were enrolled prospectively and tested for influenza using real-time RT-PCR. Their recent vaccination history was categorized into six groups according to current vaccination doses (0/1/2) and prior vaccination status (unvaccinated = 0 doses/vaccinated = 1 dose or 2 doses): (1) 0 doses in the current season and unvaccinated in prior seasons (reference group); (2) 0 doses in the current season and vaccinated in a prior season; (3) 1 dose in the current season and unvaccinated in a prior season; (4) 1 dose in the current season and vaccinated in a prior season; (5) 2 doses in the current season and unvaccinated in a prior season, and (6) 2 doses in the current season and vaccinated in a prior season.
RESULTS
A total of 799 cases and 1196 controls were analyzed. The median age of the subjects was 3 years, and the proportion of males was 54%. Overall, the vaccination rates (any vaccination in the current season) in the cases and controls were 36% and 53%, respectively. The VEs of the groups were: (2) 29% (95% confidence interval: -25% to 59%); (3) 53% (6% to 76%); (4) 70% (45% to 83%); (5) 56% (32% to 72%), and (6) 61% (42% to 73%). The one- and two-dose VEs of the current season were significant regardless of prior vaccination status. The results did not differ when stratified by influenza subtype/lineage.
CONCLUSION
Prior vaccination did not attenuate the current-season VE in children aged 1 to 5 years, supporting the annual vaccination strategy.
背景
尽管每年接种流感疫苗是预防流感相关发病和死亡的一项重要策略，但一些研究报告了既往接种疫苗对当前季节疫苗效力（VE）的负面影响。目前，既往接种疫苗的影响尚无定论，尤其是在儿童中。
方法
我们在2016/17和2017/18流感季节期间，采用检测阴性设计，对日本9家门诊就诊的1至5岁儿童进行当前季节VE与上一季节接种疫苗之间关联的评估。前瞻性纳入患有流感样疾病的儿童，并使用实时逆转录聚合酶链反应检测流感。根据当前接种剂量（0/1/2）和既往接种状况（未接种 = 0剂/接种 = 1剂或2剂），将他们最近的接种史分为六组：（1）当前季节0剂且上一季节未接种（参照组）；（2）当前季节0剂且上一季节接种；（3）当前季节1剂且上一季节未接种；（4）当前季节1剂且上一季节接种；（5）当前季节2剂且上一季节未接种，以及（6）当前季节2剂且上一季节接种。
结果
共分析了799例病例和1196例对照。受试者的中位年龄为3岁，男性比例为54%。总体而言，病例组和对照组当前季节的接种率（当前季节任何接种）分别为36%和53%。各分组的疫苗效力分别为：（2）29%（95%置信区间：-25%至59%）；（3）53%（6%至76%）；（4）70%（45%至83%）；（5）56%（32%至72%），以及（6）61%（42%至73%）。无论既往接种状况如何，当前季节的一剂和两剂疫苗效力均具有显著性。按流感亚型/谱系分层时结果无差异。
结论
既往接种疫苗并未削弱1至5岁儿童当前季节的疫苗效力，支持每年接种疫苗的策略。
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