Arrazola Martínez M P, Eiros Bouza J M, Plans Rubió P, Puig-Barberà J, Ruiz Aragón J, Torres Lana A J
Dra. María Pilar Arrazola Martínez, Servicio de Medicina Preventiva. Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n, 28041 Madrid, Spain.
Rev Esp Quimioter. 2023 Aug;36(4):334-345. doi: 10.37201/req/145.2022. Epub 2023 Apr 20.
Most of the complications and deaths related to seasonal flu occur in the elderly population (≥65 years) with comorbidities, and the influenza vaccine is the most effective way to prevent them. Immunization is less effective in older adults due to immunosenescence. MF59-adjuvanted vaccines, designed to improve the magnitude, persistence and amplitude of the immune response in elderly people, have been used in clinical practice since 1997 in their trivalent formulation and, since 2020, in their tetravalent formulation. Data from various studies show that these vaccines are not only safe for all age groups, with a reactogenicity profile similar to that of the conventional vaccine, but also that they are especially effective in boosting the immune response in the population aged 65 or over by increasing antibody titers after vaccination and significantly reducing the risk of hospital admission. Adjuvanted vaccines have been shown to provide cross-protection against heterologous strains and to be as effective as the high-dose vaccine in the population aged 65 or over. In this review, the scientific evidence on the efficacy and effectiveness of the MF59-adjuvanted vaccine in real clinical practice in people ≥65 years of age is analyzed through a narrative and descriptive review of the literature with data from clinical trials, observational studies and systematic reviews or meta-analysis.
大多数与季节性流感相关的并发症和死亡发生在患有合并症的老年人群(≥65岁)中,而流感疫苗是预防这些情况的最有效方法。由于免疫衰老,免疫接种在老年人中效果较差。MF59佐剂疫苗旨在增强老年人免疫反应的强度、持久性和幅度,自1997年以来已以三价制剂形式应用于临床实践,自2020年起以四价制剂形式应用。来自各种研究的数据表明,这些疫苗不仅对所有年龄组都安全,其反应原性与传统疫苗相似,而且在65岁及以上人群中,它们通过提高接种疫苗后的抗体滴度和显著降低住院风险,尤其有效地增强了免疫反应。佐剂疫苗已被证明可提供针对异源毒株的交叉保护,并且在65岁及以上人群中与高剂量疫苗一样有效。在本综述中,通过对来自临床试验、观察性研究以及系统评价或荟萃分析的数据进行文献叙述性和描述性综述,分析了MF59佐剂疫苗在≥65岁人群实际临床实践中的疗效和有效性的科学证据。