流感血凝抑制抗体作为疫苗介导物在儿童中的作用。

The role of influenza Hemagglutination-Inhibition antibody as a vaccine mediator in children.

机构信息

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.

The Hospital for Sick Children, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada.

出版信息

Vaccine. 2024 Aug 30;42(21):126122. doi: 10.1016/j.vaccine.2024.07.023. Epub 2024 Jul 28.

DOI:10.1016/j.vaccine.2024.07.023

PMID:39074996

Abstract

BACKGROUND

Influenza vaccination may protect through the humoral immune response, cellular immune response, or possibly both. Immunity after vaccination can be mediated through antibodies that may be detected by the rise of serum hemagglutination inhibition (HAI) titers. Our objective was to investigate the proportion of protection against influenza mediated through antibodies by measuring the rise of HAI titer (indirect effect) compared to that induced through other immune mechanisms (direct effect) for influenza A and B.

METHODS

We analysed data from a cluster randomized trial conducted during the 2008-2009 season in which Canadian Hutterite children were vaccinated against influenza. We used inverse probability weighting to calculate the indirect and direct effect of vaccination against influenza A/H3N2 and influenza B/Brisbane using HAI titres and overall vaccine efficacy.

RESULTS

We included data on 617 children from 46 Hutterite colonies, aged between 3 and 15 years who were vaccinated with either inactivated trivalent influenza vaccine or hepatitis A vaccine. Vaccine efficacy was 63 % for influenza A (H3N2) and 28 % for influenza B. The hazard ratio for protection against influenza A/H3N2 due to an indirect effect of vaccination was 0.96 (95 % confidence interval (CI) of 0.00 to 2.89) while for the direct effect it was 0.38 (95 % CI of 0.00 to 5.47). The hazard ratio for influenza B indirect effect was 0.75 (95 % CI of 0.07 to 1) and for the direct effect 0.96 (95 % CI of 0.00 to 12.02). In contrast, repeating the analysis using microneutralization in a subgroup of 488 children revealed that the protective effect for vaccination for A/H3N2 was entirely mediated by antibodies but only for 13 % for influenza B.

CONCLUSIONS

Although vaccination provided higher protective effectiveness against influenza A than B, most of the influenza A vaccine efficacy likely occurred through antibodies other than what could be detected by HAI titres. In contrast, for influenza B, while the HAI titres appeared to mediate most of the vaccine effectiveness, this was not confirmed by microneutralization analysis.

摘要

背景

流感疫苗接种可通过体液免疫应答、细胞免疫应答或可能两者共同发挥作用而起到保护作用。接种疫苗后的免疫可以通过血清血凝抑制（HAI）滴度升高所检测到的抗体来介导。我们的目的是通过测量 HAI 滴度（间接效应）与通过其他免疫机制（直接效应）诱导的流感 A 和 B 的保护比例来调查通过抗体介导的流感保护比例。

方法

我们分析了 2008-2009 季节期间在加拿大 Hutterite 儿童中进行的一项针对流感的随机对照试验的数据。我们使用逆概率加权法，根据 HAI 滴度和总体疫苗效力，计算针对流感 A/H3N2 和流感 B/Brisbane 的疫苗接种的间接和直接效应。

结果

我们纳入了来自 46 个 Hutterite 殖民地的 617 名年龄在 3 至 15 岁之间接种了灭活三价流感疫苗或甲型肝炎疫苗的儿童的数据。流感 A（H3N2）疫苗效力为 63%，流感 B 疫苗效力为 28%。由于疫苗接种的间接效应而对流感 A/H3N2 的保护的风险比为 0.96（95%置信区间（CI）为 0.00 至 2.89），而直接效应的风险比为 0.38（95%CI 为 0.00 至 5.47）。流感 B 间接效应的风险比为 0.75（95%CI 为 0.07 至 1），而直接效应的风险比为 0.96（95%CI 为 0.00 至 12.02）。相比之下，在 488 名儿童的亚组中重复使用微量中和试验的分析表明，接种疫苗对 A/H3N2 的保护作用完全通过抗体介导，但对于流感 B 仅为 13%。