Govaert T M, Thijs C T, Masurel N, Sprenger M J, Dinant G J, Knottnerus J A
Department of General Practice, University of Limburg, Maastricht, The Netherlands.
JAMA. 1994 Dec 7;272(21):1661-5.
To determine the efficacy of influenza vaccination in elderly people.
Randomized double-blind placebo-controlled trial.
Fifteen family practices in the Netherlands during influenza season 1991-1992.
A total of 1838 subjects aged 60 years or older, not known as belonging to those high-risk groups in which vaccination was previously given.
Purified split-virion vaccine containing A/Singapore/6/86(H1N1), A/Beijing/353/89(H3N2), B/Beijing/1/87, and B/Panama/45/90 (n = 927) or intramuscular placebo containing physiological saline solution (n = 911).
Patients presenting with influenzalike illness up to 5 months after vaccination; self-reported influenza in postal questionnaires 10 weeks and 5 months after vaccination; serological influenza (fourfold increase of antibody titer between 3 weeks and 5 months after vaccination).
The incidence of serological influenza was 4% in the vaccine group and 9% in the placebo group (relative risk [RR], 0.50; 95% confidence interval [CI], 0.35 to 0.61). The incidences of clinical influenza were 2% and 3%, respectively (RR, 0.53; 95% CI, 0.39 to 0.73). The effect was strongest for the combination of serological and clinical influenza (RR, 0.42; 95% CI, 0.23 to 0.74). The effect was less pronounced for self-reported influenza.
In the elderly, influenza vaccination may halve the incidence of serological and clinical influenza (in periods of antigenic drift).
确定流感疫苗对老年人的疗效。
随机双盲安慰剂对照试验。
1991 - 1992年流感季节期间荷兰的15个家庭诊所。
总共1838名60岁及以上的受试者，不属于先前接种疫苗的高危人群。
含A/新加坡/6/86(H1N1)、A/北京/353/89(H3N2)、B/北京/1/87和B/巴拿马/45/90的纯化裂解病毒疫苗（n = 927）或含生理盐水的肌肉注射安慰剂（n = 911）。
接种疫苗后长达5个月出现流感样疾病的患者；接种疫苗10周和5个月后邮寄问卷调查中自我报告的流感；血清学流感（接种疫苗后3周和5个月之间抗体滴度增加四倍）。
疫苗组血清学流感的发生率为4%，安慰剂组为9%（相对危险度[RR]，0.50；95%置信区间[CI]，0.35至0.61）。临床流感的发生率分别为2%和3%（RR，0.53；95%CI，0.39至0.73）。血清学和临床流感联合的效果最强（RR，0.42；95%CI，0.23至0.74）。自我报告的流感效果不太明显。
在老年人中，流感疫苗接种可能会使血清学和临床流感的发生率减半（在抗原漂移期）。
