流感灭活疫苗免疫持久性的Meta分析  

Immunity persistence of inactivated influenza vaccine:A meta-analysis

作　　者：胡昱[1] 龚杰 Hu Yu;Gong Jie(Institute of Immunization and Prevention,Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310051,China;Institute of Health Policy,Hangzhou Medical College,Hangzhou 310013,China)

机构地区：[1]浙江省疾病预防控制中心免疫规划所,杭州310051 [2]杭州医学院卫生健康政策研究院,杭州310013

出　　处：《国际流行病学传染病学杂志》2024年第4期251-257,共7页International Journal of Epidemiology and Infectious Disease

摘　　要：目的评价流感灭活疫苗(inactivated influenza vaccine,IIV)免疫持久性。方法检索美国国家医学图书馆数据库、考克兰Cochrane协作网图书馆、美国临床试验数据库等外文电子数据库、中国生物医学文献数据库、中国期刊全文数据库、万方全文数据库,将评价≥6月龄健康人群接种IIV的免疫原性研究纳入本次分析,合并计算疫苗接种前和接种后不同时间点,不同疫苗毒株的抗体几何平均滴度(geometric mean titer,GMT)的均数差(mean difference,MD),以及血清抗体保护率(seroprotection rate,SPR)的率差(risk difference,RD)。使用Review Manager 5.4进行Meta分析。结果共纳入8篇文献,包括6篇随机对照试验和2篇队列研究。接种佐剂IIV3(IIV3-adj)或IIV3/IIV4疫苗后6个月,儿童和成人的血清抗体GMT和SPR水平显著提高,其中儿童接种IIV3-adj的GMT MD为2.50(95%CI:2.06~2.94),SPR RD为0.62(95%CI:0.50~0.74);成人接种IIV3-adj的GMT MD为0.71(95%CI:0.47~0.95),SPR RD为0.19(95%CI:0.11~0.28)。同时,儿童和成人接种IIV3-adj和IIV3后1个月和6个月的血清抗体GMT和SPR水平均呈现明显下降趋势,其中儿童1个月时GMT的MD为1.17(95%CI:0.78~1.56),6个月时降至0.98(95%CI:0.77~1.18),SPR在1个月时的RD为0.30(95%CI:0.06~0.53),6个月时降至0.29(95%CI:0.14~0.44);成人1个月时GMT的MD为0.27(95%CI:0.20~0.33),6个月时降至0.21(95%CI:0.12~0.29),SPR在1个月时的RD为0.06(95%CI:0.01~0.11),6个月时降至0.06(95%CI:-0.02~0.15)。结论IIV免疫持久性至少可以维持一个完整的流感流行季,建议在流感流行季到来之前完成IIV接种。Objective To evaluate the immunity persistence of inactivated influenza vaccine(IIV).Methods Searching National Center for Biotechnology Information,Cochrane Library,China Biology Medicine disc,China National Knowledge Infrastructure,Wanfang Database,studies assessing the immunogenicity of IIV in healthy individuals aged≥6 months were included.Pooled mean difference(MD)of geometric mean titer(GMT)and pooled risk difference(RD)of seroprotection rate(SPR)of antibody against each vaccine strains were calculated at different time points before and after IIV immunization.Meta-analysis was made by Review Manager 5.4 software.Results A total of 8 studies were included,consisting of 6 randomized controlled trials and 2 cohort studies.Six months after vaccination with adjuvanted IIV3(IIV3-adi)or IV3/IIV4,the serum antibody GMT and SPR levels in children and adults significantly increased.For children receiving IIV3-adj,the MD of GMT was 2.50(95%CI:2.06-2.94),and the RD of SPR was 0.62(95%CI:0.50-0.74).For adults receiving IIV3-adj,the MD of GMT was 0.71(95%CI:0.47-0.95),and the RD of SPR was 0.19(95%CI:0.11-0.28).Additionally,both children and adults showed a significant decline in serum antibody GMT and SPR levels at 1 month and 6 months after receiving IIV3-adj and IIV3.In children,the MD of GMT was 1.17(95%CI:0.78-1.56)at 1 month,decreasing to 0.98(95%CI:0.77-1.18)at 6 months.While,the RD of SPR was 0.30(95%CI:0.06-0.53)at 1 month,decreasing to 0.29(95%CI:0.14-0.44)at 6 months.In adults,the MD of GMT was 0.27(95%CI:0.20-0.33)at 1 month,decreasing to 0.21(95%CI:0.12-0.29)at 6 months.While,the RD of SPR was 0.06(95%CI:0.01-0.11)at 1 month,decreasing to 0.06(95%CI:-0.02-0.15)at 6 months.Conclusions The immunogenicity of IIV can be sustained for at least a full influenza season,and it is recommended to complete IIV vaccination before the onset of the influenza season.

关 键 词：流感灭活病毒疫苗 免疫效果 持久性 META分析 血清抗体保护率 

分 类 号：R186[医药卫生—流行病学] G353.1[医药卫生—公共卫生与预防医学]