Fluad®-MF59®-Adjuvanted Influenza Vaccine in Older Adults.
Fluad®-MF59®-Adjuvanted Influenza Vaccine in Older Adults.
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老年人的Fluad®-MF59®辅助流感疫苗。
DOI：
10.3947/ic.2013.45.2.159
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发表时间：
2013-06
影响因子：
4.2
通讯作者：
Tsai TF
中科院分区：
文献类型：
--
作者：
Tsai TF
流感直接或间接导致全球四大主要死亡原因，其中老年人的死亡率最高。由于韩国人口中老年人的比例高于大多数其他国家，因此预防流感是韩国比其他地方更重要的公共卫生重点。传统灭活流感疫苗（IIV）在老年人中的免疫原性和有效性低于年轻人（-50%），但用水浸油乳剂MF59®佐剂疫苗可增加免疫原性，导致血凝抑制抗体水平相对较高，对所有流感以及需要住院治疗的病例具有更强的保护作用。最近的一项观察性研究表明，在非佐剂iv无效的一年中，佐剂疫苗可以保护老年人免受流感的侵害。在另一项多年的研究中，与未加佐剂的疫苗相比，加佐剂疫苗在预防肺炎和流感住院方面的有效性估计提高了25%。虽然mf59佐剂疫苗暂时比非佐剂疫苗更具反应性，但没有证据表明它增加了严重不良事件的风险，包括那些具有自身免疫性病因的不良事件。迄今为止的经验表明，MF59的利益与风险之间的平衡是有利的。这可能反映了佐剂的作用机制，其中角鲨烯油乳剂增加了对共同给药抗原的抗体反应，而不是更普遍地作为免疫增强剂。
Influenza directly or indirectly contributes to the four leading causes of global mortality, at rates that are highest in older adults. As the proportion of older adults in the Korean population is greater than in most other countries, influenza prevention is a greater public health priority in Korea than elsewhere. Conventional inactivated influenza vaccine (IIV) is less immunogenic and efficacious (-50%) in older than in young adults, but adjuvanting the vaccine with oil-in-water emulsion MF59® increases immunogenicity, resulting in comparatively higher levels of hemagglutination inhibition antibodies and greater protection against all influenza, as well as cases requiring hospitalization. A recent observational study demonstrated that the adjuvanted vaccine protected older adults against influenza in a year when nonadjuvanted IIV was ineffective. In another multiyear study, the adjuvanted vaccine was estimated to be 25% more effective in preventing pneumonia and influenza hospitalizations compared to nonadjuvanted vaccine. Although MF59-adjuvanted vaccine is transiently more reactogenic than nonadjuvanted vaccine, there is no evidence that it increases risks for serious adverse events, including those with an autoimmune etiology. Experience thus far indicates a favorable balance of benefit to risk for MF59. This may reflect the adjuvant's mechanism of action in which the squalene oil emulsion increases antibody responses to co-administered antigen without acting more generally as an immunopotentiator.