Enhancing Immunogenicity of Influenza Vaccine in the Elderly through Intradermal Vaccination: A Literature Analysis.
Enhancing Immunogenicity of Influenza Vaccine in the Elderly through Intradermal Vaccination: A Literature Analysis.
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DOI：
10.3390/v14112438
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发表时间：
2022-11-03
期刊：
影响因子：
--
通讯作者：
Kennedy RB
中科院分区：
文献类型：
--
作者：
Quach HQ;Kennedy RB
背景：老龄化和免疫衰老导致老年人的免疫反应逐渐下降，这一年龄段的流感疫苗的免疫原性次之。为了提高流感疫苗在老年人中的免疫原性，人们探索了几种方法，包括加入疫苗佐剂、增加抗原剂量和改变疫苗接种途径。方法：我们系统地比较了经皮内(ID)途径和肌肉(IM)或皮下(SC)途径接种的流感疫苗在≥65岁老年人中的免疫原性和安全性。结果：在纳入分析的17项研究中，3项研究比较了ID疫苗和SC疫苗的免疫原性，14项研究比较了ID疫苗和IM疫苗。在相同剂量下，ID疫苗接种通常比IM和SC途径更具免疫原性。重要的是，在ID流感疫苗中可以配制出至少3微克的血凝素抗原，而不会显著丧失免疫原性。免疫接种标准剂量的非佐剂流感疫苗与肌注佐剂流感疫苗具有相同的免疫原性。流感特异性免疫力在6个月后显著减弱，但ID、IM或SC途径接种之间的免疫力减弱没有差异。虽然ID疫苗接种引起的局部不良反应比其他途径更多，但这些反应轻微，持续时间不超过3天。结论：ID疫苗接种优于IM或SC途径，可能是弥补老年人免疫原性降低的一种合适方法。我们还得出结论，ID流感疫苗的主要好处在于它的剂量节约效应。进一步开发更具免疫原性的ID流感疫苗仍需进一步研究。
Background: Aging and immunosenescence lead to a gradual decline in immune responses in the elderly and the immunogenicity of influenza vaccines in this age group is sub-optimal. Several approaches have been explored to enhance the immunogenicity of influenza vaccines in the elderly, including incorporating vaccine adjuvant, increasing antigen dosage, and changing the route of vaccine administration. Method: We systematically compared the immunogenicity and safety of influenza vaccines administered by intradermal (ID) route and either intramuscular (IM) or subcutaneous (SC) routes in older adults aged ≥ 65. Results: Of 17 studies included in this analysis, 3 studies compared the immunogenicity of ID vaccination to that of SC vaccination and 14 studies compared ID and IM vaccinations. ID vaccination was typically more immunogenic than both IM and SC routes at the same dosage. Importantly, a minimum of 3 µg of hemagglutinin antigen could be formulated in an ID influenza vaccine without a significant loss of immunogenicity. ID administration of standard-dose, unadjuvanted influenza vaccine was as immunogenic as IM injection of adjuvanted influenza vaccine. Waning of influenza-specific immunity was significant after 6 months, but there was no difference in waning immunity between vaccinations in ID, IM, or SC routes. While ID vaccination elicited local adverse reactions more frequently than other routes, these reactions were mild and lasted for no more than 3 days. Conclusions: We conclude that ID vaccination is superior to IM or SC routes and may be a suitable approach to compensate for the reduced immunogenicity observed in elderly adults. We also conclude that the main benefit of ID influenza vaccine lies in its dose-sparing effect. Additional research is still needed to further develop a more immunogenic ID influenza vaccine.
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