The effect of antipyretics on immune response and fever following receipt of inactivated influenza vaccine in young children.
The effect of antipyretics on immune response and fever following receipt of inactivated influenza vaccine in young children.
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DOI：
10.1016/j.vaccine.2017.10.020
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发表时间：
2017-12-04
期刊：
影响因子：
5.5
通讯作者：
Broder KR
中科院分区：
文献类型：
--
作者：
Walter EB;Hornik CP;Grohskopf L;McGee CE;Todd CA;Museru OI;Harrington L;Broder KR
退烧药可在儿童接种疫苗后降低发烧；灭活流感疫苗（IIV）后，它们可能改善发烧，从而降低热性癫痫发作的风险，但也可能减弱免疫反应。我们评估了退烧药对6 - 47个月儿童免疫应答和iv后发热的影响。在三个季节的过程中，142名儿童，接受单一剂量或两种推荐剂量中的第一剂量的IIV，随机分配接受口服对乙酰氨基酚混悬液（n=59）或安慰剂（n=59）（双盲）或布洛芬（n=24）（开放标签）立即IIV，此后每4至8小时24小时。在入组时和最后一次推荐iv剂量后4周采集血液样本。通过血凝抑制试验（HAI）评估对iv的反应。血清保护定义为HAI滴度≥1:40，如果基线滴度< 1:10，则血清转化为滴度≥1:40，如果基线滴度≥1:10，则血清转化为滴度升高4倍。在iv的当天和第二天监测参与者的发烧和其他征求症状。在整个研究过程中，未观察到不同解热组和安慰剂组儿童的血清转换和疫苗接种后血清保护的显著差异。在治疗组和安慰剂组之间，征求症状（包括发烧）的频率相似。当对接受静脉注射的幼儿使用退烧药时，未观察到明显的免疫反应钝化。需要更大样本量的研究来确定退烧药对iv免疫原性的影响。
Antipyretics reduce fever following childhood vaccinations; after inactivated influenza vaccine (IIV) they might ameliorate fever and thereby decrease febrile seizure risk, but also possibly blunt the immune response. We assessed the effect of antipyretics on immune responses and fever following IIV in children ages 6 through 47 months. Over the course of three seasons, one hundred forty-two children, receiving either a single or the first of 2 recommended doses of IIV, were randomized to receive either oral acetaminophen suspension (n=59) or placebo (n=59) (double-blinded) or ibuprofen (n=24) (open-label) immediately following IIV and every 4 to 8 hours thereafter for 24 hours. Blood samples were obtained at enrollment and 4 weeks following the last recommended IIV dose. Responses to IIV were assessed by hemagglutination inhibition assay (HAI). Seroprotection was defined as an HAI titer ≥ 1:40 and seroconversion as a titer ≥ 1:40 if baseline titer < 1:10 or fourfold rise if baseline titer ≥1:10. Participants were monitored for fever and other solicited symptoms on the day of and day following IIV. Significant differences in seroconversion and post-vaccination seroprotection were not observed between children included in the different antipyretic groups and the placebo group for the vaccine antigens included in IIV over the course of the studies. Frequencies of solicited symptoms, including fever, were similar between treatment groups and the placebo group. Significant blunting of the immune response was not observed when antipyretics were administered to young children receiving IIV. Studies with larger sample sizes are needed to definitively establish the effect of antipyretics on IIV immunogenicity.
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DOI：
10.1016/0928-0197(93)90021-v
发表时间：
1993-07-01
期刊：
Clinical and diagnostic virology
影响因子：
--
作者：
Chernesky, M;O'Neill, D;Mahony, J
通讯作者：
Mahony, J
影响因子：
8
作者：
Englund, JA;Walter, EB;Neuzil, KM
通讯作者：
Neuzil, KM
影响因子：
2.4
作者：
Rose, Markus A.;Juergens, Christine;Zielen, Stefan
通讯作者：
Zielen, Stefan
影响因子：
8.8
作者：
Grohskopf, Lisa A.;Sokolow, Leslie Z.;Karron, Ruth A.
通讯作者：
Karron, Ruth A.
影响因子：
168.9
作者：
Prymula, Roman;Siegrist, Claire-Anne;Schuerman, Lode
通讯作者：
Schuerman, Lode