Influenza vaccine failure: failure to protect or failure to understand?
Influenza vaccine failure: failure to protect or failure to understand?
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DOI：
10.1080/14760584.2018.1484284
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发表时间：
2018-06
影响因子：
6.2
通讯作者：
Poland GA
中科院分区：
文献类型：
--
作者：
Poland GA
我建议将流感疫苗失败定义为收到正确储存和施用的疫苗，随后出现记录在案的流感。疫苗失败的多种机制可能会发生，有时会组合起来导致所谓的“疫苗失败”。流感疫苗失败的原因有多种，其中许多原因并不是疫苗真正的失败（例如，疫苗储存和处理不当）。在本文中，我讨论了“疫苗失败”的常见原因，这些原因可以适当或不适当地归因于疫苗。这包括宿主、病原体、疫苗和研究设计问题，例如免疫反应的遗传限制；未能正确储存、处理和施用疫苗；免疫抑制和免疫衰老问题；明显但虚假的疫苗失败；时间介导的失败；和其他人。疫苗失败的正确框架和疾病分类学可以为有关流感疫苗功效的讨论提供信息，并防止误解，进而影响疫苗的吸收。流感疫苗只有在流行毒株与疫苗毒株紧密匹配的情况下才能提供最大程度的保护；疫苗在规定的时间内正确储存、处理和施用，以产生保护性免疫水平；并施用于能够通过保护性免疫反应进行免疫反应的宿主。
I propose that influenza vaccine failure be defined as receipt of a properly stored and administered vaccine with the subsequent development of documented influenza. Several mechanisms of vaccine failure occur and can—sometimes in combination—lead to what is termed “vaccine failure.” Influenza vaccine failure occurs for a variety of reasons, many of which are not true failures of the vaccine (e.g., improper vaccine storage and handling). In this article, I discuss common causes of “vaccine failure” that are appropriately or inappropriately attributed to vaccines. This includes host, pathogen, vaccine, and study design issues such as, genetic restriction of immune response; failure to store, handle and administer vaccine properly; issues of immunosuppression and immunosenescence; apparent but false vaccine failure; time-mediated failure; and others. A proper framework and nosology for vaccine failure informs discussion about influenza vaccine efficacy and prevents misperceptions that in turn affect vaccine uptake. Influenza vaccine can only provide maximum protection to the extent that the circulating and vaccine strains closely match; the vaccine is stored, handled and administered properly and within a time frame to result in development of protective levels of immunity; and is administered to a host capable of immunologically responding with protective immune responses.
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