Both hemispheric influenza vaccine recommendations would have missed near half of the circulating viruses in Madagascar.
Both hemispheric influenza vaccine recommendations would have missed near half of the circulating viruses in Madagascar.
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DOI：
10.1111/irv.12517
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发表时间：
2017-11
影响因子：
4.4
通讯作者：
Alonso WJ
中科院分区：
文献类型：
--
作者：
Guillebaud J;Héraud JM;Razanajatovo NH;Livinski AA;Alonso WJ
由于流感传播模式复杂，流感免疫仍然在全球范围内构成严峻挑战，特别是对于热带地区。热带地区应根据当地监测情况选择世界卫生组织北半球或南半球推荐的疫苗成分。对流感免疫效果的分析忽略了每年避免引起感染的循环病毒的比例。我们针对马达加斯加调查了这个问题，因为那里的流感疫苗尚未广泛普及。 2002 年至 2014 年鉴定的 78 种马达加斯加流感毒株面临假设场景的挑战，其中向民众提供了世界卫生组织北半球和南半球推荐的疫苗组合物。通过血凝抑制测定来确定循环毒株和疫苗毒株之间的匹配。假设有 9 个月的保护期，则对毒株特异性阳性匹配进行评分，并且考虑了疫苗延迟 0 到 5 个月的情况。疫苗一经交付，马达加斯加流感毒株与北半球和南半球推荐疫苗毒株的匹配度分别为 54% 和 44%。当考虑额外的交付和应用程序延迟时，匹配值进一步下降。推荐组合物之间的差异不具有统计学显着性。我们的结果显示，即使在更有利的情况下，与北半球疫苗的匹配率也仅略高于 50%。这表明，如果实施，常规流感疫苗将无法针对马达加斯加任何流行季节流行的一半流感病毒株提供最佳保护。我们建议，流感疫苗功效的这种限制值得更多关注，并应在国家流感免疫规划的成本/效益分析中予以考虑。
Influenza immunization still poses a critical challenge globally and specifically for tropical regions due to their complex influenza circulation pattern. Tropical regions should select the WHO's Northern Hemisphere or Southern Hemisphere recommended vaccine composition based on local surveillance. Analyses of influenza immunization effectiveness have neglected to account for the proportion of circulating viruses prevented from causing infection each year. We investigate this question for Madagascar, where influenza vaccines are not widely available. Seventy‐eight Malagasy influenza strains characterized from 2002 to 2014 were challenged with hypothetical scenarios in which the WHO's Northern Hemisphere and Southern Hemisphere recommended vaccine compositions were provided to the population. Match between circulating and vaccine strains was determined by haemagglutination inhibition assays. Strain‐specific positive matches were scored assuming 9 months of protection, and scenarios incorporated vaccine delays from zero to 5 months. Malagasy influenza strains matched 54% and 44%, respectively, with the Northern Hemisphere and Southern Hemisphere recommended vaccine strains when the vaccine was delivered as soon as available. The matching values further decreased when additional delivery and application delays were considered. Differences between recommended compositions were not statistically significant. Our results showed matching with the Northern Hemisphere vaccine barely above 50%, even in the more favourable scenario. This suggests that if implemented, routine influenza vaccines would not provide an optimal protection against half of the influenza strains circulating in any epidemic season of Madagascar. We suggest that this limitation in influenza vaccine efficacy deserves greater attention, and should be considered in cost/benefit analyses of national influenza immunization programmes.
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影响因子：
9.3
作者：
Tricco AC;Chit A;Soobiah C;Hallett D;Meier G;Chen MH;Tashkandi M;Bauch CT;Loeb M
通讯作者：
Loeb M
影响因子：
5
作者：
Alonso, Wladimir J.;Viboud, Cecile;Miller, Mark A.
通讯作者：
Miller, Mark A.
影响因子：
4.4
作者：
Kelly, Heath A.;Sullivan, Sheena G.;Fielding, James E.
通讯作者：
Fielding, James E.
影响因子：
6.4
作者：
Skowronski, Danuta M.;De Serres, Gaston;Li, Yan
通讯作者：
Li, Yan
影响因子：
5.5
作者：
Waiboci, Lilian W.;Mott, Joshua A.;Katz, Mark A.
通讯作者：
Katz, Mark A.