Efficacy of live attenuated influenza vaccine in children against influenza B viruses by lineage and antigenic similarity
Efficacy of live attenuated influenza vaccine in children against influenza B viruses by lineage and antigenic similarity
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DOI：
10.1016/j.vaccine.2009.11.068
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发表时间：
2010-02-25
期刊：
影响因子：
5.5
通讯作者：
Wu, Xionghua
中科院分区：
文献类型：
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作者：
Belshe, Robert B.;Coelingh, Kathleen;Wu, Xionghua
季节性流感疫苗，包括减毒流感活疫苗（LAIV），含有三种疫苗株（两种A型和一种B型）。理想情况下，推荐疫苗株的血凝素抗原与流行野生型毒株在抗原性上相似;实际上，由于间歇性的基因重配和持续的抗原漂移，每年流行毒株和疫苗株之间的抗原匹配可能会有显着差异。对于B型流感，抗原相关性由于存在两种不同谱系而进一步复杂化。因此，B型流感疫苗组分可以具有与流行毒株完全不同的抗原谱系。使用来自9项幼儿（6个月至6岁）随机临床试验的数据，评估了LAIV对B型流感病毒株的疫苗有效性。在综合分析中，两剂LAIV在未接种过疫苗的儿童中对相同谱系且与疫苗株密切匹配的B毒株的疫苗效力为86%，对相同谱系但抗原性偏离疫苗株的毒株的效力为55%，对相反B谱系且抗原性与疫苗株无关的毒株的效力为31%。这些数据提供了对当前三价疫苗提供的保护的更准确的评估，并强调了对提供针对两种B型流感谱系的增强保护的疫苗接种策略的需要，例如四价流感疫苗。(C)2009年由Elsevier Ltd.出版
Seasonal influenza vaccines, including live attenuated influenza vaccine (LAIV), contain three vaccine strains (two type A and one type B). Ideally, the hemagglutinin antigens of the recommended vaccine strains are antigenically similar to epidemic wild-type strains; in actuality, the antigenic match between circulating and vaccine strains each year can vary significantly owing to intermittent genetic reassortment and continuous antigenic drift. For influenza B, antigenic relatedness is further complicated by the existence of two distinct lineages. Consequently, the influenza B vaccine component can be of a completely different antigenic lineage from the circulating epidemic strains. Using data from nine randomized clinical trials in young children (6 months to 6 years of age), vaccine efficacy of LAIV against influenza B strains was assessed across this spectrum of antigenic relatedness. In an integrated analysis, vaccine efficacy of two doses of LAIV in vaccine-naive children was 86% against B strains of the same lineage and closely matched to the vaccine strain, 55% against strains of the same lineage but antigenically drifted from the vaccine strain, and 31% against strains of the opposite B lineage and antigenically unrelated to the vaccine strain. These data provide a more accurate assessment of the protection provided by the current trivalent vaccine and highlight the need for vaccination strategies that provide enhanced protection against both lineages of influenza B such as a quadrivalent influenza vaccine. (C) 2009 Published by Elsevier Ltd.