Variable efficacy of repeated annual influenza vaccination
Variable efficacy of repeated annual influenza vaccination
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DOI：
10.1073/pnas.96.24.14001
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发表时间：
1999-11-23
影响因子：
11.1
通讯作者：
Perelson, AS
中科院分区：
文献类型：
--
作者：
Smith, DJ;Forrest, S;Perelson, AS
在比较首次接种流感疫苗组与接种一次以上组的疫苗效力的研究中，结论存在差异。例如，霍斯金斯研究[霍斯金斯，T. W.戴维斯，J.R.，史密斯，A. J.，米勒，C. L. & Allchin，A.（1979）Lancet i，33-35]得出结论，重复接种在长期内没有保护性，而Keitel研究[Keitel. W.一、盖特R.，库奇河a.将所述第一哈金斯L. J，& Hess，K. R.（1997）Vaccine 15，1114-1122]得出结论，重复接种提供了持续的保护。我们提出了一个解释，抗原距离假说，并通过分析霍斯金斯和凯特尔研究期间发生的七次流感暴发来检验它。假设重复疫苗效力的变化是由于疫苗株之间以及疫苗株与每次暴发流行株之间的抗原距离差异所致。为了检验该假设，根据历史血凝抑制试验表计算抗原距离，并使用免疫应答的计算机模型预测给予不同疫苗接种的个体的疫苗效力。该模型准确预测了重复接种者中观察到的疫苗效力相对于首次接种者的效力（相关性0.87）。因此，抗原距离假说为霍斯金斯和凯特尔研究之间和研究内部的差异提供了一个简洁的解释。这些结果对流感疫苗株的选择以及可能需要重复接种的其他抗原可变病原体的疫苗接种策略具有意义。
Conclusions have differed in studies that have compared vaccine efficacy in groups receiving influenza Vaccine for the first time to efficacy in groups vaccinated more than once. For example, the Hoskins study [Hoskins, T. W. Davis, J. R., Smith, A. J., Miller, C. L. & Allchin, A. (1979) Lancet i, 33-35] concluded that repeat vaccination was not protective in the long term, whereas the Keitel study [Keitel. W. A., Gate, T. R., Couch, R. a., Huggins. L. L, & Hess, K. R. (1997) Vaccine 15, 1114-1122] concluded that repeat vaccination provided continual protection. We propose an explanation, the antigenic distance hypothesis, and test it by analyzing seven influenza outbreaks that occurred during the Hoskins and Keitel studies. The hypothesis is that variation in repeat vaccine efficacy is due to differences in antigenic distances among Vaccine strains and between the vaccine strains and the epidemic strain in each outbreak. To test the hypothesis, antigenic distances were calculated from historical hemagglutination inhibition assay tables, and a computer model of the immune response was used to predict the Vaccine efficacy of individuals given different vaccinations. The model accurately predicted the observed Vaccine efficacies in repeat vaccinees relative to the efficacy in first-time vaccinees (correlation 0.87). Thus, the antigenic distance hypothesis offers a parsimonious explanation of the differences between and within the Hoskins and Keitel studies. These results have implications for the selection of influenza vaccine strains, and also for Vaccination strategies for other antigenically variable pathogens that might require repeated vaccination.