Abstract：Objective To evaluate the year-round vaccine persistency of trivalent inactivated influenza vaccine （TIV） among elderly aged 65 years and above. Methods Searching “National Center for Biotechnology Information”,“ Cochrane Library,CL”,“China Biology Medicine disc”,“China National Knowledge Infrastructure”,“Wanfang Database”,the studies of the year-round vaccine persistency of trivalent inactivated influenza vaccine among the elderly aged 65 years and above were included,and meta-analysis were made by Stata 11.0 software. Results A total of 17 studies were included. Compared with the antibody level before immunization,the standard mean differences （SMDs） of geometric mean titer （GMT） was 0.10（95%CI：-0.12-0.32）,0.57（95%CI：0.23-0.91）,0.47（95%CI：-0.20-1.15） and -0.27（95%CI：-0.51--0.04） for the total haemagglutination inhibition （HI） antibody,the HI antibody of A/H1N1,the HI antibody of A/H3N2 and the HI antibody of B,respectively,by 360 day. The risk differences （RD） of sero-protection rate （SP） was 0.06（95%CI：-0.04-0.16）,0.09（95%CI：-0.15-0.33）,-0.08（95%CI：-0.28-0.13） and 0.00（95%CI：-0.13 - -0.13） for the total haemagglutination inhibition （HI） antibody,the HI antibody of A/H1N1,the HI antibody of A/H3N2 and the HI antibody of B,respectively,by 360 day. Conclusion The HI antibody responses following TIV vaccination do not reliably persist year-round in the elderly aged 65 years and above. Clinic trials and health economic evaluation studies are needed to assess the feasibility and cost-effectiveness of multiple doses schedule of TIV in elderly.
胡昱, 李倩, 汪颖, 陈雅萍. 65岁及以上老年人接种TIV一年内免疫持久性的Meta分析[J]. 预防医学, 2017, 29(11): 1109-1114,1118.
HU Yu, LI Qian, WANG Ying, CHEN Ya-ping. A meta-analysis of the year-round vaccine persistency of trivalent inactivated influenza vaccine among elderly aged 65 years and above. Preventive Medicine, 2017, 29(11): 1109-1114,1118.
[1] BRANDENBURG B,KOUDSTAAL W,GOUDSMIT J,et al. Mechanisms of hemagglutinin targeted influenza virus neutralization[J]. PLoS ONE,2013,8（12）：e80034. [2] ANDREWS N,MCMENAMIN J,DURNALL H,et al. Effectiveness of trivalent seasonal influenza vaccine in preventing laboratory-confirmed influenza in primary care in the United Kingdom：2012/13 end of season results[J]. Eurosurveillance,2014,19（27）：20851. [3] CASTILLA J,MART I NEZ-BAZ I,MARTÍNEZ-ARTOLA V,et al. Decline in influenza vaccine effectiveness with time after vaccination,Navarre,Spain,season 2011/12[R]. Surveillance and Outbreak Reports,2013,18（5）：17-24. [4] SKOWRONSKI D M,TWEED S A,DE SERRES G. Rapid decline of influenza vaccine-induced antibody in the elderly：is it real,or is it relevant?[J]. J Infect Dis,2008,197（4）：490-502. [5] GUYATT G H,OXMAN A D,VIST G E,et al. GRADE：an emerging consensus on rating quality of evidence and strength of recommendations[J]. BMJ,2008,336（7650）：924-926. [6] MINUTELLO M,SENATORE F,CECCHINELLI G,et al. Safety and immunogenicity of an inactivated subunit influenza virus vaccine combined with MF59 adjuvant emulsion in elderly subjects,immunized for three consecutive influenza seasons[J]. Vaccine,1999,17（2）：99-104. [7] VAN HOECKE C,PRIKAZSKY V,UTÖI,et al. Immunogenicity of an inactivated split influenza vaccine in institutionalized elderly patients[J]. Gerontology,1996,42（4）：190-198. [8] BUXTON J A,SKOWRONSKI D M,NG H,et al. Influenza revaccination of elderly travelers：antibody response to single influenza vaccination and revaccination at 12 weeks[J]. J Infect Dis,2001,184（2）：188-191. [9] IORIO A M,CAMILLONI B,BASILEO M,et al. Effects of repeated annual influenza vaccination on antibody responses against unchanged vaccine antigens in elderly frail institutionalized volunteers[J]. Gerontology,2007,53（6）：411-418. [10] BEN-YEHUDA A,JOSEPH A,BARENHOLZ Y,et al. Immunogenicity and safety of a novel IL-2-supplemented liposomal influenza vaccine （INFLUSOME-VAC） in nursing-home residents[J]. Vaccine,2003,21（23）：3169-3178. [11] SONG J Y,CHEONG H J,HWANG I S,et al. Long-term immunogenicity of influenza vaccine among the elderly：Risk factors for poor immune response and persistence[J]. Vaccine,2010,28（23）：3929-3935. [12] RÜMKE H C,RICHARDUS J H,ROMBO L,et al. Selection of an adjuvant for seasonal influenza vaccine in elderly people：modelling immunogenicity from a randomized trial[J]. BMC Infect Dis,2013,13：348. [13] COUCH R B,BAYAS J M,CASO C,et al. Superior antigen-specific CD4+ T-cell response with AS03-adjuvantation of a trivalent influenza vaccine in a randomised trial of adults aged 65 and older[J]. BMC Infect Dis,2014,14：425. [14] MCELHANEY J E,BERAN J,DEVASTER J M,et al. AS03-adjuvanted versus non-adjuvanted inactivated trivalent influenza vaccine against seasonal influenza in elderly people：a phase 3 randomised trial[J]. The Lancet Infectious Diseases,2013,13（6）：485-496. [15] SONG J Y,CHEONG H J,NOH JY,SEO YB,CHOI WS,CHO G J,et al. Long-term and cross-reactive immunogenicity of inactivated trivalent influenza vaccine in the elderly：MF59-adjuvanted vaccine versus unadjuvanted vaccine[J]. J Med Virol, 2013,85：1591-1597. [16] TINOCO J C,PAVIA-RUZ N,CRUZ-VALDEZ A,et al. Immunogenicity,reactogenicity,and safety of inactivated quadrivalent influenza vaccine candidate versus inactivated trivalent influenza vaccine in healthy adults aged≥18 years：a phase III,randomized trial[J]. Vaccine,2014,32（13）：1480-1487. [17] FREY S E,REYES M R,REYNALES H,et al. Comparison of the safety and immunogenicity of an MF59-adjuvanted with a non-adjuvanted seasonal influenza vaccine in elderly subjects[J]. Vaccine,2014,32（39）：5027-5034. [18] SCHEIFELE D W,MCNEIL S A,WARD B J,et al. Safety,immunogenicity,and tolerability of three influenza vaccines in older adults[J]. Human Vaccines & Immunotherapeutics,2013,9（11）：2460-2473. [19] SAIKI I,KOIZUMI K,GOTO H,et al. The long-term effects of a kampo medicine,juzentaihoto,on maintenance of antibody titer in elderly people after influenza vaccination[J]. Evid Based Complement Alternat Med,2013,2013：568074. [20] SEO Y B,CHOI W S,LEE J,et al. Comparison of the immunogenicity and safety of the conventional subunit,MF59-adjuvanted,and intradermal influenza vaccines in the elderly[J]. Clin Vaccine Immunol,2014,21（7）：989-996. [21] NACE D A,LIN C J,ROSS T M,et al. Randomized,controlled trial of high-dose influenza vaccine among frail residents of long-term care facilities[J]. J Infect Dis,2015, 211（12）：1915-1924. [22] CHAN T C,HUNG I F N,CHAN K H,et al. Immunogenicity and safety of intradermal trivalent influenza vaccination in nursing home older adults：a randomized controlled trial[J]. Journal of the American Medical Directors Association,2014,15（8）：607-605. [23] DUNNING A J,DIAZGRANADOS C A,VOLOSHEN T,et al. Correlates of protection against influenza in the elderly：results from an influenza vaccine efficacy trial[J]. Clin Vaccine Immunol,2016,23（3）：228-235. [24] COUDEVILLE L,BAILLEUX F,RICHE B,et al. Relationship between haemagglutination-inhibiting antibody titres and clinical protection against influenza：development and application of a bayesian random-effects model[J]. BMC Med Res Methodol,2010,10：18. [25] OHMIT S E,PETRIE J G,MALOSH R E,et al. Influenza vaccine effectiveness in households with children during the 2012-2013 season：assessments of prior vaccination and serologic susceptibility[J]. J Infect Dis,2015,211（10）：1519-1528. [26] BEYER W E,PALACHE A M,SPRENGER M J,et al. Effects of repeated annual influenza vaccination on vaccine sero-response in young and elderly adults[J]. Vaccine,1996,14（14）：1331-1339. [27] NATH K D,BUREL J G,SHANKAR V,et al. Clinical factors associated with the humoral immune response to influenza vaccination in chronic obstructive pulmonary disease[J]. Int J Chron Obstruct Pulmon Dis,2014,9：51-56. [28] SHERIDAN P A,PAICH H A,HANDY J,et al. The antibody response to influenza vaccination is not impaired in type 2 diabetics[J]. Vaccine,2015,33（29）：3306-3313. [29] GORONZY J J,WEYAND C M. Understanding immunosenescence to improve responses to vaccines[J]. Nat Immunol,2013,14（5）：428-436. [30] WIJNANS L,VOORDOUW B. A review of the changes to the licensing of influenza vaccines in Europe[J]. Influenza Other Respir Viruses,2016,10（1）：2-8.
