Immunogenicity and Reactogenicity of Influenza Vaccine in the Elderly

老年人接種流行性感冒疫苗之血清免疫反應與副作用

李侑珊(Yow-Shan Lee) ； 姚建安(Chien-An Yao) ； 高全良(Chuan-Liang Kao) ； 雷永兆(Yung-Chao Lei) ； 洪凌鈺(Ling-Yu Hung) ； 黃國晉(Kuo-Chin Huang)

《台灣老年醫學雜誌》 2卷3期 (2007/02) Pp. 164-175

摘要

本研究乃比較年輕人與年齡大於60歲的老年人對於流行性感冒疫苗所產生的血清免疫反應及副作用的差異性。
本研究採前瞻性、非隨機、單一中心、開放性、無對照的研究。受試者於疫苗注射前與後四個禮拜各留一管血清學檢查，利用血液凝集抑制試驗(HAI)定量流感疫苗注射所引起的抗體效價。再以統計檢定兩組之血液凝集抑制試驗抗體效價(HAI)≥40的比率、血清轉換率(seroconversion)、及滴定量幾何平均(geometric mean titers)增加值的差異等。
本研究共有120位受試者參與此研究。在參與實驗的受試者，其中66位爲年齡20至60歲的年輕人，54位爲年齡大於60歲的老年人。年輕人與老年人的血清免疫反應並無差異，施打疫苗前大部份的受試者其HAI皆大於40。年輕人與老人的副作用除了局部反應如施打處的腫（24.2%在年輕人，3.7%在老人）與痛（56.1%在年輕人，24.1%在老人）在年輕人比老年人略多之外也無差異。
流感疫苗產生的免疫力與副作用在年輕人與老年人身上並無明顯差異。雖然此篇文章有許多排除條件，還是應該鼓勵老年人每年接受流感疫苗注射；然而台灣施打流感疫苗的病毒抗原種類是否適當，值得未來研究探討。

關鍵字

流感疫苗 ； 老年人 ； 血清免疫 ； 副作用

並列摘要

Objective: To compare the immunogenicity and reactogenicity of influenza vaccine in younger adults and elderly people aged over 60 years old.
Methods: This was a prospective, non-randomized, single-center, open-labeled, non-comparative study of inactivated influenza vaccine containing A/H1N1, A/H3N2 and B strains. Subjects had their sera collected just prior to and 4 weeks after vaccination. Antibody titers induced to the viruses were determined using hemagglutinin inhibition. Serological parameters measured included the proportion of subjects achieving an anti-hemagglutination antibody titer ≥ 40, seroconversion rate, geometric titer and mean fold increase.
Results: 120 participants entered the study with 66 younger adults aged 20-60 years and 54 elderly aged above 60 years. Younger adults and elderly subjects reported no significant difference in serologic parameters including the proportion of subjects achieving an anti-hemagglutination antibody titer ≥ 40, seroconversion rate, and mean fold increase. The pre-vaccination titers for 3 strains were ≥ 40 in most subjects. There were no difference in rate of adverse reactions between the two groups except for injection site swelling (24.2% in adult group and 3.7% in elderly group) and pain at injection site (56.1% in adult group and 24.1% in elderly group).
Conclusion: The immunogenicity and reactogenicity of influenza vaccine in younger adults are not significantly different from those in elderly people. Despite the exclusion criteria in this study, annual vaccination should be encouraged in elderly. However, the appropriateness of the strain compositions for influenza vaccine in Taiwan requires further researches.

並列關鍵字

influenza vaccination ； elderly ； immunogenicity ； reactogenicity