Эффективность живой гриппозной реассортантной вакцины

17.02.2009

Summary

The safety and efficacy of the live attenuated cold-adapted reassortant influenza vaccine have been successfully demonstrated following widespread public health use across different geographical areas and varied ethnic groups. The main factor of efficacy of influenza vaccines is match of vaccine and circulating epidemic influenza strains. The aim of this study was to investigate the influence of antigenic differences between influenza vaccine and circulating virus on the efficacy of vaccine. The results of multicenter, double-blinded, placebo-controlled influenza vaccine trials involving more than 130,000 healthy children 3 - 14 years old and adults were analyzed. The LAIV appears to give high protection during period of circulation drift epidemic strains. Using clinical parameters of generalized acute respiratory disease, during period of circulation drift epidemic strains vaccine efficacy was 23.5 - 59.0 (efficacy of LAIV among children with culture and serological confirmation of influenza in the epidemic season - 94.4%) Clinical trials in humans demonstrated that LAIV provides with long-term protection against influenza-associated diseases. The 42% level of protection was demonstrated among children who received LAIV in the previous, but not current, epidemic season. Additional benefit of LAIV relates to providing protection shortly after administration, prior to the development of the adaptive immune response. Reduction of ARD among children in the first week post vaccination was 36.6%. It is very important that vaccinated people had lower incidence of complications in compare with unvaccinated groups.

Литература

  1. Александрова Г.И., Климов А.И. Живая вакцина против гриппа. -СПб.: Наука, 1994. - 151 с.
  2. Григорьева Е.П., Дешева Ю.А., Донина С.А. и др. Сравнительная оценка безвредности, иммуногенной активности и профилактической эффективности взрослого и детского вариантов живой гриппозной вакцины у школьников 7 - 14 лет // Вопросы вирусологии. 2002. № 4. С. 24 - 27.
  3. Дриневский В.П., Дорошенко Е.М., Гаврилов А.А. и др. Профилактика гриппа живой гриппозной вакциной у детей // Эпидемиология и вакцинопрофилактика. 2005. № 5 (24). С. 35 - 37.
  4. Иванников Ю.Г., Исмагулов А.Т. Эпидемиология гриппа. - Алма-Ата, 1983. - 204 с.
  5. Полежаев Ф.И., Будиловский Г.Н., Гармашова Л.М. и др. Безвредность и высокая иммуногенность для детей 3 - 15 лет моно- и дивакцины из рекомбинантных вирусов гриппа А/Бразилия/11/87 (H1N1) и А/Бангкок/1/79 (H3N2), полученных на основе вируса А/Ленинград/134/47/57 (H2N2) // Вопросы вирусологии. 1984. № 6. C. 710 - 714.
  6. Реброва О.Ю. Статистический анализ медицинских данных. Применение пакета прикладных программ STATISTICA. - М.: МедиаСфера, 2002. - 213 с.
  7. Kendal A.P. Cold adapted live attenuated Influenza vaccines developed In Russia: can they contribute to meeting the needs for Influenza control In other countries? // Eur. J. Epid. 1997. V. 13. P. 591 - 609.
  8. Halloran M.E., Haber M., Lomgini I.M., Struchiner Jr, C.J. Direct and indirect effects in vaccine efficacy and effectiveness // American Journal of Epidemiology. 1991. V. 133. № 4. P. 323 - 331.
  9. Nichol K.L. Live attenuated influenza virus vaccines: new options for the prevention of influenza // Vaccine. 2001. V. 19. P. 4373 - 4377.
  10. Nichol K.L., Mallon K.P., Mendelman PM. Cost benefit of influenza vaccination in healthy, working adults: an economic analysis based on the results of a clinical trial of trivalent live attenuated influenza virus vaccine // Vaccine. 2003. V. 21. P 2207 - 2217.
  11. Rudenko L.G., Slepushkin A.N., Monto A.S. et al. Efficacy of live attenuated and inactivated influenza vaccines in schoolchildren and their unvac-cinated contacts in Novgorod, Russia // The Journal of Infect. Dis. 1993. V. 168. P. 881 - 887.
  12. Rudenko L.G., Lonskaya N.I., Klimov A.I. et al. Clinical and epidemiologi-cal evaluation of a live, cold-adapted influenza vaccine for 3 - 14-year-olds // Bulletin WHO. 1996. № 1. P. 77 - 84.
  13. Rudenko L.G., Alexandrova G.I. Current strategies for the prevention of influenza by the Russian cold-adapted live influenza vaccine among different populations // Proceedings of the World Congress on Options for the Control of Influenza IV held in Crete, Greece, 23rd - 28th September, 2000. - Amsterdam-London-New-York-Oxford-Paris-Shannon-Sin-gapore-Tokyo: Excerpta Medica, 2001. P. 945 - 950.
  14. Rudenko L.G. Fifty years experience with live attenuated influenza vaccines in Russia // World Health Organization. Options for live attenuated influenza vaccines (LAIV) in the control of epidemic and pandemic, 12 - 13 June 2007
  15. Whitaker-Dowling P., Maassab H.F., Younger J.S. Dominant-negative mutants as antiviral agents: simultaneous infection with the cold-adapted live-virus vaccine for influenza A protects ferrets from disease produced by wild-type influenza A // The Journal of Infect. Dis. 1991. V. 164. P. 1200 - 1202.
  16. Younger J.S., Treanor J.J., Whitaker-Dowling P. et al. Effect of simultaneous administration of cold-adapted and wild-type influenza a viruses on experimental wild type influenza in humans // Journal of Clinical Microbiology. 1994. V. 32. P 750 - 754.