皮内注射与肌肉注射接种流感疫苗。快速审查,medRxiv - Infectious Diseases

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皮内注射与肌肉注射接种流感疫苗。快速审查
medRxiv - Infectious Diseases Pub Date : 2020-10-08 , DOI: 10.1101/2020.10.06.20205989
Oluwaseun Egunsola , Fiona Clement , John Taplin , Liza Mastikhina , Joyce W. Li , Diane L. Lorenzetti , Laura E. Dowsett , Tom Noseworthy

背景：疫苗对于预防流感至关重要。我们合成了有关减少或完全皮内剂量与完全肌肉内剂量相比的流感疫苗免疫原性和安全性的公开文献。方法：对文献进行快速回顾。检索MEDLINE，EMBASE和对照试验的Cochrane中央登记册，以查找2010年至2020年6月5日之间发表的研究。包括所有比较皮内和肌肉注射流感疫苗的研究。进行了免疫原性和安全性结果的随机效应荟萃分析。结果：共纳入30项相关研究。对于H1N1，H3N2和B株，分别在3 mcg，6 mcg，7.5 mcg和9 mcg皮内疫苗剂量与15 mcg肌内疫苗剂量之间，血清转化率相等，但对于H1N1（RR 1.10，95％CI：1.01-1.20）和B菌株（RR 1.40，95％CI：1.13-1.73），与15 mcg肌肉内剂量相比，皮内15 mcg显着更高。皮内注射9 mcg和15 mcg的血清保护率与三种菌株的15 mcg肌内注射剂量相同，但H1N1菌株的皮下15 mcg剂量明显更高（RR 1.05，95％CI：1.01- 1.09）。皮内给药使局部不良事件明显增加。皮内注射9 mcg时，发烧和畏寒明显更高，而所有其他全身性不良事件在所有剂量下均相同。结论：由于免疫原性的相似性，降低剂量的皮内流感疫苗似乎是标准剂量的肌内疫苗的合理替代方案。

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Intradermal versus Intramuscular Administration of Influenza Vaccination. Rapid Review

Background: Vaccinations are essential for prevention of influenza. We synthesized the published literature on the immunogenicity and safety of the influenza vaccine at reduced or full intradermal doses compared with full intramuscular doses. Methods: A rapid review of the literature was completed. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for studies published from 2010 until June 5th, 2020. All studies comparing intradermal and intramuscular influenza vaccinations were included. Random-effects meta-analyses of immunogenicity and safety outcomes were conducted. Results: A total of 30 relevant studies were included. Seroconversion rates were equivalent between the 3 mcg, 6 mcg, 7.5 mcg, and 9 mcg intradermal vaccine doses and the 15 mcg intramuscular vaccine dose for each of the H1N1, H3N2, and B strains, but significantly higher with the 15 mcg intradermal compared with the 15 mcg intramuscular dose, for the H1N1 (RR 1.10, 95% CI: 1.01-1.20) and B strains (RR 1.40, 95% CI: 1.13-1.73). Seroprotection rates for the 9 mcg and 15 mcg intradermal doses were equivalent with the 15 mcg intramuscular dose for all the three strains, except for the 15 mcg intradermal dose for the H1N1 strain which was significantly higher (RR 1.05, 95% CI: 1.01-1.09). Local adverse events were significantly higher with intradermal doses. Fever and chills were significantly higher with the 9 mcg intradermal dose, while all other systemic adverse events were equivalent for all doses. Conclusion: Reduced dose intradermal influenza vaccination appears to be a reasonable alternative to standard dose intramuscular vaccination because of the similarity in immunogenicity.

更新日期：2020-10-08

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