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A Systematic Review of Safety and Immunogenicity of Influenza Vaccination Strategies in Solid Organ Transplant Recipients
Clinical Infectious Diseases ( IF 11.8 ) Pub Date : 2017-12-14 , DOI: 10.1093/cid/cix1081
Pearlie P Chong 1 , Lara Handler 2 , David J Weber 3, 4
Affiliation  

Immunogenicity from seasonal inactivated influenza vaccine (IIV) remains suboptimal in solid organ transplant recipients (SOTRs). We conducted a systematic review that compared the safety and immunogenicity of nonstandard influenza vaccination strategies with single-dose IIV in SOTRs. Booster doses and possibly high-dose (HD) influenza vaccination strategies seem to hold promise for improving vaccination immunogenicity in SOTRs. Administration of intradermal and MF59-adjuvanted trivalent IIV (IIV3) did not improve vaccine immunogenicity compared with single-dose intramuscular IIV. Alternative vaccine strategies were generally well tolerated; SOTRs who received HD, intradermal or adjuvanted IIV3 had a higher frequency of infection site reactions, while systemic adverse events were more frequent in SOTRs who received HD IIV3. Allograft rejection rates were similar in both groups. SOTRs should continue to receive standard-dose IIV annually in accordance with current recommendations, pending future studies to determine the optimal timing, frequency, and dosage of IIV using the booster-dose strategy.

中文翻译:

固体器官移植受者中流感疫苗接种策略的安全性和免疫原性的系统综述

在实体器官移植接受者(SOTR)中,季节性灭活流感疫苗(IIV)的免疫原性仍然欠佳。我们进行了系统评价,比较了非标准流感疫苗接种策略与单剂量IIV在SOTR中的安全性和免疫原性。加强剂量和可能的大剂量(HD)流感疫苗接种策略似乎有望改善SOTR中的疫苗接种免疫原性。与单剂量肌内IIV相比,皮内和MF59佐剂的三价IIV(IIV3)的给药并未改善疫苗的免疫原性。替代疫苗策略通常被很好地耐受;接受HD,皮内或佐剂IIV3的SOTRs发生感染部位反应的频率更高,而接受HD IIV3的SOTRs的全身不良事件更为频繁。两组的同种异体移植排斥率相似。SOTRs应该按照当前的建议继续每年接受标准剂量的IIV,有待进一步研究以确定使用加强剂量策略的IIV的最佳时机,频率和剂量。
更新日期:2017-12-14
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