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青少年和成人中白喉-破伤风-无细胞百日咳疫苗的免疫原性和抗体持久性:一项文献系统综述显示,对现有疫苗的反应各异。

Immunogenicity and antibody persistence of diphteria-tetanus-acellular pertussis vaccination in adolescents and adults: a systematic review of the literature showed different responses to the available vaccines.

作者信息

Squeri Raffaele, Genovese Cristina

机构信息

Department of Biomedical Sciences and Morphological and Functional Images (BIOMORF), University of Messina, Italy.

出版信息

J Prev Med Hyg. 2021 Jan 14;61(4):E530-E541. doi: 10.15167/2421-4248/jpmh2020.61.4.1832. eCollection 2020 Dec.

Abstract

INTRODUCTION

In industrialized countries, the routine use of Bordetella pertussis vaccines has shifted the burden of Bordetella pertussis disease from children to infants, adolescents and adults, leading to the necessity for booster doses.

MATERIALS AND METHODS

We prepared a review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) with the aims of: a) describing the immunogenicity of the main available vaccines for adolescents and adults; b) describing antibody persistence after immunization with the main vaccines available in childhood and adults and, also, possible co-administration; and c) identifying the gold standard for adolescent and adult immunizations.

RESULTS

We identified 6906 records. After removing duplicate records, we included 12 RCT (Randomized Controlled Trial) (people aged 11-73): 7 of these studies had only 1 control group, 4 had 2 control groups and 1 had 5 control groups; moreover, of the 12 studies included, only 2 regarded co-administration, while all concerned immunogenicity. Nine of the 12 studies had a Jadad score above 3 points, and 10 out of 12 met the criteria of Cochrane Back Review Group Criteria List for Methodological Quality Assessment.

DISCUSSION AND CONCLUSION

We found a limited number of good-quality RCTs investigating our object. The 5-component vaccines, although containing a lower dose of antigen, proved more effective than the 1-component vaccine. Evidence supports the use of 5-component vaccines for booster sessions in adolescence and adulthood.

摘要

引言

在工业化国家,常规使用百日咳博德特氏菌疫苗已使百日咳疾病负担从儿童转移至婴儿、青少年和成人,这导致了加强剂量的必要性。

材料与方法

我们根据系统评价和Meta分析的首选报告项目(PRISMA)编写了一篇综述,目的如下:a)描述主要可用疫苗对青少年和成人的免疫原性;b)描述儿童和成人接种主要可用疫苗后抗体的持久性以及可能的联合接种情况;c)确定青少年和成人免疫接种的金标准。

结果

我们识别出6906条记录。去除重复记录后,我们纳入了12项随机对照试验(RCT)(年龄在11 - 73岁之间):其中7项研究只有1个对照组,4项有2个对照组,1项有5个对照组;此外,在纳入的12项研究中,只有2项涉及联合接种,而所有研究均涉及免疫原性。12项研究中有9项的雅达得分高于3分,12项中有10项符合Cochrane系统评价组方法学质量评估标准清单的标准。

讨论与结论

我们发现针对我们的研究对象进行高质量RCT研究的数量有限。5组分疫苗虽然含有的抗原剂量较低,但比1组分疫苗更有效。有证据支持在青少年期和成年期使用5组分疫苗进行加强接种。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9da/7888403/e34acb9a3664/jpmh-2020-04-e530-g001.jpg

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