Har högdos, intradermalt influensavaccintillräckligt god effekt, immunogenicitet ochsäkerhet hos äldre? : En litteraturstudie om effekten, immunogeniciteten och säkerhetav högdos influensavaccin och intradermal injektion hos äldre.

Sammanfattning: There are four different types of influenza virus: A, B, C and D which cause influenza.Generally, influenza virus A, B and C infects humans. Rarely, influenzavirus D occursin humans, but it often infects animals. The influenza virus consists of a viral RNAenclosed in a capsid surrounded by an envelope, which has different surface structures,hemagglutinin (H) and neuramindase (N). Based on these surface structures,influenzavirus is classified into different subtypes.Vaccination is the most effective way to fight influenza. Although influenza affectsindividuals of all ages, the elderly are most vulnerable to serious complications.The intradermal (ID) administration of a high-dose inactivated trivalentinfluenzavaccine (IIV3-HD), is a new strategy that could improve the antibody responsein the elderly.This study examined whether a IIV3-HD vaccine might give higher safety,immunogenicity and efficacy compared to a standard-dose (IIV3-SD) vaccine for theprevention of laboratory-confirmed influenza illness in older adults, and examinedwhether HD-ID is a suitable vaccination strategy for the elderly compared to SD orstandard dose intramuscular (SD-IM) vaccine.The PubMed database was used to search for studies.The chosen studies weremulticenter, randomized, controlled trials. Three of them aimed to assess IIV3-HDcompared to IIV3-SD, and two evaluated the administration of the vaccine via the IDroute.  The results from the five studies showed that Hemagglutination Inhibition (HAI) titersand seroprotection rates were significantly higher in the IIV3-HD group than in theIIV3-SD group. No major difference was demonstrated as regards to the safety profilebetween the two groups. In addition, the number of patients who had laboratoryconfirmed influenza illness was less in the IIV3-HD compared to the IIV3-SD group.Both HD and ID administration are presented as suitable vaccination strategies for theelderly compared to SD or standard dose intramuscular (SD-IM) vaccines.The conclusion from the first three studies is that high-dose, inactivated trivalentinfluenza vaccine has better efficacy, immunogenicity and safety in the elderlycompared to standard dose of trivalent influenza vaccine, further from the last twostudies that intradermal administration of vaccine and high-dose vaccine had betterimmunogenicity and tolerance when used compared with the SD-IM vaccine.