Преимущества и недостатки инактивированной и живой вакциныпротив гриппа


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Аннотация

Приведен анализ данных литературы, касающихся сравнения безопасности, эффективности и некоторых
других свойств холодоадаптированной живой гриппозной вакцины (ХЖГВ) и инактивированной гриппозной вакцины (ИГВ). ИГВ и ХЖГВ не различаются по системным реакциям после введения препарата, но не
исключена потенциальная возможность неблагоприятных реакций при вакцинации лиц с аллергией к белкам куриных эмбрионов, а также персистенции/реверсии холодоадаптированных штаммов при вакцинации лиц с первичными нарушениями иммунной системы. До настоящего времени нет убедительных данных о том, что при борьбе с пандемиями гриппа ХЖГВ имеет преимущество перед ИГВ. Необходимы дoполнительные контролируемые полевые сравнительные исследования эффективности ИГВ и ХЖГВ при
иммунизации пожилых лиц. Получены ограниченные данные о безвредности и иммуногенности ХЖГВ для
детей в возрасте от 2 мес. Определенным недостатком ХЖГВ является необходимость двукратной вакцинации лиц всех возрастных групп для получения хорошего иммунного ответа ко всем трем компонентам
ХЖГВ. При применении ИГВ двукратная вакцинация рекомендуется только для лиц, не болевших гриппом.
Интраназальное введение ХЖГВ с практической и психологической точки зрения имеет преимущество перед введением ИГВ с помощью шприца. Преимуществом ХЖГВ перед ИГВ может оказаться способность
этого препарата защищать от дрейфовых вариантов вируса гриппа, хотя необходимы дальнейшие исследования. Оптимальным субстратом для производства ИГВ и ХЖГВ могут быть перевиваемые линии клеток, удовлетворяющие требованиям ВОЗ. Оптимальной возрастной группой для профилактики гриппа с
помощью ХЖГВ являются дети, в то время как ИГВ более подходит для вакцинации взрослых и пожилых
лиц.

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