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zoom RSS 妊婦全員にインフルエンザワクチン接種 乳児にも効果/英国医療事情

<<   作成日時 : 2010/10/07 23:17   >>

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 母親が妊娠中にワクチン接種を受けると、乳児はインフルエンザにかかりにくくなるという。米軍健康監視センターによるアメリカインディアン1,169人の女性の研究から、生後6ヶ月間の感染が41%減少したことがわかった。
 今冬、英国ではすべての妊婦にインフルエンザワクチンが提供されることになった。
 インフルエンザは特に妊婦にとって危険である。この研究で子どもへの利益も考慮されるべき点であることも示された。
 研究データから、抗体が母親から子どもに手渡されたことを示しているという。
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 英国政府により初めて全ての妊婦に季節性インフルエンザワクチンが提供される計画が発表された。ブタインフルエンザがより妊婦に危険であり流行が続きそうであることから、1回限りで実施される。ワクチンには他の2つのインフルエンザ株も含まれている。妊婦だけでなく、65才以上、糖尿病などの持病を持つ人、医療従事者にも提供される。妊婦50万人を含めて1400万人以上が対象となる。

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29 September 2010 Last updated at 23:04 GMT
Pregnant women to be offered seasonal flu jab
By Nick Triggle Health reporter, BBC News
http://www.bbc.co.uk/news/health-11437219

All pregnant women will be offered the seasonal flu jab for the first time, under plans unveiled by the government.
The one-off move has been sanctioned as the swine flu virus - which is more risky for pregnant women than others - is likely to be still circulating.
The vaccine will offer protection against that and two other flu strains.
As well as pregnant women, it will be offered to the normal target groups - the over 65s, people with conditions such as diabetes and health workers.
This amounts to more than 14 million people, of which pregnant women account for about 500,000.
The Department of Health said GPs will have already started getting the vaccine and should complete the £100m programme by December.

Evidence
Officials urged all the at-risk groups to come forward - take-up traditionally varies between about 75% for the elderly and 50% for those with health conditions, to just over 10% for health staff.
While it is a temporary move because of the swine flu risk, experts are currently reviewing evidence which could lead the government to keep pregnant women in the eligible group in future years.
Other countries, including the US, already offer it to pregnant women and they were included in the UK swine flu vaccination programme.
Some pregnant women in the UK will also have had the seasonal vaccine in the past, as a number would have fallen into the group targeted because of underlying health conditions.
It had long-been anticipated that this winter's flu jab would include protection against swine flu.
The other two strains are ones that evidence from the southern hemisphere, which has been through its winter season, suggests are in circulation.
However, the move has caused some concern among GPs, as they know some patients refused the swine flu jab last year - despite regulators dismissing any safety fears.
The General Medical Council has urged doctors to be up-front about what is in the vaccine.
Jane O'Brien, the assistant director of standards at the GMC, said: "Doctors must give patients the information they want, or need, so the patient can make a decision about treatment.
"This would include telling a patient this year's seasonal flu jab contains the swine flu strain if they think the patient may have concerns about it."
Professor David Salisbury, the government's director of immunisation, said patients would be "foolhardy" to not have the vaccine because of fears about the swine flu strain.
"To not have the vaccine because of a prejudice about swine flu is putting yourself at unnecessary risk. That attitude is ignoring the realities of the risk."

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4 October 2010 Last updated at 20:02 GMT
Flu jabs during pregnancy 'help protect child'
http://www.bbc.co.uk/news/health-11471311

画像Babies are less likely to get flu if their mothers have had the vaccine during pregnancy, a US study says.

Researchers examined 1,169 women from an American Indian tribe, finding it reduced infections by 41% in the first six months of life.
The study by the US Armed Forces Health Surveillance Centre is just the latest to suggest such a link.
And it comes as all pregnant women in the UK are to be offered a winter flu jab for the first time.
When the announcement was made last week, government officials said it was just a one-off move in response to the swine flu strain which is likely to be circulating again.
Possible benefit
The virus was particularly risky for pregnant women.
However, the government's vaccine advisers are also considering whether pregnant women - as they already are in the United States - should be offered the flu vaccine on a permanent basis.
The issue of a possible benefit for the unborn child is being taken into account as part of that process.
Angelica Eick, who led the study, published in the Archives of Pediatrics and Adolescent Medicine, said blood samples from the study showed antibodies were passed on from mother to child.
She said this supported the case for mothers being vaccinated, as babies are generally not given immunisations before six months of age.

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Maternal Influenza Vaccination and Effect on Influenza Virus Infection in Young Infants

Angelia A. Eick, PhD; Timothy M. Uyeki, MD, MPH, MPP; Alexander Klimov, PhD; Henrietta Hall, MS; Raymond Reid, MD; Mathuram Santosham, MD; Katherine L. O’Brien, MD, MPH

Arch Pediatr Adolesc Med. Published online October 4, 2010. doi:10.1001/archpediatrics.2010.192

Objective To assess the effect of seasonal influenza vaccination during pregnancy on laboratory-confirmed influenza in infants to 6 months of age.

Design Nonrandomized, prospective, observational cohort study.

Setting Navajo and White Mountain Apache Indian reservations, including 6 hospitals on the Navajo reservation and 1 on the White Mountain Apache reservation.

Participants A total of 1169 mother-infant pairs with mothers who delivered an infant during 1 of 3 influenza seasons.

Main Exposure Maternal seasonal influenza vaccination.

Main Outcome Measures In infants, laboratory-confirmed influenza, influenzalike illness (ILI), ILI hospitalization, and influenza hemagglutinin inhibition antibody titers.

Results A total of 1160 mother-infant pairs had serum collected and were included in the analysis. Among infants, 193 (17%) had an ILI hospitalization, 412 (36%) had only an ILI outpatient visit, and 555 (48%) had no ILI episodes. The ILI incidence rate was 7.2 and 6.7 per 1000 person-days for infants born to unvaccinated and vaccinated women, respectively. There was a 41% reduction in the risk of laboratory-confirmed influenza virus infection (relative risk, 0.59; 95% confidence interval, 0.37-0.93) and a 39% reduction in the risk of ILI hospitalization (relative risk, 0.61; 95% confidence interval, 0.45-0.84) for infants born to influenza-vaccinated women compared with infants born to unvaccinated mothers. Infants born to influenza-vaccinated women had significantly higher hemagglutinin inhibition antibody titers at birth and at 2 to 3 months of age than infants of unvaccinated mothers for all 8 influenza virus strains investigated.

Conclusions Maternal influenza vaccination was significantly associated with reduced risk of influenza virus infection and hospitalization for an ILI up to 6 months of age and increased influenza antibody titers in infants through 2 to 3 months of age.

Author Affiliations: Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Drs Eick, Reid, Santosham, and O’Brien); Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Uyeki and Klimov and Ms Hall). Dr Eick is now with the Armed Forces Health Surveillance Center, Silver Spring, Maryland.

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妊婦全員にインフルエンザワクチン接種 乳児にも効果/英国医療事情 医師の一分/BIGLOBEウェブリブログ
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