Vacunas (English Edition)最新文献_第4页

Seasonal influenza in the wake of COVID-19: Redressing the H3N2 outbreak and its implications for public health 2019冠状病毒病后的季节性流感：应对H3N2疫情及其对公共卫生的影响

Vacunas (English Edition)

Pub Date : 2025-07-01 Epub Date: 2025-07-31 DOI: 10.1016/j.vacune.2025.500422

Farid Rahimi , Amin Talebi Bezmin Abadi

引用次数: 0

Preliminary analysis of combined vaccines against respiratory syncytial virus and human metapneumovirus 呼吸道合胞病毒与人偏肺病毒联合疫苗的初步分析

Vacunas (English Edition)

Pub Date : 2025-07-01 Epub Date: 2025-07-21 DOI: 10.1016/j.vacune.2025.500460

Jordi Reina, Eugenia Cabrera

The epidemiological and etiological importance of respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) in lower respiratory tract infections, both in children and adults, dictates the need for a combined vaccine that protects against both viruses. Both viruses have a single-stranded RNA genome of 15.2 kb for RSV and 13.3 kb for hMPV. Serotypes or subgroups that cocirculate each season have been described for both viruses. Of the different proteins contained in both viruses, the F proteins have a high degree of similarity in structure and conformation, sharing between 30 and 35% of their sequence; therefore, they have been used to develop combined vaccines. Attenuated combined vaccines use a strain of hMPV deleted in the SH gene, which is replaced by the RSV F protein gene. This strain replicated in cell cultures and mice allowing for the initiation of a trial in mice. The humoral and cellular immunity induced by this vaccine was heterologous and encompassed different subtypes of both viruses, and also protected animals from exogenous infection. Preliminary data have been reported on a combined mRNA vaccine with the F protein in its preF form. The results showed that both vaccines increased neutralizing antibody titers against RSV-A and RSV-B, and hMPV in children aged 5–8 months and 8–23 months who were both seronegative and previously seronegative against this virus, meaning that the immune response is independent of the prior presence of antibodies. A chimeric vaccine consisting of the globular head of the RSV F protein and the stem of hMPV is also in the very preliminary phase. Definitive data are not yet available, yet it is quite possible that a combined vaccine that could prevent RSV and hMPV infections will be available in the near future.

呼吸道合胞病毒（RSV）和人中肺病毒（hMPV）在儿童和成人下呼吸道感染中的流行病学和病原学重要性表明，需要一种针对这两种病毒的联合疫苗。两种病毒的单链RNA基因组RSV为15.2 kb， hMPV为13.3 kb。这两种病毒在每个季节都有共同流行的血清型或亚群。在两种病毒中含有的不同蛋白质中，F蛋白在结构和构象上有高度的相似性，它们的序列有30%到35%是相同的；因此，它们已被用于开发联合疫苗。减毒联合疫苗使用SH基因中缺失的hMPV毒株，取而代之的是RSV F蛋白基因。该菌株在细胞培养物和小鼠中复制，从而开始在小鼠中进行试验。该疫苗诱导的体液和细胞免疫是异源的，包含了两种病毒的不同亚型，并保护动物免受外源性感染。已报道了一种含有F蛋白preF形式的mRNA联合疫苗的初步数据。结果显示，这两种疫苗均可提高5-8月龄和8-23月龄儿童抗RSV-A、RSV-B和hMPV的中和抗体滴度，这些儿童的血清抗体均为阴性或之前的血清抗体均为阴性，这意味着免疫反应与抗体的存在无关。由RSV F蛋白的球形头和hMPV的茎组成的嵌合疫苗也处于非常初步的阶段。目前还没有确切的数据，但很有可能在不久的将来会有一种可以预防RSV和hMPV感染的联合疫苗。

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引用次数: 0

Rational in-silico design of a multi-epitope vaccine against human Rhinovirus an immune simulation and molecular dynamics simulation approach 人鼻病毒多表位疫苗的合理芯片设计及其免疫模拟和分子动力学模拟方法

Vacunas (English Edition)

Pub Date : 2025-07-01 Epub Date: 2025-07-31 DOI: 10.1016/j.vacune.2025.500427

Najeebullah, I.U. Haq, M. Rahiyab, S.S. Ali, I. Khan, A. Iqbal

Background

The Rhinovirus (HRV) belongs to the Enterovirus genus in the Picornaviridae family and is a positive-sense single-stranded RNA virus. Commonly accountable for respiratory tract infections, which include common colds. It is yet unknown how to treat HRV infection.

Methods

This study employed robust immunoinformatics techniques to predict the B-cell, CTL, and HTL epitopes on the Genome Polyprotein. Both non-allergic and antigenic epitopes were chosen in order to produce a subunit vaccine that patients could receive.

Results

The vaccine's immunogenicity score was reported as − 4.46838, and its antigenic ratio yielded values of 0.5625 and 0.450999, respectively, using ERRAT, Rampage, and ProSa-web servers to validate the vaccine model. Consequently, the Z-score was − 6.85, the ERRAT score was 90.432, and the Ramachandran plot value was generated as 86.0%. When TLR-7 was utilized to dock the vaccine, it revealed a good interaction with 151 non-bonding components, 7 hydrogen bonds, and 1 salt bridge. Using MD modeling, the stability of the docked complex was assessed. The vaccine had a GC content of 48.4% and a CAI value of 0.99% when it was reverse-translated. To implement the concept in a wet laboratory, the reverse translated vaccine sequence was cloned in pET28a (+) vector.

Conclusion

The vaccine developed in this work has to be experimentally validated in order to ensure its efficacy against the disease. The final application of this new research will be in the treatment of HRV-related illnesses as well as in upcoming experimental testing to verify the safety and immunogenicity of the suggested vaccine design.

鼻病毒（HRV）属于小核糖核酸病毒科肠病毒属，是一种正义单链RNA病毒。通常会引起呼吸道感染，包括普通感冒。目前尚不清楚如何治疗HRV感染。方法采用稳健的免疫信息学技术预测基因组多蛋白上的b细胞、CTL和HTL表位。选择非过敏性和抗原表位是为了生产患者可以接受的亚单位疫苗。结果该疫苗的免疫原性评分为- 4.46838，其抗原比分别为0.5625和0.450999，采用ERRAT、Rampage和ProSa-web服务器对疫苗模型进行验证。因此，z得分为- 6.85，ERRAT得分为90.432，生成的Ramachandran图值为86.0%。当TLR-7与疫苗对接时，发现它与151个非键成分、7个氢键和1个盐桥具有良好的相互作用。利用MD模型对对接物的稳定性进行了评价。反译疫苗的GC含量为48.4%，CAI值为0.99%。为了在潮湿实验室中实现这一概念，将反翻译疫苗序列克隆到pET28a（+）载体上。结论研制的疫苗需经过实验验证，以保证其对该病的防治效果。这项新研究的最终应用将是治疗hrv相关疾病，以及即将进行的实验测试，以验证所建议的疫苗设计的安全性和免疫原性。

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引用次数: 0

Development of a novel multi-epitope vaccine candidate for Marburg virus applying advanced immunoinformatics strategies: A computational analysis 应用先进免疫信息学策略开发一种新型马尔堡病毒多表位候选疫苗：计算分析

Vacunas (English Edition)

Pub Date : 2025-07-01 Epub Date: 2025-07-31 DOI: 10.1016/j.vacune.2025.500461

Md. Nafij Mashrur , M. Nazmul Hoque , Soharth Hasnat , Sakhawat Hossen Saikat , Md. Mehedi Hasan , Faria Khan Hridy , Nurul Amin Rani , Fardous Mohammad Safiul Azam

Objectives

Marburg virus (MbVs), which causes Marburg viral disease (MbVD), primarily manifests flu-like symptoms, but critical hemorrhagic fever appears toward the end. It transmits through direct contact between individuals or animals. While incidences may be rare, the elevated mortality rate of this virus is a significant concern. Currently, there is no vaccine for this lethal virus. Immunization is essential for reducing the mortality rate associated with this disease. We recommend employing immunoinformatics techniques and MbV structural proteins to develop multi-epitope vaccine.

Methods

A multi-epitope vaccine was created using B-cell and T-cell epitopes of MbV, along with adjuvants and specific linkers. The proposed vaccine was assessed for antigenicity, allergenicity, toxicity, and population coverage. Additionally, in silico immune response models were conducted. The vaccine design was further analyzed for expression and cloning viability utilizing the pET-28a(+) vector.

Results

The designed vaccine exhibited antigenic, non-allergenic, and non-toxic properties. It demonstrated excellent global population coverage and induced a robust immune response in silico. Furthermore, the in silico assessments confirmed the effective expression and cloning of the vaccine in E. coli, indicating its feasibility for large-scale manufacturing in the pharmaceutical industry.

Conclusion

The results suggest that the proposed vaccine design may effectively elicit immune responses against MbV. Future studies must incorporate in vivo testing to validate these findings.

目的马尔堡病毒（MbVs）引起马尔堡病毒病（MbVD），主要表现为流感样症状，但晚期出现重症出血热。它通过个体或动物之间的直接接触传播。虽然发病率可能很罕见，但这种病毒的高死亡率令人严重关切。目前还没有针对这种致命病毒的疫苗。免疫接种对于降低与该病有关的死亡率至关重要。我们建议利用免疫信息学技术和MbV结构蛋白开发多表位疫苗。方法利用MbV的b细胞和t细胞抗原表位、佐剂和特异性连接体制备多抗原表位疫苗。对该疫苗的抗原性、过敏原性、毒性和人口覆盖率进行了评估。此外，还建立了计算机免疫反应模型。利用pET-28a（+）载体进一步分析疫苗设计的表达和克隆可行性。结果所设计的疫苗具有抗原性、非致敏性和无毒性。它表现出良好的全球人口覆盖率，并在硅片上诱导了强大的免疫反应。此外，计算机评估证实了该疫苗在大肠杆菌中的有效表达和克隆，表明其在制药工业中大规模生产的可行性。结论所设计的疫苗能有效地引起对MbV的免疫应答。未来的研究必须结合体内试验来验证这些发现。

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引用次数: 0

Intranasal influenza vaccine: Exploration of parental motives for refusal or acceptance 鼻内流感疫苗：父母拒绝或接受的动机探讨

Vacunas (English Edition)

Pub Date : 2025-07-01 Epub Date: 2025-07-24 DOI: 10.1016/j.vacune.2025.500453

Virginia Reverte, Matilde Zornoza-Moreno, Consuelo Lucía Álvarez-García, Jaime Jesús Pérez-Martín

Introduction

Influenza in children under 5 years of age has a higher risk of causing serious complications that may require hospitalization and even death. Since 2012, the World Health Organization and other international organizations have recommended influenza vaccination for children aged 6 to 59 months. School-based influenza vaccination was introduced in the study community in the 2023–2024 campaign for children aged 3 and 4 years, and although it is known that school immunization is a way to facilitate the process, some parents still show reluctance and refuse to vaccinate their children. The main objective of this study was to find out their reasons.

Material and methods

A qualitative study was designed using focus group technique to collect information.

Results

From the parents' opinions, we were able to identify two main reasons for the refusal of influenza vaccination: a lowered perception of the risks associated with influenza in children who have no associated risk factor and a lack of confidence in the vaccine, based mainly on the lack of specificity to the virus strain circulating that season. The sending of numerous reminders, the fact that vaccination does not exempt the child from getting sick, or misconceptions about whether some vaccines are mandatory or not were also mentioned as reasons.

Discussion and conclusions

The results obtained are very useful for the design of the next information campaigns aimed at families, whose purpose is to improve influenza vaccination coverage.

5岁以下儿童患流感，有较高的风险引起严重并发症，可能需要住院治疗，甚至死亡。自2012年以来，世界卫生组织和其他国际组织建议6至59个月的儿童接种流感疫苗。研究社区在2023-2024年为3岁和4岁儿童开展了以学校为基础的流感疫苗接种运动，尽管众所周知，学校免疫是促进这一进程的一种方式，但一些家长仍然表现出不情愿，拒绝为孩子接种疫苗。本研究的主要目的是找出他们的原因。材料与方法采用焦点小组技术进行定性研究。结果从家长的意见中，我们能够确定拒绝接种流感疫苗的两个主要原因：对没有相关危险因素的儿童的流感相关风险的认知降低，以及对疫苗缺乏信心，主要基于对该季节流行的病毒株缺乏特异性。他们还提到了许多提醒，接种疫苗并不能使孩子免于生病的事实，或者对某些疫苗是否强制性的误解。讨论和结论所获得的结果对设计下一次针对家庭的信息运动非常有用，其目的是提高流感疫苗接种的覆盖率。

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引用次数: 0

A mathematical model for assessing vaccination's efficacy as a preventative strategy against newly emerging COVID-19 variants 用于评估疫苗接种作为预防新出现的COVID-19变体的有效性的数学模型

Vacunas (English Edition)

Pub Date : 2025-07-01 Epub Date: 2025-07-31 DOI: 10.1016/j.vacune.2025.500392

Akeem Olarewaju Yunus, Morufu Oyedunsi Olayiwola

Objective

This study aims to evaluate the effectiveness of vaccination in curbing the spread of emerging SARS-CoV-2 variants using the SEVIAR mathematical model with Caputo fractional orders. The model integrates vaccine-induced immunity and assesses the impact of vaccination on transmission dynamics while determining herd immunity thresholds.

Method

The SEVIAR model was applied to real-world data from Rivers State, Nigeria, to simulate disease transmission dynamics within vaccinated populations. Fractional calculus was employed to address the complexities of disease spread and the nuanced effects of vaccination. Sensitivity analyses and computer simulations were performed to examine the influence of varying vaccination rates and timing on mitigating variant transmission and reducing hospitalization rates.

Results

The findings demonstrate a strong association between higher vaccination rates and decreased transmission and hospitalization, even amid the emergence of new SARS-CoV-2 variants. Sensitivity analysis highlighted the critical role of early diagnosis and timely immunization in controlling the spread of variants. Thresholds for achieving herd immunity were identified, underscoring the need for sustained high vaccination coverage to manage variant transmission effectively.

Conclusions

The study underscores the importance of continuous and robust vaccination campaigns, particularly in the context of evolving COVID-19 variants. It highlights the utility of fractional calculus in modeling the dynamics of SARS-CoV-2 variants and optimizing public health responses. For policymakers, these findings provide valuable guidance in formulating strategies to address the challenges posed by emerging virus strains. Given the virus's evolving nature, ongoing evaluation of vaccine efficacy and adaptive public health strategies are essential to controlling the pandemic effectively.

目的利用带有Caputo分数阶的SEVIAR数学模型，评价疫苗接种对抑制新发SARS-CoV-2变异体传播的有效性。该模型整合了疫苗诱导的免疫，并在确定群体免疫阈值的同时评估疫苗接种对传播动力学的影响。方法将SEVIAR模型应用于尼日利亚Rivers State的真实数据，模拟接种疫苗人群中的疾病传播动态。分数微积分被用来解决疾病传播的复杂性和疫苗接种的微妙影响。进行敏感性分析和计算机模拟，以检查不同的疫苗接种率和时间对减轻变异传播和降低住院率的影响。研究结果表明，即使在出现新的SARS-CoV-2变体的情况下，更高的疫苗接种率与减少传播和住院之间存在密切关联。敏感性分析强调了早期诊断和及时免疫在控制变异传播中的关键作用。确定了实现群体免疫的阈值，强调需要持续的高疫苗接种覆盖率，以有效管理变异传播。该研究强调了持续和强有力的疫苗接种运动的重要性，特别是在COVID-19变体不断演变的背景下。它强调了分数阶微积分在SARS-CoV-2变异动力学建模和优化公共卫生应对方面的实用性。对于决策者来说，这些发现为制定应对新出现的病毒毒株带来的挑战的战略提供了有价值的指导。鉴于病毒不断演变的性质，持续评估疫苗效力和适应性公共卫生战略对于有效控制大流行至关重要。

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引用次数: 0

Cytokine production and TLR 7/8 gene expression following BBIBP-CorV COVID-19 vaccination BBIBP-CorV - COVID-19疫苗接种后细胞因子产生和TLR 7/8基因表达

Vacunas (English Edition)

Pub Date : 2025-07-01 Epub Date: 2025-07-31 DOI: 10.1016/j.vacune.2025.500459

Ali Mohammed Ashraf , Marwan Y. Al-Maqtoofi , Ahmed A. Burghal

Introduction and objective

The impact of inactivated vaccines for COVID-19, BBIBP-CorV COVID-19, on the human immune system was not studied. This study investigates the immune response induced by the BBIBP-CorV COVID-19 vaccine.

Method

A total of 90 blood samples (5 ml each) were collected from participants (mean age: 20 years) in Basrah, Iraq. The study included 60 vaccinated individuals (38 males, 22 females), 60 days post-BBIBP-CorV vaccination and 30 unvaccinated controls (15 males, 15 females). Blood was divided: 2 ml in EDTA tubes for TLR7/TLR8 mRNA expression (RT-qPCR) and 3 ml in clotting activator tubes for serum isolation to measure IL-7, IL-10, IL-12, IL-18, and IL-21 levels (sandwich ELISA). Data were compared with controls and analysed for statistical differences. Volunteers with flu, COVID-19 symptoms, fever, chronic diseases, or immunocompromised conditions were excluded.

Results

The BBIBP-CorV vaccine did not disrupt cytokine production, with no significant differences in IL-7, IL-10, IL-12, IL-18, and IL-21 levels between vaccinated and unvaccinated groups after 60 days (p > 0.05). However, TLR7 and TLR8 mRNA expression was significantly upregulated (p < 0.05) in vaccinated individuals compared to controls, indicating enhanced innate immune activation without affecting cytokine balance. These findings highlight the vaccine's ability to stimulate immunity while maintaining normal cytokine levels.

Conclusions

These results are particularly significant as they demonstrate that the BBIBP-CorV COVID-19 vaccine successfully induces immunological responses via TLR7 and TLR8 activation without abnormal effects on cytokine production. As a pilot study, these findings lay a strong foundation for future research.

前言与目的未研究新型冠状病毒病（COVID-19）灭活疫苗BBIBP-CorV COVID-19对人体免疫系统的影响。本研究探讨了BBIBP-CorV COVID-19疫苗诱导的免疫应答。方法从伊拉克巴士拉市的参与者（平均年龄：20岁）中采集90份血样（每份5 ml）。该研究包括60名接种疫苗的个体（38名男性，22名女性），接种bbibp - corv疫苗60天后和30名未接种疫苗的对照组（15名男性，15名女性）。分血：EDTA管中2 ml用于TLR7/TLR8 mRNA表达（RT-qPCR），凝血激活剂管中3 ml用于血清分离，检测IL-7、IL-10、IL-12、IL-18和IL-21水平（夹心ELISA）。将数据与对照组进行比较，并分析统计学差异。有流感、COVID-19症状、发烧、慢性疾病或免疫功能低下的志愿者被排除在外。结果BBIBP-CorV疫苗未破坏细胞因子的产生，接种组和未接种组在接种60天后IL-7、IL-10、IL-12、IL-18和IL-21水平无显著差异(p >；0.05)。然而，TLR7和TLR8 mRNA表达显著上调(p <；0.05)，表明先天免疫激活增强，但不影响细胞因子平衡。这些发现强调了疫苗在保持正常细胞因子水平的同时刺激免疫力的能力。结论BBIBP-CorV - COVID-19疫苗通过激活TLR7和TLR8成功诱导免疫应答，且未对细胞因子产生异常影响。作为一项初步研究，这些发现为今后的研究奠定了坚实的基础。

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引用次数: 0

The global threat of human metapneumovirus (HMPV): A call to action amid recent surges in China 人偏肺病毒（HMPV）的全球威胁：在中国最近疫情激增之际呼吁采取行动

Vacunas (English Edition)

Pub Date : 2025-04-01 Epub Date: 2025-05-29 DOI: 10.1016/j.vacune.2025.500389

Lysandro Pinto Borges , Lara Góis Floresta , Rajiv Gandhi Gopalsamy , Athesh Kumaraswamy , Bernardo Ferreira Brasileiro , Cleverson Luciano Trento , Lucas Alves da Mota Santana

引用次数: 0

Simulation of a novel approach in measles disease dynamics models to predict the impact of vaccinations on eradication and control 麻疹疾病动力学模型中预测疫苗接种对根除和控制影响的新方法的模拟

Vacunas (English Edition)

Pub Date : 2025-04-01 Epub Date: 2025-05-29 DOI: 10.1016/j.vacune.2025.100385

Akeem Olarewaju Yunus, Morufu Oyedunsi Olayiwola

Introduction

Measles, a highly contagious disease caused by Morbillivirus, poses significant public health risks due to its rapid spread and severe complications. Symptoms, such as fever, rashes, red eyes, and coughing, typically appear 8–12 days post-infection. Given recent resurgences, especially in areas with low vaccination coverage, it is essential to understand measles transmission and assess the role of vaccination awareness in outbreak control.

Method

A mathematical model was developed to examine measles transmission and the influence of vaccination awareness. Stability analysis evaluated the model's behavior, while the basic reproductive number, R₀, was derived using the next-generation matrix approach. Sensitivity analysis assessed how parameter variations impact outbreaks. Numerical simulations, utilizing the iterative Laplace transform and Atangana-Baleanu fractional derivative operator, explored solution conditions and stability at various fractional orders.

Results

Simulations showed that vaccination awareness significantly reduces measles transmission. Increased awareness lowered R, decreasing outbreak risk. Fractional orders provided insights into disease persistence, highlighting the importance of behavioral factors in control strategies. Sensitivity analysis identified parameters crucial for targeted interventions.

Conclusion

This study underscores the importance of vaccination awareness in controlling measles, showing that education-based strategies can reduce transmission. By integrating behavioral factors in a fractional calculus framework, this research supports efforts against endemic diseases like measles. The findings suggest that awareness campaigns, alongside vaccination, can alter transmission dynamics, offering a novel approach to enhance control measures. This model provides a basis for further research on behavioral interventions in disease modeling.

麻疹是一种由麻疹病毒引起的高度传染性疾病，由于其传播迅速和严重并发症，对公众健康构成重大威胁。症状，如发烧、皮疹、红眼和咳嗽，通常在感染后8-12 天出现。鉴于最近麻疹再次出现，特别是在疫苗接种覆盖率低的地区，了解麻疹传播并评估疫苗接种意识在疫情控制中的作用至关重要。方法建立数学模型，考察麻疹传播和疫苗接种意识的影响。稳定性分析评估了模型的行为，而基本繁殖数R0则使用下一代矩阵方法推导。敏感性分析评估了参数变化如何影响疫情。利用迭代拉普拉斯变换和Atangana-Baleanu分数阶导数算子进行数值模拟，探讨了不同分数阶下的解条件和稳定性。结果模拟结果显示，疫苗接种意识显著降低麻疹传播。提高意识，降低R，降低爆发风险。分数顺序提供了对疾病持续性的见解，突出了行为因素在控制策略中的重要性。敏感性分析确定了有针对性干预措施的关键参数。结论本研究强调了疫苗接种意识在控制麻疹中的重要性，表明以教育为基础的策略可以减少传播。通过在分数阶微积分框架中整合行为因素，这项研究支持了针对麻疹等地方病的努力。这些发现表明，提高认识运动和疫苗接种可以改变传播动态，为加强控制措施提供了一种新方法。该模型为进一步研究疾病建模中的行为干预提供了基础。

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引用次数: 0

Immunization against Haemophilus influenzae type b outside the routine vaccination schedule 常规疫苗接种计划之外的b型流感嗜血杆菌免疫接种

Vacunas (English Edition)

Pub Date : 2025-04-01 Epub Date: 2025-05-21 DOI: 10.1016/j.vacune.2025.500425

Guillermo Mena , Eva Calderón , Marta Aldea , Susana Otero-Romero

The epidemiology of the invasive disease caused by Haemophilus influenzae has changed drastically since the introduction of vaccines in the routine vaccination schedule. In high-income countries, Haemophilus influenzae infection has gone from being a disease predominantly occurring in children and due to serotype b, to being a disease more frequent in adults and caused mainly by non-typeable strains. Therefore, it is important to take into account adult vaccination risk factors such as hematopoietic stem cell transplantation, functional or surgical asplenia, or certain innate or acquired immune deficits. In addition to these established factors, this document reviews the aspects to be taken into account by the physician, such as the degree of functional hypoesplenia, the type of affectation of the complement pathway or the affectation of the immunity of the individual caused by monoclonal gammopathies.

自从在常规疫苗接种计划中引入疫苗以来，由流感嗜血杆菌引起的侵袭性疾病的流行病学发生了巨大变化。在高收入国家，流感嗜血杆菌感染已从一种主要发生于儿童的疾病（由于血清型b），转变为一种更常见于成人的疾病，主要由不可分型菌株引起。因此，重要的是要考虑成人接种疫苗的危险因素，如造血干细胞移植，功能性或手术性脾功能减退，或某些先天或获得性免疫缺陷。除了这些已确定的因素外，本文还回顾了医生应考虑的方面，如功能性脾功能减退的程度、补体途径的影响类型或单克隆γ病引起的个体免疫的影响。

引用次数: 0