通过系统评价评估儿童接种流感减毒活疫苗的有效性与安全性

doi:10.5246/jcps.2026.02.012

中国药学(英文版) ›› 2026, Vol. 35 ›› Issue (2): 162-172.DOI: 10.5246/jcps.2026.02.012

通过系统评价评估儿童接种流感减毒活疫苗的有效性与安全性

李聪¹^,^#, 黄怡²^,^#, 杨如杏², 邹姒妮¹, 王建荣¹^,³, 李桢¹^,^*()

^1. 东莞市妇幼保健院儿科, 广东东莞 523057
^2. 广东医科大学第二临床医学院内科学系, 广东东莞 523808
^3. 新疆医科大学第五附属医院新生儿科, 新疆乌鲁木齐 830011

收稿日期:2025-10-27 修回日期:2025-11-21 接受日期:2026-01-04 出版日期:2026-03-05 发布日期:2026-03-05
通讯作者: 李桢

Systematic review of the effectiveness and safety of live attenuated influenza vaccine in children

Cong Li¹^,^#, Yi Huang²^,^#, Ruxing Yang², Sini Zou¹, Jianrong Wang¹^,³, Zhen Li¹^,^*()

^1. Department of Pediatrics, Dongguan Maternity and Child Healthcare Hospital, Dongguan 523057, Guangdong, China
^2. Department of Internal Medicine, Second Clinical Medical College of Guangdong Medical University, Dongguan 523808, Guangdong, China
^3. Department of Pediatrics, the Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang, China

Received:2025-10-27 Revised:2025-11-21 Accepted:2026-01-04 Online:2026-03-05 Published:2026-03-05
Contact: Zhen Li
About author:
^# Co-first author.

摘要/Abstract

摘要：

流感减毒活疫苗(LAIV)是一种无需注射的鼻内接种疫苗, 因其给药便捷且能诱导黏膜免疫而在儿童中广泛应用。本研究基于临床试验和真实世界研究, 通过系统评价对LAIV在儿童群体中的有效性和安全性进行了评估。研究结果显示, LAIV能诱导强烈的黏膜免疫(分泌型IgA水平提升10倍)和全身抗体反应, 尤其对H1N1和B型毒株效果显著, 但对H3N2毒株的效力相对较低。安全性数据表明LAIV耐受性良好, 仅出现短暂轻微不良反应, 严重反应罕见。然而, 在哮喘患儿中观察到喘息症状轻微增加, 提示该亚群需谨慎使用。与灭活流感疫苗(IIV)相比, LAIV具有防护效果, 并额外具有减少社区传播的优势。目前LAIV仍面临预存免疫力干扰和热稳定性限制等挑战, 但新一代LAIV有望解决这些问题。因此, LAIV仍是儿童流感预防的重要工具, 尤其适用于抗拒注射的群体, 但需进一步优化毒株匹配并完善安全性。

关键词: 流感减毒活疫苗, 儿童, 有效性, 安全性, 系统评价

Abstract:

Live attenuated influenza vaccine (LAIV) is a needle-free, intranasal vaccine widely used in pediatric populations due to its ease of administration and its ability to induce mucosal immunity. This systematic review evaluated the effectiveness and safety of LAIV in children by analyzing data from clinical trials and real-world studies. The findings demonstrated that LAIV elicited robust mucosal IgA responses, approximately tenfold higher, and strong systemic antibody responses, particularly against H1N1 and B strains, although its efficacy against H3N2 remained comparatively lower. Safety assessments showed that LAIV was generally well-tolerated, with mostly transient mild adverse events and rare occurrences of serious reactions. However, a slight increase in wheezing episodes was observed in children with asthma, indicating a need for caution in this subgroup. When compared to inactivated influenza vaccines (IIV), LAIV provided comparable protection while offering the additional benefit of reducing transmission in community settings. Challenges such as interference from pre-existing immunity and limited thermo-stability were noted, but advancements in next-generation LAIV formulations hold promise for addressing these limitations. Overall, LAIV continues to be a valuable tool for pediatric influenza prevention, especially for needle-averse populations, although strain-specific optimization and further safety improvements remain necessary.

Key words: LAIV, Children, Effectiveness, Safety, Systematic review

Supporting:

李聪, 黄怡, 杨如杏, 邹姒妮, 王建荣, 李桢. 通过系统评价评估儿童接种流感减毒活疫苗的有效性与安全性[J]. 中国药学(英文版), 2026, 35(2): 162-172.

Cong Li, Yi Huang, Ruxing Yang, Sini Zou, Jianrong Wang, Zhen Li. Systematic review of the effectiveness and safety of live attenuated influenza vaccine in children[J]. Journal of Chinese Pharmaceutical Sciences, 2026, 35(2): 162-172.

图/表 5

Table 1. The comparisons between LAIV and IIV.

Table 2. The LAIV safety profile in children from 2014 to 2024.

Table 3. The effectiveness of LAIV in children.

Table 4. The total LAIV effectiveness in children from 2014 to 2024.

Table 5. The comparisons between DelNS1-2019-nCoV-RBD-OPT1 and LAIV.

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通过系统评价评估儿童接种流感减毒活疫苗的有效性与安全性

Systematic review of the effectiveness and safety of live attenuated influenza vaccine in children

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