Respon Imun terhadap Vaksin Influenza pada Remaja
DOI:
https://doi.org/10.21776/ub.jkb.2012.027.02.9Abstract
Influenza merupakan penyakit yang mudah menular dengan mortalitas dan morbiditas tinggi serta sering menimbulkan kejadian  luar biasa, epidemi, dan pandemi. Pada anak  sekolah,  influenza menyebabkan  tingginya angka absensi dan remaja merupakan  sumber  penularan  terbesar .  Penelitian  dilakukan  untuk menilai  respons  imun   terhadap  vaksin influenza pada kelompok remaja 12–18 tahunpada bulan Juni–September 2008, di Puskesmas Garuda Bandung. Desain dilakukan dengan  intervensional,  longitudinal, acak sederhana, dan tersamar tunggal. Vaksin  influenza yang mengandung 3 jenis virus A/H1N1, A/H3N2 dan B, disuntikkan intramuskular. Pengambilan darah dilakukan pra dan pasca vaksinasi. Pemeriksaan kadar antibodi dilakukan dengan metode hemaglutinasi inhibisi (HI). Respons imun dinilai berdasarkan nilai serokonversi, dan peningkatan geometric mean titer (GMT). Subjek dibagi 2 kelompok, 69 (52,7%) remaja pertengahan (12–15  tahun) dan 62  (47,3%)  remaja akhir  (16–18  tahun). Semua  subjek  telah mempunyai kadar antibodi protektif HI>1:40 pascavaksinasi. Nilai serokonversi kedua kelompok berbeda bermakna pada pra  (p=0,02) dan pascavaksinasi (p=0,02). Serokonversi  terhadap virus A/H3N2 antara remaja pertengahan dan akhir berbeda bermakna pada pravaksinasi (p=0,02). Pada pra dan pascavaksinasi  terdapat peningkatan GMT bermakna  terhadap ketiga  jenis virus  influenza  (Zw 9,73; 9,19; 9,59 dan p=0,00). Simpulan, vaksinasi influenza pada remaja menghasilkan kadar protektif. Respons imun remaja pertengahan dan akhir  tidak berbeda, namun  remaja pertengahan  tampak  lebih  responsif.
Kata Kunci: Influenza, Â remaja, Â responsimun, vaksin
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References
Centers for Disease Control and Prevention. Update: Influenza Activity-United States, September 28, 2008–April 4, 2009, and Composition of the 2009-10 Influenza Vaccine. Morbidity and Mortality Weekly Report. 2009; 58(14): 369–374.
Mari K and Blum R. International Adolescent Health. In: Fisher M (Ed). Textbook of Adolescent Health Care edisi 1. New York: American Academy of Pediatrics; 2011; p. 17–21.
Jaspan HE, Lawn SD, Safrit JT, and Bekker L. The Maturing Immune System: Impl ications for Development and Testing H1N1 Vaccines for Children and Adolescents. AIDS. 2006; 20(4): 483–494.
Radzik M, Sherer S, and Neinstein L. Psychosocial Development in Normal Adolescents. In: Neinstein LS (Ed). Adolescent Health Care 5th edition. Philadelphia: Lippincott WIlliams and Wilkin; 2008; p. 27-31.
Chng WJ, Tan GB, and Kuperan P. Establishment of Adult Peripheral Blood Lymphocyte Subset Reference Range For an Asian Population by Single-Platform Flow Cytometry: Influence of Age, Sex, and Race and Comparison with Other Published Studies. Clinical and Diagnostic Laboratory Immunology. 2004; 11(1): 168–173.
Davis MM, King JC, Moag L, Cummings G, and Magder LS. Count ywide S chool -Bas ed Inf luenza Immunization: Direct and Indirect Impact on Student Absenteeism. Pediatrics. 2008; 122(1): e260–265.
Kim TH, Johnstone J, and Loeb M. Vaccine Herd Effect. Scandinavian Journal of Infectious Disease. 2011; 3(9): 683–689.
Charu V, Viboud C, Simonsen L, et al. Influenza-Related Mortality Trends in Japanese and American Seniors: Evidence for the Indirect Mortality Benefit of Vaccinating Schoolchildren. Plos One. 2011; 6(11): e26282.
Fiore AE, Uyeki TM, Broder K, et al. Prevention and Control of Influenza with Vaccines Recommendations of the Advisory Committee on Immunization Practices (ACIP). Morbidity and Mortality Weekly Report. 2010; 59(8): 1-62.
Wright P, Neumann G, and Kawaoka Y. Orthomyxoviruses. In: Knipe D (Ed). Fields Virology 5th edition. Philadelphia: Lippincott William & Wilkins; 2007; p. 1691–1727.
Ikatan Dokter Anak Indonesia. Jadwal Imunisasi Untuk A n a k d a n R e m a j a 2 0 0 8 . ( O n l i n e). http://www.idai.or.id/remaja/artikel.asp?q=201176101020
Murphy K, Travers P, and Walport M. Antigen Recognition by B-Cell and T-Cell Receptors. In: Taylor & Francis. Janeway's Immunobiology 7th edition. New York: Garland Science; 2008; p. 111–142.
Bridges CB, Katz JM, Levandowski R, and Cox NJ. Inactivated Influenza Vaccines. In: Plotkin SA (Ed). Vaccines 5th edition. Philadelphia: WB Saunders; 2008; p. 259–290.
Barr IG, McCauley J, Cox N, et al. Epidemiological, Antigenic and Genetic Characteristics of Seasonal Influenza A(H1n1), A(H3n2) and B Influenza Viruses: Basis for the WHO Recommendation on the
Composition of Influenza Vaccines for Use in the 2009–2010 Northern Hemisphere Season. Vaccine. 2010; 28(5): 1156–1167.
Taunbenberger JK. The Originan d Virulence of the
'Spanish" Influenza Virus. Proceedings of the American Philosophical Society. 2006; 150(1): 86-112.
Haaheim LR. Basic Influenza Virology and Immunology. In: Van-Tam J (Ed). Introduction to Pandemic Influenza 1st edition. Cambridge: Cambridge University Press; 2010; p. 14–26.
Englund JA, Walter EB, Fairchok MP, Monto AS, and Neuzil KM. A Comparison of 2 Influenza Vaccine Schedules in 6-to 23-Month-Old Children. Pediatrics. 2005; 115(4): 1039–1047.
Food and Drug Administration. Guidance for Industry, Toxicity Grading Scale For Healthy Adult and dolescent Volunteers Enrolled in Preventive Vaccine Trial .(Online) 2005. http://www.fda.gov/ BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Vaccines/ucm074775.htm
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