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Сообщение от AlexGold
Данные большинства результатов клинических исследований, посвященных вопросу безопасности вакцины против гриппа у больных с БА, показывают, что данная вакцинация не увеличивает частоту обострений астмы, частоту использования противоастматических препаратов или обращений за медицинской помощью по поводу основного заболевания. Вот, например, недавнее высококачественное исследование:
THE SAFETY OF INACTIVATED INFLUENZA VACCINE IN ADULTS AND CHILDREN WITH ASTHMA
From The American Lung Association Asthma Clinical Research Centers
New Engl J Med 2001;345:1529-1536
Background. Influenza causes substantial morbidity in adults and children with asthma, and vaccination can prevent influenza and its complications. However, there is concern that vaccination may cause exacerbations of asthma.
Methods. To investigate the safety of the inactivated trivalent split-virus influenza vaccine in adults and children with asthma, we conducted a multicenter, randomized, double-blind, placebo-controlled, crossover trial in 2032 patients with asthma (age range, 3 to 64 years). The order of injection of vaccine and placebo was assigned randomly, with a mean of 22 days between the injections. Each day during the two weeks after each injection, the patients recorded peak expiratory flow rates, symptoms thought to be related to the injection, use of asthma medications, unscheduled health care visits for asthma, and asthma related absences from school or work. The primary outcome measure was an exacerbation of asthma in the two weeks after the injections.
Results. The frequency of exacerbations of asthma was similar in the two weeks after the influenza vaccination and after placebo injection (28,8 percent and 27,7 percent, respectively; absolute difference, 1,1 percent; 95 percent confidence interval, -1,4 percent to 3,6 percent). The exacerbation rates were similar in subgroups defined according to age, severity of asthma, and other factors. Among symptoms thought to be associated with the injection, only body aches were more frequent after the vaccine injection than after placebo injection (25,1 percent vs. 20,8 percent, P<0,001).
Conclusions. The inactivated influenza vaccine is safe to administer to adults and children with asthma, including those with severe asthma. Given the morbidity of influenza, all those with asthma should receive the vaccine annually.
Учитывая эти данные, считается, что польза вакцинации против гриппа больных с БА (профилактика тяжелого течения гриппа у таких больных с риском развития обострения основного заболевания) значительно превышает риск вакцинации. В связи с этим, таким больным рекомендована ежегодная вакцинация против гриппа. Ее проводят вне обострения, на фоне базовой или некоторого усиления базовой терапии.
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