Influenza – Krankheitslast und Impfprävention bei Kindern und Jugendlichen

ZUSAMMENFASSUNG

Influenza-ähnliche Atemwegsinfektionen sind eine weltweite bevölkerungsmedizinische Herausforderung. Die Vielfalt viraler Erreger lässt sich nicht klinisch unterscheiden, aber die Grippeschutzimpfung ist ein wichtiges Präventionsinstrument. Neben dem akut febrilen Krankheitsbild mit Myalgie, Zephalgie und Atembeschwerden müssen nicht-respiratorische Komplikationen (Influenza-assoziierte Myopathie, ZNS- oder kardiale Beteiligung) berücksichtigt werden. Aufgrund ständiger viral-genetischer Veränderungen und fehlendem Langzeitschutz bedarf es alljährlich neuer Influenzavakzine mit wissenschaftlichen und logistischen Herausforderungen. Die von Jahr zu Jahr unterschiedliche Schutzwirkung und teils auch Verträglichkeit jeweiliger Grippeimpfstoffe machen Impfkampagnen anspruchsvoll. Diese Übersicht stellt Krankheitslast, Wirksamkeit und Anwendungssicherheit zugelassener Influenzavakzine dar. Individuen mit allergischer Hühnerei-Sensibilisierung können unter Praxisbedingungen ohne zusätzliche Vorsichtsmaßnahmen grippegeimpft werden. Zukünftige Vakzine werden durch rekombinante oder Zellkultur-basierte Herstellungsverfahren besser verfügbar und möglicherweise noch wirksamer sein.

ABSTRACT

Influenza-like illness (ILI) is an important public health problem worldwide. Being caused by many different viral agents that are not clinically distinguishable from one another, influenza vaccination is an important preventive tool. Influenza typically causes an acute/febrile illness with myalgia, headache, and cough. Besides respiratory symptoms, non-respiratory complications (e. g., influenza-associated myopathy, cns pathology, and myocarditis) must be considered. Due to the yearly changes in viral antigenic configuration and the lack of long-lasting protection, new flu vaccines need to be composed and distributed annually, with huge scientific and logistic efforts. Immunization campaigns are challenged from season to season by varying effectiveness, and sometimes safety of available vaccines. This review discusses the burden of influenza and the safety and effectiveness profile of influenza vaccines recommended in children and adolescents. Individuals with allergic egg-sensitization can receive influenza vaccines without additional precautions beyond those recommended for all vaccines. Future improvements of flu vaccines include cell-culture based production and recombinant vaccines.

Schlüsselwörter

Influenza - Schutzimpfung - Wirksamkeit - Anwendungssicherheit

Keywords

Influenza - vaccination - efficacy - effectiveness - safety

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