Quelle: Quelle: Medline Abstract Fachblatt Arch Intern Med.

Alte Menschen benötigen bei der Grippeimpfung einen stärkeren Impfstoff als Jüngere


Von Dr. med. Jochen Kubitschek

Völlig unabhängig von der sog. „Vogelgrippe“ fordert die ganz gewöhnliche Virus-Grippe Jahr für Jahr zahlreiche viele Todesopfer. Besonders gefährdet sind ältere Menschen, da deren Immunsystem nicht mehr so gut funktioniert wie in jüngeren Jahren.

Nun hat ein amerikanisches Forscherteam herausgefunden, daß es Sinn macht Menschen über 65 mit Grippe-Impfstoffen zu impfen, die deutlich höheren Impfstoffkonzentrationen enthalten.

Je höher konzentriert die Impfstoffe waren, um so stärker fiel auch die Reaktion des Immunsystems und somit die Schutzwirkung der Impfung aus. Die Impfungen wurden in allen getesteten Konzentrationen gut vertragen. Die gelegentlich beobachteten Hautreaktionen verschwanden schnell wieder ohne weitere negative Folgen zu hinterlassen.

Arch Intern Med. 2006 May 22;166(10):1121-7.

Safety of high doses of influenza vaccine and effect on antibody responses in elderly persons.


Keitel WA, Atmar RL, Cate TR, Petersen NJ, Greenberg SB, Ruben F, Couch RB.


Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Tex 77030, USA. wkeitel@bcm.tmc.edu


BACKGROUND: Immune responses after influenza immunization are reduced in elderly individuals, the group at greatest risk for complications and death after influenza. Improved vaccines are needed to address this problem.

METHODS: Ambulatory individuals 65 years and older (N = 202) were assigned randomly to receive a single intramuscular injection of the 2001-2002 formulation of trivalent inactivated influenza vaccine containing 15, 30, or 60 microg of hemagglutinin per strain (up to 180 microg total per dose) or placebo. Clinical and serologic responses were assessed during the month after immunization.

RESULTS: Increasing dosages of vaccine elicited significantly higher serum antibody levels, frequencies of antibody responses, and putative protective titers after vaccination. Mean serum hemagglutination inhibition antibody titers 1 month after immunization in groups given 0-, 15-, 30-, and 60-microg dosages were 23, 37, 50, and 61 against influenza A/H1N1; 43, 86, 91, and 125 against influenza A/H3N2; and 10, 14, 18, and 24 against influenza B, respectively. Mean serum hemagglutination inhibition and neutralizing antibody levels against the 3 vaccine antigens in participants given the 60-microg dosage were 44% to 71% and 54% to 79%, respectively, higher than those in participants given the standard 15-microg dosage, and the 60-microg dosage level nearly doubled the frequency of antibody responses in those whose preimmunization antibody titers were in the lower half of the antibody range. Dose-related increases in the occurrence of injection site reactions were observed (P<.001), but all dosages were well tolerated.

CONCLUSION: The improved immunogenicity of high-dose influenza vaccine among elderly persons should lead to enhanced protection against naturally occurring influenza.