Pustaka Ilmiah Universitas Padjadjaran

Abstrak

Respon Imun terhadap Vaksin Influenza pada Remaja (Adolescent Immune Response to Influenza Vaccine)

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.

As a contagious disease, influenzacan cause seasonal outbreaks, epidemics and pandemics resulting high mortality and morbidity. Adolescents are the major source of transmission, resulting in high rates of absenteeism in school-age children. The aim of this study was to asses the immuneresponse of adolescent toward sinfluenza vaccine.The interventional, longitudinal, simple randomized, single blind study was conducted to12-18 years old adolescents, in Garuda Public Health Center Bandung,on June to September 2008. Influenza vaccine consists of 3 virus type A/H1N1, A/H3N2 and B was injected intramusculary. Blood samples was taken pre and post vaccination. Antibody titer was measured using hemaglutinationinhibition assays. The immune response was determined based on The seroconversion Rate and increase ingeometric mean titer (GMT). The subjects were divided into two age groups, 69 (52,7%) middle (12-15 years) and 62 (47,3%) late adolescents (16-18 years). All of the subjects had post vaccination antibody titers HI= 1:40. The seroconversion rate between groups were significantly different (p=0,02 and p=0,02). The seroconversion to A/H3N2 between groups were significantly different in pre-vaccination (p=0,02). Significant difference was found between GMT for three types of influenza virus (Zw 9.73, 9.19, 9.59 and p=0,00). In conclusion, vaccination for influenza in adolescent resulted in protective level. Although there is no difference between the middle and late adolescent, middle adolescents seems more responsive to influenza vaccine.