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提要

在泰国，流感依旧是严重的公共健康问题。仅2025年前8个月，就报告了超46万例流感病例，造成53人死亡。接种疫苗仍是降低发病率、住院率和死亡率的最有效手段。
新疫苗选择：减毒活流感疫苗（LAIV）为鼻喷式接种，无需注射，目前获批适用于2-49岁人群。该疫苗在全球已应用超20年，累计接种剂量超2亿剂。
疗效证实：临床数据显示，该疫苗对儿童和青少年的保护效力高达88%，可使住院风险降低63%，免疫保护期最长可达12个月。
双重免疫防护：与传统注射式流感疫苗不同，减毒活流感疫苗可同时激发呼吸道黏膜免疫和全身循环免疫。
无针接种，耐受性良好：疫苗安全性高且接种便捷，尤其适合害怕打针的人群。最常见的副作用为轻微、暂时性的鼻塞或流涕。

流感：持续存在的健康隐患

流感是一种常见的呼吸道病毒感染性疾病，可侵袭各年龄段人群，且可能引发严重并发症。
在泰国，流感全年均可发生，雨季和冬季的发病率会显著上升。
据泰国疾病控制厅（DDC）数据，2025年1月至8月，该国流感报告病例达464,891例，相当于每10万人中有716.18例感染，共造成53人死亡（病死率为0.011%）。
目前，泰国每周仍新增约1万例流感病例。

每年接种流感疫苗，仍是降低流感感染率、住院率和死亡率的最有效策略。

年度疫苗接种仍是降低流感相关感染率、住院率和死亡率的最有效策略。

什么是鼻喷式流感疫苗？

鼻喷式流感疫苗属于减毒活流感疫苗（LAIV），其成分是弱化的流感病毒。这些病毒不具备致病能力，但能有效刺激人体免疫系统产生针对流感的保护性抗体。
与传统注射式疫苗不同，减毒活流感疫苗通过鼻腔喷雾接种，而非肌肉注射。

重要提示：该疫苗须由医生或儿科医生开具处方并接种，不可自行使用，也无法在药店购买。

适用人群

鼻喷式流感疫苗推荐用于2-49岁的健康人群。

鼻喷式疫苗的有效性

减毒活流感疫苗在全球应用已超20年，累计接种剂量超2亿剂，其安全性和有效性均已得到充分验证。

核心优势包括：

无针接种：通过鼻腔喷雾方式接种，接受度更高，尤其适合儿童或害怕打针的人群。
防护效力高：对儿童和青少年的保护效力高达88%。与传统灭活流感疫苗（TIV）相比，防护效力提升约55%，可使住院率降低63%。
免疫保护期长：免疫保护可维持12个月，而注射式疫苗的保护效力可能在4-6个月后下降。
降低社区传播风险：儿童和青少年是流感传播的主要群体，为该人群接种疫苗有助于保护家庭、学校及更广泛的社区。
免疫应答更强：减毒活流感疫苗模拟自然感染过程，可同时诱导鼻腔局部的黏膜免疫（产生免疫球蛋白A）和全身免疫（激发T细胞应答），且免疫效果至少持续1年。

接种剂量与程序

年龄组	接种剂量	接种程序

2-8岁儿童	1剂或2剂**	若需接种2剂，两剂间隔至少1个月
2-8岁儿童	1剂（总计0.2毫升)**	每流感季接种1剂

*接种剂次需根据既往疫苗接种史，遵循国家免疫规划指南确定。
**每剂疫苗为0.1毫升，两侧鼻腔各喷雾接种0.1毫升。

可能出现的副作用

疫苗的副作用大多轻微且具有自限性，可自行缓解，包括：

流涕或鼻塞
低热

部分人群接种时，因吸入细微雾滴，可能会感到鼻腔有轻微清凉感。

现行推荐建议

泰国儿科感染病学会（PIDST）和泰国感染病协会（IDAT）建议所有人群每年接种流感疫苗。

对于2-49岁人群，鼻喷式流感疫苗（LAIV）是一种有效且便捷的选择。
- 对于6月龄及以上儿童，灭活注射式流感疫苗同样适用且被推荐接种。

安全性说明
减毒活流感疫苗采用冷适应、温度敏感型流感病毒株制备。
这意味着该病毒仅能在鼻腔和上呼吸道的低温环境中复制，无法在肺部等体温较高的部位繁殖。
因此，该疫苗不会引发流感疾病，对符合接种条件的人群而言是安全的。

Ambrose, C. S., et al. "The Efficacy of Intranasal Live Attenuated Influenza Vaccine in Children 2 through 17 Years of Age: A Meta-Analysis of 8 Randomized Controlled Studies." Vaccine, vol. 30, no. 5, 2012, pp. 886–892.
Ambrose, C. S., et al. "The Efficacy of Live Attenuated and Inactivated Influenza Vaccines in Children as a Function of Time Postvaccination." Pediatric Infectious Disease Journal, vol. 29, 2010, pp. 806-811.
Annual Report of the Chief Medical Officer 2015. On the State of the Public's Health, Baby Boomers: Fit for the Future. UK Government, assets.publishing.service.gov.uk/media/5a74b998e5274a3f93b484c9/CMO_baby_boomers_annual_report_2015.pdf. Accessed 1 Nov. 2023.
Ashkenazi, S., et al. "Superior Relative Efficacy of Live Attenuated Influenza Vaccine Compared with Inactivated Influenza Vaccine in Young Children with Recurrent Respiratory Tract Infections." Pediatric Infectious Disease Journal, vol. 25, 2006, pp. 870-879.
Barría, M. I., et al. "Localized Mucosal Response to Intranasal Live Attenuated Influenza Vaccine in Adults." Journal of Infectious Diseases, vol. 207, no. 1, 2013, pp. 115-124.
Belshe, R. B., et al. "Live Attenuated versus Inactivated Influenza Vaccine in Infants and Young Children." New England Journal of Medicine, vol. 356, 2007, pp. 685-696.
Chief Medical Officer for Scotland. "Seasonal Flu Immunisation Childhood and School Programme 2023/24 – Cohort Confirmation." Scottish Government, www.sehd.scot.nhs.uk/cmo/CMO(2023)09.pdf. Accessed 1 Nov. 2023.
Czumbel, I., et al. "Management and Control of Communicable Diseases in Schools and Other Child Care Settings: Systematic Review on the Incubation Period and Period of Infectiousness." BMC Infectious Diseases, vol. 18, no. 1, 2018, p. 199.
เอกสารกำกับยา FluMist. สำนักงานคณะกรรมการอาหารและยา.
Fiore, A. E., et al. "Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2008." MMWR Recommendations and Reports, vol. 57, no. RR-7, 2008, pp. 1–60.
Finnish Institute for Health and Welfare. "Vaccination Coverage Atlas." THL, www.thl.fi/roko/vaccreg/atlas/public/atlas-en.html?show=influenza. Accessed 1 Nov. 2023.
Fleming, D. M., et al. "Comparison of the Efficacy and Safety of Live Attenuated Cold-Adapted Influenza Vaccine, Trivalent, with Trivalent Inactivated Influenza Virus Vaccine in Children and Adolescents with Asthma." Pediatric Infectious Disease Journal, vol. 25, 2006, pp. 860-869.
Hoft, D. F., et al. "Live and Inactivated Influenza Vaccines Induce Similar Humoral Responses, but Only Live Vaccines Induce Diverse T-cell Responses in Young Children." Journal of Infectious Diseases, vol. 204, no. 6, 2011, pp. 845–853.
Kassianos, G., et al. "Implementation of the United Kingdom's Childhood Influenza National Vaccination Programme: A Review of Clinical Impact and Lessons Learned Over Six Influenza Seasons." Vaccine, vol. 38, no. 36, 2020, pp. 5747–5758.
Maassab, H. F., and D. C. DeBorde. "Development and Characterization of Cold-Adapted Viruses for Use as Live Virus Vaccines." Vaccine, vol. 3, no. 5, 1985, pp. 355–369.
Mohn, K. G., et al. "Longevity of B-cell and T-cell Responses after Live Attenuated Influenza Vaccination in Children." Journal of Infectious Diseases, vol. 211, no. 9, 2015, pp. 1541–1549.
Nohynek, H. "Seasonal Influenza Vaccine Coverage, Especially Live-Attenuated Vaccine Coverage, Increases Steadily among Children in Finland According to a Nationwide Register-Based Cohort Study." Poster presentation, European Society for Paediatric Infectious Diseases Annual Meeting, 6–11 May 2019, Ljubljana, Slovenia.
Pediatric Infectious Disease Society of Thailand. "ตารางการให้วัคซีนในเด็กและวัยรุ่นไทย แนะนำโดย สมาคมโรคติดเชื้อในเด็กแห่งประเทศไทย 2568." www.pidst.or.th/A1517.html.
Piedra, P. A., et al. "Trivalent Live Attenuated Intranasal Influenza Vaccine Administered during the 2003-2004 Influenza Type A (H3N2) Outbreak Provided Immediate, Direct, and Indirect Protection in Children." Pediatrics, vol. 120, 2007, pp. e553-564.
Public Health England. "National Flu Immunisation Programme 2023 to 2024 Letter." UK Government, www.gov.uk/government/publications/national-flu-immunisation-programme-plan/national-flu-immunisation-programme-2023-to-2024-letter. Accessed 1 Nov. 2023.
---. "Surveillance of Influenza and Other Respiratory Viruses in the UK Winter 2018 to 2019." UK Government, webarchive.nationalarchives.gov.uk/ukgwa/20220401215804/https://www.gov.uk/government/statistics/annual-flu-reports. Accessed 1 Nov. 2023.
---. "Surveillance of Influenza and Other Respiratory Viruses in the UK Winter 2019 to 2020." UK Government, webarchive.nationalarchives.gov.uk/ukgwa/20220401215804/https://www.gov.uk/government/statistics/annual-flu-reports. Accessed 1 Nov. 2023.
---. "Surveillance of Influenza and Other Respiratory Viruses in the UK Winter 2020 to 2021." UK Government, webarchive.nationalarchives.gov.uk/ukgwa/20220401215804/https://www.gov.uk/government/statistics/annual-flu-reports. Accessed 1 Nov. 2023.
---. "The Flu Immunisation Programme 2013/14 – Extension to Children." UK Government, assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/225360/Children_s_flu_letter_2013.pdf. Accessed 1 Nov. 2023.
Statens Serum Institut. "Influenza Vaccination." SSI, en.ssi.dk/vaccination/vaccination-of-risk-groups/influenza. Accessed 1 Nov. 2023.
Thai Association of Infectious Diseases. "คำแนะนำการให้วัคซีนป้องกันโรคสำหรับผู้ใหญ่และผู้สูงอายุ." idthai.org/Contents/Views/?d=!17!9!!1046!.
THL. "Nasal Spray Influenza Vaccine for Children." Finnish Institute for Health and Welfare, thl.fi/en/web/infectious-diseases-and-vaccinations/vaccines-a-to-z/influenza-vaccine/nasal-spray-influenza-vaccine-for-children. Accessed 1 Nov. 2023.
UK Health Security Agency. "Seasonal Influenza Vaccine Uptake in Children of School Age: Monthly Data, 2022 to 2023." UK Government, www.gov.uk/government/statistics/seasonal-influenza-vaccine-uptake-in-children-of-school-age-monthly-data-2022-to-2023. Accessed 1 Nov. 2023.
---. "Surveillance of Influenza and Other Seasonal Respiratory Viruses in Winter 2021 to 2022." UK Government, www.gov.uk/government/statistics/annual-flu-reports/surveillance-of-influenza-and-other-seasonal-respiratory-viruses-in-winter-2021-to-2022. Accessed 1 Nov. 2023.
Welsh Government. "Reimbursable Vaccines and Eligible Cohorts for the 2023 to 2024 NHS Seasonal Influenza (Flu) Vaccination Programme (WHC/2022/031)." www.gov.wales/reimbursable-vaccines-and-eligible-cohorts-2023-2024-nhs-seasonal-influenza-flu-vaccination. Accessed 1 Nov. 2023.

鼻喷式流感疫苗：无需注射的防护选择

提要