流感疫苗为流感的一级预防。[43]Jackson LA, Gaglani MJ, Keyserling HL, et al. Safety, efficacy, and immunogenicity of an inactivated influenza vaccine in healthy adults: a randomized, placebo-controlled trial over two influenza seasons. BMC Infect Dis. 2010;10:71.http://www.ncbi.nlm.nih.gov/pubmed/20236548?tool=bestpractice.com[44]Beyer WE, Nauta JJ, Palache AM, et al. Immunogenicity and safety of inactivated influenza vaccines in primed populations: a systematic literature review and meta-analysis. Vaccine. 2011;29:5785-5792.http://www.ncbi.nlm.nih.gov/pubmed/21624411?tool=bestpractice.com[45]Demicheli V, Jefferson T, Ferroni E, et al Vaccines for preventing influenza in healthy adults. Cochrane Database Syst Rev. 2018 Feb 1;2:CD001269.http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD001269.pub6/fullhttp://www.ncbi.nlm.nih.gov/pubmed/29388196?tool=bestpractice.com[46]Bitterman R, Eliakim-Raz N, Vinograd I, et al. Influenza vaccines in immunosuppressed adults with cancer. Cochrane Database Syst Rev. 2018 Feb 1;2:CD008983.http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD008983.pub3/fullhttp://www.ncbi.nlm.nih.gov/pubmed/29388675?tool=bestpractice.com[47]Jefferson T, Rivetti A, Di Pietrantonj C, Demicheli V. Vaccines for preventing influenza in healthy children. Cochrane Database Syst Rev. 2018 Feb 1;2:CD004879.http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD004879.pub5/fullhttp://www.ncbi.nlm.nih.gov/pubmed/29388195?tool=bestpractice.com[48]Demicheli V, Jefferson T, Di Pietrantonj C, et al. Vaccines for preventing influenza in the elderly. Cochrane Database Syst Rev. 2018 Feb 1;2:CD004876.http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD004876.pub4/fullhttp://www.ncbi.nlm.nih.gov/pubmed/29388197?tool=bestpractice.com[49]Rondy M, El Omeiri N, Thompson MG, et al. Effectiveness of influenza vaccines in preventing severe influenza illness among adults: A systematic review and meta-analysis of test-negative design case-control studies. J Infect. 2017 Nov;75(5):381-394.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5912669/http://www.ncbi.nlm.nih.gov/pubmed/28935236?tool=bestpractice.com[50]Vasileiou E, Sheikh A, Butler C, et al. Effectiveness of influenza vaccines in asthma: a systematic review and meta-analysis. Clin Infect Dis. 2017 Oct 15;65(8):1388-1395.https://academic.oup.com/cid/article/65/8/1388/3862448http://www.ncbi.nlm.nih.gov/pubmed/28591866?tool=bestpractice.com [ 
]In healthy adults, what are the benefits and harms of vaccines for preventing influenza?https://cochranelibrary.com/cca/doi/10.1002/cca.2024/full显示答案 [ ]In healthy children, what are the benefits and harms of vaccines for preventing influenza?https://cochranelibrary.com/cca/doi/10.1002/cca.2021/full显示答案 [ ]Does randomized controlled trial evidence support the use of vaccines to prevent influenza in the elderly?https://cochranelibrary.com/cca/doi/10.1002/cca.2022/full显示答案国际指南在推荐哪些人应接种疫苗方面的意见存在差异。目前，美国疾病预防控制中心 (CDC) 推荐，所有年龄≥ 6 月龄且没有疫苗接种禁忌证的人群都应接种流感疫苗。[51]Grohskopf LA, Sokolow LZ, Broder KR, et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 influenza season. MMWR Recomm Rep 2018;67(No. RR-3):1–20.https://www.cdc.gov/mmwr/volumes/67/rr/rr6703a1.htm?s_cid=rr6703a1_whttp://www.ncbi.nlm.nih.gov/pubmed/30141464?tool=bestpractice.comCDC: Influenza (Flu)从 2018 年至 2019 年，疾病预防控制中心 (CDC) 免疫接种咨询委员会 (Advisory Committee on Immunization Practices, ACIP) 推荐在恰当时，可使用任何经批准、与年龄相适应的流行性感冒疫苗，包括减毒活疫苗（在之前两个流行性感冒季未推荐接种减毒活疫苗）。[51]Grohskopf LA, Sokolow LZ, Broder KR, et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 influenza season. MMWR Recomm Rep 2018;67(No. RR-3):1–20.https://www.cdc.gov/mmwr/volumes/67/rr/rr6703a1.htm?s_cid=rr6703a1_whttp://www.ncbi.nlm.nih.gov/pubmed/30141464?tool=bestpractice.com 婴幼儿（<6个月）接种流感疫苗的试验正在进行中。[52]Englund JA, Walter E, Black S, et al. Safety and immunogenicity of trivalent inactivated influenza vaccine in infants: a randomized double-blind placebo-controlled study. Pediatr Infect Dis J. 2010;29:105-110.http://www.ncbi.nlm.nih.gov/pubmed/19934787?tool=bestpractice.com 年龄为 6 月龄至 8 岁的儿童在第一个流感疫苗接种季节期间需要注射两剂流感疫苗（接种间隔≥ 4 周），以优化接种效果。[51]Grohskopf LA, Sokolow LZ, Broder KR, et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 influenza season. MMWR Recomm Rep 2018;67(No. RR-3):1–20.https://www.cdc.gov/mmwr/volumes/67/rr/rr6703a1.htm?s_cid=rr6703a1_whttp://www.ncbi.nlm.nih.gov/pubmed/30141464?tool=bestpractice.com 美国儿科学会 (American Academy of Pediatrics, AAP) 推荐在 2018 到 2019 年将灭活流行性感冒疫苗作为所有儿童的首选，因为针对甲型流行性感冒 (H1N1) 的减毒活疫苗在过去的流行性感冒季有效性较差。[53]Committee on Infectious Diseases. Recommendations for prevention and control of influenza in children, 2018-2019. Pediatrics. 2018 Oct;142(4).http://pediatrics.aappublications.org/content/early/2018/08/30/peds.2018-2367http://www.ncbi.nlm.nih.gov/pubmed/30177511?tool=bestpractice.com ACIP 建议，6 月龄至 8 岁的儿童如果在 2016 年 7 月 1 日之前已接种≥2 剂三价或四价流行性感冒疫苗，则在 2016 年至 2017 年流行性感冒季只需接种一剂疫苗。[51]Grohskopf LA, Sokolow LZ, Broder KR, et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 influenza season. MMWR Recomm Rep 2018;67(No. RR-3):1–20.https://www.cdc.gov/mmwr/volumes/67/rr/rr6703a1.htm?s_cid=rr6703a1_whttp://www.ncbi.nlm.nih.gov/pubmed/30141464?tool=bestpractice.com 从 9 岁开始，推荐每年仅接种一剂。[54]Robinson CL, Bernstein H, Romero JR, et al. Advisory Committee on Immunization Practices recommended immunization schedule for children and adolescents aged 18 years or younger - United States, 2019. MMWR Morb Mortal Wkly Rep. 2019 Feb 8;68(5):112-114.https://www.cdc.gov/mmwr/volumes/68/wr/mm6805a4.htmhttp://www.ncbi.nlm.nih.gov/pubmed/30730870?tool=bestpractice.com 孕妇可以接受任何已批准、推荐使用、与年龄相适应的灭活疫苗；不应在妊娠期间使用流行性感冒减毒活疫苗。[51]Grohskopf LA, Sokolow LZ, Broder KR, et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 influenza season. MMWR Recomm Rep 2018;67(No. RR-3):1–20.https://www.cdc.gov/mmwr/volumes/67/rr/rr6703a1.htm?s_cid=rr6703a1_whttp://www.ncbi.nlm.nih.gov/pubmed/30141464?tool=bestpractice.com 妊娠期间的流行性感冒疫苗接种与婴儿出生后 6 个月内的住院或死亡风险增加无关，[55]Sukumaran L, McCarthy NL, Kharbanda EO, et al. Infant hospitalizations and mortality after maternal vaccination. Pediatrics. 2018 Feb 20. pii: e20173310.http://pediatrics.aappublications.org/content/early/2018/02/16/peds.2017-3310http://www.ncbi.nlm.nih.gov/pubmed/29463582?tool=bestpractice.com 并且可能有助于预防孕妇因流行性感冒而住院。[56]Thompson MG, Kwong JC, Regan AK, et al; PREVENT Workgroup. Influenza vaccine effectiveness in preventing influenza-associated hospitalizations during pregnancy: a multi-country retrospective test negative design study, 2010-2016. Clin Infect Dis. 2018 Oct 11. [Epub ahead of print].https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciy737/5126390http://www.ncbi.nlm.nih.gov/pubmed/30307490?tool=bestpractice.com 其他国际指南推荐高风险人群接种流感疫苗。咨询和遵循当地的指南推荐意见。
对于 2018-2019（北半球）流行性感冒季，世界卫生组织建议四价疫苗含有甲型/密歇根/45/2015 (H1N1) pdm09 样病毒、甲型/新加坡/INFIMH-16-0019/2016 (H3N2) 样病毒、乙型/科罗拉多/06/2017 样病毒（乙型/维多利亚/2/87 系）和乙型/普吉岛/3073/2013 样病毒（乙型/山形/16/88 系）。三价疫苗的乙型流行性感冒病毒成分应该为乙型/维多利亚/2/87 系的乙型/科罗拉多/06/2017 样病毒。[57]World Health Organization. Recommended composition of influenza virus vaccines for use in the 2018-2019 northern hemisphere influenza season. February 2018 [internet publication].http://www.who.int/influenza/vaccines/virus/recommendations/2018_19_north/en/
在美国，美国儿科学会 (AAP) 的推荐指出，对于有任何严重程度鸡蛋过敏的所有儿童，可以接种流行性感冒灭活疫苗或流行性感冒减毒活疫苗，除了针对任何疫苗所建议的注意事项，无其他注意事项。[19]Committee on Infectious Diseases. Recommendations for prevention and control of influenza in children, 2018-2019. Pediatrics. 2018 Oct;142(4).http://pediatrics.aappublications.org/content/142/4/e20182367.longhttp://www.ncbi.nlm.nih.gov/pubmed/30177511?tool=bestpractice.com 美国 ACIP 的推荐如下：[51]Grohskopf LA, Sokolow LZ, Broder KR, et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 influenza season. MMWR Recomm Rep 2018;67(No. RR-3):1–20.https://www.cdc.gov/mmwr/volumes/67/rr/rr6703a1.htm?s_cid=rr6703a1_whttp://www.ncbi.nlm.nih.gov/pubmed/30141464?tool=bestpractice.com
有鸡蛋过敏史且在暴露于鸡蛋后仅出现荨麻疹的个体应接种流行性感冒疫苗（任何已批准、推荐使用、与年龄相适应的流行性感冒疫苗）。
已报告对鸡蛋有过敏反应（发生诸如血管性水肿、呼吸窘迫、头晕目眩或反复性呕吐等症状），或者需要使用肾上腺素或其他紧急医疗干预的人群，可接种流行性感冒疫苗（任何已批准、推荐使用、与年龄相适应的流行性感冒疫苗）。应由具备识别和治疗严重过敏反应经验的医师来接种疫苗。
能够吃轻微烹饪的鸡蛋（例如，炒蛋）且无反应的人群不太可能发生过敏。鸡蛋过敏的人群可能耐受鸡蛋烘焙产品（例如面包或蛋糕）。但耐受含有鸡蛋食品的人不排除对鸡蛋过敏的可能性。可通过以下情况确定鸡蛋过敏：一致的对鸡蛋和含有鸡蛋的食品不良反应史、皮肤检查和/或血液检查中检测到抗鸡蛋蛋白 IgE 阳性。
对于没有食用过或接触过鸡蛋，但基于既往接受的过敏试验而怀疑鸡蛋过敏的人，接种流感疫苗前要咨询擅长治疗过敏性疾病的医生。
只要既往有对流感疫苗发生严重过敏反应，不管怀疑对何种成分产生反应，均是将来接种疫苗的一个禁忌证。
无论有无过敏史，所有的疫苗接种均需在配备专业人员和设备的环境中进行，能够快速识别和处理严重过敏反应。
通过先皮肤试验再接种疫苗的两步骤方法是没有必要的。[58]Kelso JM, Greenhawt MJ, Li JT, et al. Adverse reactions to vaccines practice parameter 2012 update. J Allergy Clin Immunol. 2012;130:25-43.http://www.ncbi.nlm.nih.gov/pubmed/22608573?tool=bestpractice.com 利用昆虫病毒表达系统和重组 DNA 技术制成的三价疫苗现可用于 18 岁或以上的成人。不像其他的疫苗，这种疫苗在生产过程中不使用流感病毒或鸡蛋。一种基于细胞的四价疫苗在美国可用于4岁及以上人群，在欧洲可用于 9岁及以上的人群。这种基于细胞的四价疫苗使用在哺乳动物来源的培养细胞中生长的流感病毒，而不是鸡蛋来进行制备。[59]Centers for Disease Control and Prevention. Cell-based flu vaccines. Oct 2018 [internet publication].https://www.cdc.gov/flu/protect/vaccine/cell-based.htm[60]European Medicines Agency. Flucelvax tetra. Oct 2018 [internet publication].https://www.ema.europa.eu/en/medicines/human/EPAR/flucelvax-tetra
疫苗效果可因接种者的年龄、既往免疫力水平以及正确预测流行的特定病毒毒株而不同。[6]Fukuda K, Kieny MP. Different approaches to influenza vaccination. N Engl J Med. 2006;355:2586-2587.http://www.nejm.org/doi/full/10.1056/NEJMe068257http://www.ncbi.nlm.nih.gov/pubmed/17167142?tool=bestpractice.com[61]Wilde JA, McMillan JA, Serwint J, et al. Effectiveness of influenza vaccine in health care professionals: a randomized trial. JAMA. 1999;281:908-913.http://jama.jamanetwork.com/article.aspx?articleid=189023http://www.ncbi.nlm.nih.gov/pubmed/10078487?tool=bestpractice.com[62]Bridges CB, Thompson WW, Meltzer MI, et al. Effectiveness and cost-benefit of influenza vaccination of healthy working adults: a randomized controlled trial. JAMA. 2000;284:1655-1663.http://jama.jamanetwork.com/article.aspx?articleid=193139http://www.ncbi.nlm.nih.gov/pubmed/11015795?tool=bestpractice.com[63]Nichol KL, Mendelman PM, Mallon KP, et al. Effectiveness of live, attenuated intranasal influenza virus vaccine in healthy, working adults: a randomized controlled trial. JAMA. 1999;282:137-144.http://jama.jamanetwork.com/article.aspx?articleid=302147http://www.ncbi.nlm.nih.gov/pubmed/10411194?tool=bestpractice.com[64]Edwards KM, Dupont WD, Westrich MK, et al. A randomized controlled trial of cold-adapted and inactivated vaccines for the prevention of influenza A disease. J Infect Dis. 1994;169:68-76.http://www.ncbi.nlm.nih.gov/pubmed/8277200?tool=bestpractice.com[65]Ohmit SE, Victor JC, Rotthoff JR, et al. Prevention of antigenically drifted influenza by inactivated and live attenuated vaccines. N Engl J Med. 2006;355:2513-2522.http://www.nejm.org/doi/full/10.1056/NEJMoa061850#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/17167134?tool=bestpractice.com[66]DiazGranados CA, Denis M, Plotkin S. Seasonal influenza vaccine efficacy and its determinants in children and non-elderly adults: a systematic review with meta-analyses of controlled trials. Vaccine. 2012;31:49-57.http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0053498/http://www.ncbi.nlm.nih.gov/pubmed/23142300?tool=bestpractice.com[67]Manzoli L, Ioannidis JP, Flacco ME, et al. Effectiveness and harms of seasonal and pandemic influenza vaccines in children, adults and elderly: a critical review and re-analysis of 15 meta-analyses. Hum Vaccin Immunother. 2012;8:851-862.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3495721/http://www.ncbi.nlm.nih.gov/pubmed/22777099?tool=bestpractice.com[68]Osterholm MT, Kelley NS, Sommer A, et al. Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12:36-44.http://www.ncbi.nlm.nih.gov/pubmed/22032844?tool=bestpractice.com疫苗对健康成年人有效：有高质量的证据表明，健康成年人接种流感减毒活疫苗或灭活疫苗可高度有效预防感染。[61]Wilde JA, McMillan JA, Serwint J, et al. Effectiveness of influenza vaccine in health care professionals: a randomized trial. JAMA. 1999;281:908-913.http://jama.jamanetwork.com/article.aspx?articleid=189023http://www.ncbi.nlm.nih.gov/pubmed/10078487?tool=bestpractice.com[62]Bridges CB, Thompson WW, Meltzer MI, et al. Effectiveness and cost-benefit of influenza vaccination of healthy working adults: a randomized controlled trial. JAMA. 2000;284:1655-1663.http://jama.jamanetwork.com/article.aspx?articleid=193139http://www.ncbi.nlm.nih.gov/pubmed/11015795?tool=bestpractice.com[63]Nichol KL, Mendelman PM, Mallon KP, et al. Effectiveness of live, attenuated intranasal influenza virus vaccine in healthy, working adults: a randomized controlled trial. JAMA. 1999;282:137-144.http://jama.jamanetwork.com/article.aspx?articleid=302147http://www.ncbi.nlm.nih.gov/pubmed/10411194?tool=bestpractice.com[64]Edwards KM, Dupont WD, Westrich MK, et al. A randomized controlled trial of cold-adapted and inactivated vaccines for the prevention of influenza A disease. J Infect Dis. 1994;169:68-76.http://www.ncbi.nlm.nih.gov/pubmed/8277200?tool=bestpractice.com[65]Ohmit SE, Victor JC, Rotthoff JR, et al. Prevention of antigenically drifted influenza by inactivated and live attenuated vaccines. N Engl J Med. 2006;355:2513-2522.http://www.nejm.org/doi/full/10.1056/NEJMoa061850#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/17167134?tool=bestpractice.com系统评价或者受试者＞200名的随机对照临床试验（RCT）。
老年人接种疫苗的效果：
大多数流感相关死亡病例都发生在老年人群（65 岁或以上）中。[69]Monto AS, Rotthoff J, Teich E, et al. Detection and control of outbreaks in well-vaccinated nursing home populations. Clin Infect Dis. 2004;39:459-464.http://www.ncbi.nlm.nih.gov/pubmed/15356805?tool=bestpractice.com[70]Nichol KL, Nordin JD, Nelson DB, et al. Effectiveness of influenza vaccine in the community-dwelling elderly. N Engl J Med. 2007;357:1373-1381.http://www.nejm.org/doi/full/10.1056/NEJMoa070844#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/17914038?tool=bestpractice.com[71]De Villiers PJ, Steele AD, Hiemstra LA, et al. Efficacy and safety of a live attenuated influenza vaccine in adults 60 years of age and older. Vaccine. 2009;28:228-234.http://www.ncbi.nlm.nih.gov/pubmed/19796721?tool=bestpractice.com 系统评价发现，居住于长期护理机构的人群比居住于社区的健康老年人接种疫苗所获得的健康相关结局方面的益处更明显。[18]Jefferson T, Rivetti D, Rivetti A, et al. Efficacy and effectiveness of influenza vaccines in elderly people: a systematic review. Lancet. 2005;366:1165-1174.http://www.ncbi.nlm.nih.gov/pubmed/16198765?tool=bestpractice.com 一项发表于 meta 分析之后的集合队列研究证实，接种流感疫苗的老年人的死亡率显著降低（1.0% vs 未接种疫苗个体的 1.6%）。[70]Nichol KL, Nordin JD, Nelson DB, et al. Effectiveness of influenza vaccine in the community-dwelling elderly. N Engl J Med. 2007;357:1373-1381.http://www.nejm.org/doi/full/10.1056/NEJMoa070844#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/17914038?tool=bestpractice.com 老年患者的死亡率随着每年接种流感疫苗人数的增加而降低。[72]Armstrong BG, Mangtani P, Fletcher A, et al. Effect of influenza vaccination on excess deaths occurring during periods of high circulation of influenza: cohort study in elderly people. BMJ. 2004;329:660.http://www.bmj.com/content/329/7467/660.fullhttp://www.ncbi.nlm.nih.gov/pubmed/15313884?tool=bestpractice.com 接种高剂量疫苗，并在流行季节中期对低滴度抗体者加强免疫，可能对老年人有好处。[73]Cools HJ, Gussekloo J, Remmerswaal JE, et al. Benefits of increasing the dose of influenza vaccine in residents of long-term care facilities: a randomized placebo-controlled trial. J Med Virol. 2009;81:908-914.http://www.ncbi.nlm.nih.gov/pubmed/19319953?tool=bestpractice.com[74]DiazGranados CA, Dunning AJ, Kimmel M, et al. Efficacy of high-dose versus standard-dose influenza vaccine in older adults. N Engl J Med. 2014;371:635-645.http://www.nejm.org/doi/full/10.1056/NEJMoa1315727#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/25119609?tool=bestpractice.com[75]Nace DA, Lin CJ, Ross TM, et al. Randomized, controlled trial of high-dose influenza vaccine among frail residents of long-term care facilities. J Infect Dis. 2015;211:1915-1924.http://jid.oxfordjournals.org/content/211/12/1915.longhttp://www.ncbi.nlm.nih.gov/pubmed/25525051?tool=bestpractice.com可以使用任何经许可的、适合年龄的疫苗。[51]Grohskopf LA, Sokolow LZ, Broder KR, et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 influenza season. MMWR Recomm Rep 2018;67(No. RR-3):1–20.https://www.cdc.gov/mmwr/volumes/67/rr/rr6703a1.htm?s_cid=rr6703a1_whttp://www.ncbi.nlm.nih.gov/pubmed/30141464?tool=bestpractice.com
吉兰-巴雷综合征 (Guillain-Barre syndrome, GBS) 的风险：
GBS 是易感个体在感染和（罕见情况下）免疫接种后出现的累及周围神经的急性自身免疫性疾病。在美国，GBS 的风险增加与 1976 年接种猪流感疫苗（猪源甲型流感 H1N1 亚型/NJ/76）有关。[76]Lehmann HC, Hartung HP, Kieseier BC, et al. Guillain-Barré syndrome after exposure to influenza virus. Lancet Infect Dis. 2010;10:643-651.http://www.ncbi.nlm.nih.gov/pubmed/20797646?tool=bestpractice.com 全国疫苗不良事件报告系统中流感疫苗相关的 GBS 病例报告数量从 1992-1993 年的 37 例上升到 1993-1994 年的 74 例。针对这些病例进行的研究结果表明，对两个流感季节的数据进行整合，调整后的相对风险值为 1.7，提示每百万接种流感疫苗的人口中可额外增加约 1 例 GBS 。[77]Lasky T, Terracciano GJ, Magder L, et al. The Guillain-Barré syndrome and the 1992-1993 and 1993-1994 influenza vaccines. N Engl J Med. 1998;339:1797-1802.http://www.ncbi.nlm.nih.gov/pubmed/9854114?tool=bestpractice.com 这种风险似乎比正常发生流感造成的总体健康风险小得多。
如果接种流感疫苗之后 6 周内曾有 GBS 病史，则使用流感疫苗需谨慎，因为有 GBS 复发的风险。在这些情况下，需要权衡疫苗接种的风险和获益。[51]Grohskopf LA, Sokolow LZ, Broder KR, et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 influenza season. MMWR Recomm Rep 2018;67(No. RR-3):1–20.https://www.cdc.gov/mmwr/volumes/67/rr/rr6703a1.htm?s_cid=rr6703a1_whttp://www.ncbi.nlm.nih.gov/pubmed/30141464?tool=bestpractice.com
