Faktor-Faktor Prediktor Serokonversi Pasca-Vaksinasi Influenza pada Lansia

Saskia Aziza Nursyirwan, Sukamto Koesnoe, Edy Rizal Wahyudi, Arif Mansjoer

Abstract

Pendahuluan. Vaksin influenza sebagai satu-satunya modalitas pencegahan infeksi virus influenza yang ada saat ini memiliki efikasi yang lebih rendah pada lansia dibanding dewasa muda. Hal ini dimungkinkan karena pada lansia terjadi perubahan respon imun akibat penuaan serta faktor-faktor risiko lain. Penelitian ini dilakukan untuk mengidentifikasi faktor-faktor prediktor serokonversi pasca-vaksinasi influenza pada lansia.

Metode. Studi kohort retrospektif pada populasi lansia di posyandu lansia Jakarta Timur yang mendapatkan vaksin influenza. Sebanyak 277 subjek diperiksa titer antibodi pra dan satu bulan pasca-vaksinasi influenza. Faktor-faktor risiko berupa usia, jenis kelamin, status olahraga, status merokok, penyakit DM tipe 2, paru, kardiovaskular, status nutrisi MNA (Mini Nutritional Assessment), status GDS (Geriatric Depression Scale), dan titer antibodi pra-vaksinasi dinilai pada masing-masing subjek.

Hasil. Proporsi lansia yang mengalami serokonversi (kenaikan titer pasca-vaksinasi sebanyak 4 kali lipat titer awal) adalah 50,9% (141/277). Pada analisis multivariat, faktor-faktor prediktor serokonversi satu bulan pasca-vaksinasi influenza pada lansia di komunitas adalah keadaan tidak depresi (p=0,048, OR=2,1, IK=1,01-4,30), status olahraga ≥ 5 kali seminggu minimal 30 menit (p=0,013, OR 4,0, IK 1,34-11,76), dan titer antibodi pra-vaksinasi yang tidak seroprotektif (p=0,000, OR 6,4, IK 3,40-11,99).

Simpulan. Faktor-faktor prediktor serokonversi pasca-vaksinasi influenza pada lansia di komunitas adalah status depresi, status olahraga, dan titer antibodi pra-vaksinasi influenza.

 

Kata Kunci: faktor prediktor, influenza, serokonversi, vaksinasi

 

Predictor Factors Affecting Seroconversion Post-Influenza Vaccination in the Elderly

Introduction. The influenza vaccine as the most effective method for preventing influenza virus infection currently has lower efficacy in the elderly than younger adults due to change of immune response as well as other risk factors. This study aims to identify predictor factors affecting seroconversion post-influenza vaccination in elderly.

Methods. retrospective cohort study in the elderly population in East Jakarta Posyandu who got the influenza vaccine. A total of 277 subjects with antibody titre pre and one month post-vaccination influenza were examined. Risk factors such as age, gender, exercise status, smoking status, type 2 diabetes, pulmonary, and cardiovascular disease, nutritional status of MNA (Mini Nutritional Assessment), GDS (Geriatric Depression Scale), and pre-vaccination antibodi titre were assessed in each subject.

Results. The proportion of elderly people who seroconverted (fourfold rise or more in antibody titer post-vaccination) was 50.9% (141/277). On multivariate analysis, the predictor factors that affect seroconversion of one month post- influenza vaccination in the elderly on the community is a no depression state (p = 0.048, OR = 2.1, CI = 1.01 to 4.30), exercise status ≥5 times per week minimal 30 minutes  (p = 0.013, OR 4.0, CI 1.34 to 11.76), and not seroprotective pre-vaccination (p=0.000, OR 6.4, CI 3.40 to 11.99). 

Conclusion. Predictor factors affecting seroconversion post-influenza vaccination in the elderly on the community is depression status, exercise status and pre-vaccination antibody titre.

Keywords

influenza, predictor factor, seroconversion, vaccination

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