Tesis

Faktor-Faktor Prediktor Serokonversi Pasca-Vaksinasi Influenza pada Lansia = Predictor Factors Affecting Seroconversion Post-Influenza Vaccination in the Elderly.

Latar Belakang : Infeksi virus influenza menyebabkan morbiditas dan mortalitas yang cukup signifikan pada lansia. Vaksin influenza sebagai satu-satunya modalitas pencegahan yang ada saat ini memiliki efikasi yang lebih rendah pada lansia dibanding dewasa muda (17-53% vs 70-90%). Hal ini dimungkinkan karena pada lansia terjadi perubahan respons imun akibat penuaan serta faktorfaktor

risiko lain. Beberapa studi telah dilakukan untuk menilai status kesehatan lansia sebagai faktor risiko terhadap respons antibodi terhadap vaksinasi influenza.

Metode : Penelitian ini merupakan 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 pravaksinasi dinilai pada masing-masing subjek.

Hasil
Penelitian : 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 pascavaksinasi
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).

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

Kata Kunci : influenza, vaksinasi, serokonversi, faktor prediktor.


Background : Influenza virus infection causes significant morbidity and mortality in the elderly. The influenza vaccine as the only existing prevention modalities currently has lower efficacy in the elderly than younger adults (17-53% vs. 7090%). This is possible because the elderly changes due to aging of the immune response as well as other risk factors. Several studies have been conducted to assess the health status of the elderly as a risk factor for antibody responses to influenza vaccination. Methods: This study is a 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 prevaccination (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, vaccination, seroconversion, predictor factor.