A Phase 3, Randomized, Observer-Blind Study to Evaluate Safety, Tolerability, and Immunogenicity of mRNA-1345, an mRNA Vaccine Targeting Respiratory Syncytial Virus, When Coadministered With a High-Dose, Quadrivalent Seasonal Influenza Vaccine in Adults ≥65 Years of Age

The main purpose of this study is to evaluate the safety and immunogenicity of mRNA-1345 RSV vaccine when coadministered with a high dose (HD) quadrivalent seasonal influenza vaccine (Fluzone HD) in adults ≥65 years of age. The study will examine the impact of Fluzone HD on the immune response to mRNA-1345 against RSV-A and RSV-B, as well as the impact of mRNA-1345 on the immune response to Fluzone HD against 4 vaccine-matched Influenza A and B strains.

开始日期2023-09-25

申办/合作机构

ModernaTX, Inc.

NCT04487041 / Recruiting临床4期IIT

Tfh Dysfunction in HIV and Aging

The purpose of this research is to evaluate blood samples from HIV infected and non-HIV infected people to understand how aging and HIV infection affect the immune responses (body defenses against infection) to the flu vaccine.

开始日期2020-10-30

申办/合作机构

University of Miami

NCT03699839 / Completed临床2/3期IIT

Reducing the Burden of Influenza After Solid-Organ Transplantation: the STOP-FLU Trial [Swiss Trial in Solid Organ Transplantation on Prevention of Influenza]

Influenza is associated with significant morbidity and mortality in solid-organ transplant (SOT) recipients and it is mainly prevented by seasonal influenza vaccination. Unfortunately, the immunogenicity of standard influenza vaccine is suboptimal in this population. Vaccination with a high-dose (HD) influenza vaccine or an MF59-adjuvanted (MF59a) vaccine have significantly reduced the incidence of influenza and increased the immunogenicity of influenza vaccine in the elderly. The investigators will compare the immunogenicity and efficacy of two new vaccination strategies, consisting in vaccination with a HD influenza vaccine or an MF59a influenza vaccine, to the standard-dose non-adjuvanted vaccination (standard of care) in a population of SOT recipients.

开始日期2018-10-26

申办/合作机构

Centre Hospitalier Universitaire Vaudois

[+7]

100 项与 Seasonal influenza virus vaccine high dose (Sanofi Pasteur) 相关的临床结果

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100 项与 Seasonal influenza virus vaccine high dose (Sanofi Pasteur) 相关的转化医学

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100 项与 Seasonal influenza virus vaccine high dose (Sanofi Pasteur) 相关的专利（医药）

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项与 Seasonal influenza virus vaccine high dose (Sanofi Pasteur) 相关的文献（医药）

2024-10-01·LANCET INFECTIOUS DISEASES

Safety and immunogenicity of the intranasal H3N2 M2-deficient single-replication influenza vaccine alone or coadministered with an inactivated influenza vaccine (Fluzone High-Dose Quadrivalent) in adults aged 65–85 years in the USA: a multicentre, randomised, double-blind, double-dummy, phase 1b trial

Article

作者: Greenberg, Harry ; Rhee, Margaret ; Belshe, Robert ; Bilsel, Pamuk ; Murray, Bryan ; Fierro, Carlos ; Marshall, David ; Neumann, Gabriele ; Coelingh, Kathleen ; Moser, Michael J ; Eiden, Joseph ; Herber, Renee ; Kawaoka, Yoshihiro ; Turner, Mark ; Davis, Matthew ; Aitchison, Roger ; White, Alexander

BACKGROUND:

Older adults (aged ≥65 years) show increased susceptibility to severe disease with influenza virus infection, accounting for 70-85% of annual influenza-related fatalities in the USA. Stimulating mucosal antibodies and T cells might enhance the low vaccine effectiveness seen in older adults for currently licensed inactivated influenza vaccines, which induce mainly serum antibodies. We aimed to evaluate the safety and immunogenicity of the intranasal H3N2 M2-deficient single-replication (M2SR) vaccine, alone or coadministered with a licensed inactivated influenza vaccine (Fluzone High-Dose Quadrivalent; hereafter referred to as Fluzone HD), in older adults.

METHODS:

In this multicentre, randomised, double-blind, double-dummy, phase 1b trial, individuals aged 65-85 years who were considered healthy or with stable chronic conditions with no recent (<6 months) influenza vaccinations were recruited from five clinical trial sites in the USA and randomly assigned (3:3:3:1) using a permuted block design to receive the H3N2 M2SR vaccine and Fluzone HD, the H3N2 M2SR vaccine and placebo, Fluzone HD and placebo, or placebo alone. All participants received a single intranasal spray and a single intramuscular injection, whether active or placebo, to maintain masking. The primary outcome was to assess the safety of H3N2 M2SR, administered alone or with Fluzone HD, in the safety analysis set, which included all participants who were randomly assigned and received treatment. Serum and mucosal antibodies were assessed as a secondary endpoint, and cell-mediated immunity as an exploratory endpoint, in participants in the per-protocol population, which included individuals in the safety analysis set without major protocol deviations. This trial is registered with ClinicalTrials.gov, NCT05163847.

FINDINGS:

Between June 14 and Sept 15, 2022, 305 participants were enrolled and randomly assigned to receive the H3N2 M2SR vaccine plus placebo (n=89), H3N2 M2SR vaccine plus Fluzone HD (n=94), Fluzone HD plus placebo (n=92), or placebo alone (n=30). All randomly assigned participants were included in the safety analysis set. The most frequently reported local symptoms up to day 8 in groups that received M2SR were rhinorrhoea (43% [38 of 89] in the H3N2 M2SR plus placebo group and 38% [36 of 94] in the H3N2 M2SR plus Fluzone HD group), nasal congestion (51% [45 of 89] and 35% [33 of 94]), and injection-site pain (8% [seven of 89] and 49% [46 of 94]), and the most frequently reported solicited systemic symptoms were sore throat (28% [25 of 89]) for M2SR and decreased activity (26% [24 of 94]) for the M2SR plus Fluzone HD group. In the Fluzone HD plus placebo group, the most frequently reported local symptom was injection-site pain (48% [44 of 92]) and systemic symptom was muscle aches (22% [20 of 92]). The frequency of participants with any treatment-emergent adverse event related to vaccination was low across all groups (2-5%). One serious adverse event was reported, in a participant in the Fluzone HD plus placebo group. M2SR with Fluzone HD induced seroconversion (≥four-fold increase in haemagglutination inhibition antibodies from baseline to day 29) in 44 (48%) of 91 participants, compared with 28 (31%) of 90 participants who seroconverted in the Fluzone HD plus placebo group (p=0·023). M2SR with Fluzone HD also induced mucosal and cellular immune responses.

INTERPRETATION:

The H3N2 M2SR vaccine coadministered with Fluzone HD in older adults was well tolerated and provided enhanced immunogenicity compared with Fluzone HD administered alone, suggesting potential for improved efficacy of influenza vaccination in this age group. Additional studies are planned to assess efficacy.

FUNDING:

US Department of Defense.

2024-08-16·The Journal of infectious diseases

Concomitant Administration of Ad26.RSV.preF/RSV preF Protein Vaccine and High-Dose Influenza Vaccine in Adults 65 Years and Older: A Noninferiority Trial

Article

作者: Scheys, Ilse ; Bastian, Arangassery Rosemary ; Widagdo, Widagdo ; Ligtenberg, Nynke ; Heijnen, Esther ; Comeaux, Christy A ; De Paepe, Els ; Callendret, Benoit ; Jastorff, Archana M

Abstract:

Background:

Since influenza and respiratory syncytial virus (RSV) carry significant burden in older adults with overlapping seasonality, vaccines for both pathogens would ideally be coadministered in this population. Here we evaluate the immunogenicity and safety of concomitant administration of Ad26.RSV.preF/RSV preF protein and high-dose seasonal influenza vaccine (Fluzone-HD) in adults ≥65 years old.

Methods:

Participants were randomized 1:1 to the Coadministration or Control group. The Coadministration group received concomitant Ad26.RSV.preF/RSV preF protein and Fluzone-HD on day 1 and placebo on day 29, while the Control group received Fluzone-HD and placebo on day 1 and Ad26.RSV.preF/RSV preF protein on day 29. Influenza hemagglutination-inhibiting and RSV preF–binding antibody titers were measured postvaccination and tested for noninferiority between both groups. Safety data were collected throughout the study and analyzed descriptively.

Results:

Coadministered Ad26.RSV.preF/RSV preF protein and Fluzone-HD vaccines induced noninferior immune responses compared to each vaccine administered alone. Seroconversion and seroprotection rates against influenza were similar between groups. Both vaccines remained well tolerated upon concomitant administration.

Conclusions:

Coadministration of Ad26.RSV.preF/RSV preF protein and Fluzone-HD showed an acceptable safety profile and did not hamper the immunogenicity of either vaccine, thus supporting that both vaccines can be concomitantly administered in adults ≥65 years old.

2023-08-01·Vaccine: X

High-dose influenza vaccine in older adults by age and seasonal characteristics: Systematic review and meta-analysis update

Article

作者: Lee, Jason K H ; Yin, J Kevin ; Loiacono, Matthew M ; Samson, Sandrine I ; Lam, Gary K L

This updated systematic review and meta-analysis of randomized and observational studies published up to April 2023 assessed the relative performance of high-dose inactivated influenza vaccine (HD-IIV) and standard-dose influenza vaccines (SD-IIV) against influenza-associated outcomes in older adults (≥65 years). The analysis included studies conducted over 12 influenza seasons (2009/2010 to 2019/2020, 2021/2022), including over 45 million individuals aged ≥ 65 years, and showed that HD-IIV provided significantly better protection than SD-IIV against influenza-like illness and influenza-related hospitalizations, as well as cardiovascular, cardiorespiratory, and all-cause hospitalizations. Subgroup analyses showed HD-IIV consistently provided better protection than SD-IIV against influenza outcomes across the age range (65+, 75+ 85+ years), and regardless of the predominantly circulating influenza strain and vaccine antigenic match/mismatch. Randomized studies continue to drive high-quality evidence on the effectiveness of high-dose inactivated influenza vaccine relative to SD-IIV against severe influenza outcomes in adults aged ≥ 65 years, supported by observational data.

项与 Seasonal influenza virus vaccine high dose (Sanofi Pasteur) 相关的新闻（医药）

2024-06-17

·生物制品圈

赛诺菲疫苗管线最新进展：12款候选产品，2年内推动5个项目进临床3期

近日，赛诺菲举办了疫苗投资者活动，主要讨论了疫苗产品管线以及公司的疫苗研发是如何支持其药物开发策略的。下面是12条疫苗管线情况，涉及领域包括流感（3个）、脑膜炎（3个)、RSV（3个）、肺炎（1个）、衣原体（1个）和痤疮（1个）。1、Fluzone HDFluzone HD是美国唯一获得许可的高剂量四价流感疫苗，被批准用于65岁及以上人群，在老年人市场中占据主导地位。目前，Fluzone HD正在进行用于小儿流感的2期试验。2、Flu QIV四价流感疫苗Flu QIV的免疫原性数据显示，A菌株与SoC免疫反应相当，B菌株的免疫应答趋势低于SoC；在反应原性方面，与目前获得许可的流感疫苗相比，该疫苗的反应原性更高，但系统严重副作用显著低于Moderna的mRNA-1010（非头对头）。3、Neuraminidase (NA)mNRA NA抗原疫苗免疫原性与Fluzone HD相当；同时其有良好的耐受性和安全性，亦与Fluzone HD相当。4、MenQuadfiMenQuadfi是赛诺菲的一款创新性脑膜炎球菌疫苗。该疫苗可针对4种血清组在多个年龄段人群中产生高免疫应答，并且耐受性良好。据临床数据显示：在10-17岁青少年中，MenQuadfi有更高或与与辉瑞的ACWY相当的免疫反应；在2-12个月的婴幼儿，3剂MenQuadfi比4剂的GSK的ACWY有更高的免疫反应。据了解，目前还没有其他ACWY注射产品可用，这也是MenQuadfi 的一大优势。赛诺菲预计2023年7月向FDA提交MenQuadfi 的上市申请，并于2024年上市销售。在美国，MenQuadfi已被用于超60%以上的MS（多发性硬化症）。为了巩固市场领导地位，MenQuadfi还在进行国际推广，其目前已经在53个国家注册，且区域范围还在不断扩大中，另外该疫苗在WHO进行资格预审。40份国内人用疫苗申请上市技术审评报告领取方式：关注【药时空】公众号，进入公众号后台，回复关键字“疫苗技术审评资料”，以上资料免费送！PS：后续还会统计汇总CDE上市药品信息中的抗体药物部分，请持续关注本公众号~5、MenB新型MenB配方（SP0230）可提供最佳保护。针对乙型脑膜炎球菌（meningitis B，Men-B）的项目SP0230的1/2期数据显示，赛诺菲配方的耐受性良好、所有抗原都是免疫原性的、防护度也达到了预期水平，可顺利进入下一阶段的研究。值得注意的是，MenB制剂在B菌株间具有很强的交叉保护潜力。6、MenPentaMenPenta也是脑膜炎候选疫苗之一，目前的临床前数据支持MenPenta项目在2023H2时推进到临床1/2阶段研究，并预计2027年在美国提交申请。7、Beyfortus（nirsevimab）Beyfortus是全球首个且唯一可广泛应用于婴儿人群的RSV预防用长效单克隆抗体，由赛诺菲和阿斯利康联合开发，通过结合表达于病毒粒子和受染细胞表面的RSV融合（F）蛋白达到中和RSV的目的，用于预防由RSV引起的下呼吸道疾病。此次赛诺菲公布了Beyfortus的3b期临床试验HARMONIE的数据：该疫苗接种新生儿可以将RSV相关下呼吸道症状住院率降低83%，预计比孕妇接种RSV疫苗有效率高出3倍。2022年11月，Beyfortus获欧盟委员会批准，作为单剂量被动免疫疗法，用于所有新生儿和婴儿，在其第一个RSV季节预防RSV下呼吸道疾病（LRTI）。今年1月，FDA接受Beyfortus的生物制品许可申请（BLA），预计在2023年第3季度公布审查结果；4月，该疫苗在加拿大获批上市；最近该疫苗在国内的上市申请也被CDE纳入了优先审评。8、RSV toddler（SP0125）SP0125为一款减毒活疫苗，也是首个被设计可用于保护所有幼儿的的RSV疫苗。据SP0125的1/2期数据显示，在安全性方面，SP0125与安慰剂类似；在疫苗应答方面，两次使用高剂量配方后，SP0125的疫苗反应强烈（93%），另外，低剂量和高剂量配方之间存在边际差异。赛诺菲预计该疫苗将于2024年上半年进入3期临床。9、RSV older adult (OA，SP0256)SP0256是一款同类第一的RSV-hMPV-PIV三联mRNA疫苗，主要用于老年人。据SP0256的1/2期试验结果显示，RSV OA mRNA疫苗耐受性良好，且显著提高了RSV中和抗体应答。该阳性结果表明SP0256可作为赛诺菲组合呼吸道疫苗的支柱产品。10、PCV21（SP0202）PCV21是由SK bioscience与赛诺菲联合研发的21价肺炎球菌结合候选疫苗，其将特定蛋白与肺炎链球菌的多糖荚膜相结合。该疫苗覆盖21种血清型，高于目前市场上使用的PCV/13/15/20疫苗。此次赛诺菲公布了PCV21疫苗的临床2期试验情况，安全性和免疫原性表现积极：PCV21在儿童人群中耐受性良好，所有4种剂量的安全性均与PCV13相当；与PCV20相比，PCV21的免疫反应良好。另外，PCV21不会干扰共同接种的推荐儿科疫苗（例如破伤风、白喉、百日咳、脊髓灰质炎和B型流感嗜血杆菌疫苗）的免疫原性和安全性。预计该疫苗将于2024年上半年启动临床3期试验，并于2027年提交上市申请。11、Chlamydia（衣原体候选疫苗）创新的多抗原衣原体候选疫苗实现了靶向免疫特性，预计将于2024年进入临床1/2期。12、Acne（青春痘疫苗）痤疮是一种慢性炎症性皮肤病，是全球第8大常见疾病。用于痤疮的治疗性mRNA候选疫苗临床前结果良好，预计该疫苗将于2023年下半年进入临床1/2期。总结：赛诺菲通过BIC/FIC疫苗管道推动创新，自2021年12月疫苗投资者事件以来，赛诺菲有3个新产品获批；领先的mRNA平台提高了其流感护理标准；预计2022/2023年将有6条新的候选疫苗管线进行1/2期试验；预计到2025年，赛诺菲在不同的预防和治疗领域至少启动5个创新疫苗项目的3期试验。另外，在销售额方面，赛诺菲预计到2030年疫苗年销售额将超过100亿欧元。注：文中图片均来自于赛诺菲的Vaccines Investor Event，June 29, 2023。

疫苗临床3期临床2期信使RNA申请上市

2024-06-11

·医药笔记

Moderna：新冠/流感联苗三期临床成功

2024年6月10日，Moderna宣布新冠/流感联苗mRNA-1083三期临床达到主要终点。相比于已上市的单苗联合使用，mRNA-1083诱导更强的免疫响应。 mRNA-1083免疫，流感GMR与赛诺菲Fluzone HD流感疫苗相当，新冠GMR与Spikevax相当。 Moderna的新冠、流感、RSV疫苗均获得三期临床成功，其中新冠、RSV疫苗已经获批上市。丰富的呼吸道病毒疫苗产品，为联苗开发奠定了基础，mRNA的形式也更容易做成联合疫苗。 Moderna后续研发管线还有多款呼吸道病毒联苗，包括流感/RSV联苗、新冠/流感/RSV联苗、RSV/MPV联苗等。内容来源于网络，如有侵权，请联系删除。

信使RNA疫苗上市批准核酸药物

2024-06-10

·BioSpace

Moderna Announces Positive Phase 3 Data for Combination Vaccine Against Influenza and COVID-19

mRNA-1083 met its primary endpoints, eliciting higher immune responses against influenza virus and SARS-CoV-2 than licensed flu and COVID vaccines in adults 50 years and older, including an enhanced influenza vaccine in adults 65 years and older CAMBRIDGE, MA / ACCESSWIRE / June 10, 2024 / Moderna, Inc. (NASDAQ:MRNA) today announced that its Phase 3 trial of mRNA-1083, an investigational combination vaccine against influenza and COVID-19, has met its primary endpoints, eliciting a higher immune response than the licensed comparator vaccines used in the trial. "Combination vaccines have the potential to reduce the burden of respiratory viruses on health systems and pharmacies, as well as offer people more convenient vaccination options that could improve compliance and provide stronger protection from seasonal illnesses," said Stéphane Bancel, Chief Executive Officer of Moderna. "Moderna is the only company with a positive Phase 3 flu and COVID combination vaccine. Building on the momentum of positive Phase 3 data across our respiratory portfolio, we continue to address significant unmet medical needs and advance public health." mRNA-1083 comprises components of mRNA-1010, Moderna's vaccine candidate for seasonal influenza, and mRNA-1283, Moderna's next-generation COVID-19 vaccine candidate. Each investigational vaccine has independently demonstrated positive Phase 3 clinical trial results. The ongoing Phase 3 clinical trial (ClinicalTrials.gov Identifier:NCT06097273) is a randomized, observer-blind, active control study evaluating the safety, reactogenicity and immunogenicity of mRNA-1083 in two independent age group cohorts of approximately 4,000 adults each. One cohort, consisting of adults 65 years and older, compared mRNA-1083 to co-administered Fluzone HD®, an enhanced influenza vaccine, and Spikevax®, Moderna's currently licensed COVID-19 vaccine. The other cohort of adults 50 to 64 years of age compared mRNA-1083 to co-administered, Fluarix®, a standard dose influenza vaccine, and Spikevax. The immune responses from a single dose of mRNA-1083 were found to be non-inferior versus the co-administered, routinely recommended, licensed comparators. In both age cohorts, mRNA-1083 also elicited statistically significantly higher immune responses against three influenza virus strains (H1N1, H3N2, and B/Victoria) and against SARS-CoV-2. In the 65 years and older cohort, overall Geometric Mean Ratios (GMRs) of the mRNA-1083 group compared to the Fluzone HD group for the influenza strains were 1.155 (95% CI: 1.094, 1.220) for A/H1N1, 1.063 (95% CI: 1.007, 1.122) for A/H3N2 and 1.118 (95% CI: 1.070, 1.167) for B/Victoria. The GMR of mRNA-1083 compared to Spikevax for the SARS-CoV-2 variant Omicron XBB.1.5 was 1.641 (95% CI: 1.526, 1.765). In the 50 to 64 years of age cohort the GMRs of the mRNA-1083 group compared to the Fluarix group for the influenza virus strains were 1.414 (95% CI: 1.333, 1.500) for A/H1N1, 1.380 (95% CI: 1.310, 1.454) for A/H3N2, and 1.216 (95% CI: 1.163, 1.270) for B/Victoria. The GMR of mRNA-1083 compared to Spikevax for the SARS-CoV-2 variant Omicron XBB.1.5 was 1.308 (95% CI: 1.219, 1.404). Immunogenicity was also tested against the B/Yamagata strain of influenza and mRNA-1083 met non-inferiority criteria in both age cohorts. Due to the disappearance of the B/Yamagata lineage from circulation, WHO has recommended a trivalent influenza vaccine composition without B/Yamagata for 2024/2025 vaccines. mRNA-1083 showed an acceptable tolerability and safety profile. The majority of solicited adverse reactions were grade 1 or 2 in severity and consistent with the licensed vaccines used in the trial. The most commonly solicited adverse reactions were injection site pain, fatigue, myalgia and headache. Moderna plans to present the Phase 3 clinical data for mRNA-1083 at an upcoming medical conference as well as submit it for publication. The Company will engage with regulators on next steps. About Moderna Moderna is a leader in the creation of the field of mRNA medicine. Through the advancement of mRNA technology, Moderna is reimagining how medicines are made and transforming how we treat and prevent disease for everyone. By working at the intersection of science, technology and health for more than a decade, the company has developed medicines at unprecedented speed and efficiency, including one of the earliest and most effective COVID-19 vaccines. Moderna's mRNA platform has enabled the development of therapeutics and vaccines for infectious diseases, immuno-oncology, rare diseases and autoimmune diseases. With a unique culture and a global team driven by the Moderna values and mindsets to responsibly change the future of human health, Moderna strives to deliver the greatest possible impact to people through mRNA medicines. For more information about Moderna, please visit modernatx.com and connect with us on X (formerly Twitter), Facebook, Instagram, YouTube and LinkedIn. Spikevax® is a registered trademark of Moderna. Fluzone HD® is a registered trademark of Sanofi Pasteur. Fluarix® is a registered trademark of the GlaxoSmithKline group of companies. Forward-Looking Statements This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, as amended, including statements regarding: the potential for mRNA-1083 specifically, and combination vaccines generally, to reduce the burden of respiratory virus season; the safety and efficacy of mRNA-1083; and Moderna's plans to present data related to mRNA-1083 and to engage with regulators. The forward-looking statements in this press release are neither promises nor guarantees, and you should not place undue reliance on these forward-looking statements because they involve known and unknown risks, uncertainties, and other factors, many of which are beyond Moderna's control and which could cause actual results to differ materially from those expressed or implied by these forward-looking statements. These risks, uncertainties, and other factors include, among others, those risks and uncertainties described under the heading "Risk Factors" in Moderna's Annual Report on Form 10-K for the fiscal year ended December 31, 2023, and in subsequent filings made by Moderna with the U.S. Securities and Exchange Commission, which are available on the SEC's website at Except as required by law, Moderna disclaims any intention or responsibility for updating or revising any forward-looking statements contained in this press release in the event of new information, future developments or otherwise. These forward-looking statements are based on Moderna's current expectations and speak only as of the date of this press release. Moderna Contacts Media: Elise Meyer Sr. Director, Corporate Communications +1 617-852-7041 Elise.Meyer@modernatx.com Investors: Lavina Talukdar Senior Vice President & Head of Investor Relations +1 617-209-5834 Lavina.Talukdar@modernatx.com SOURCE: Moderna, Inc. View the original press release on accesswire.com

临床结果疫苗临床3期信使RNA免疫疗法

100 项与 Seasonal influenza virus vaccine high dose (Sanofi Pasteur) 相关的药物交易

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适应症	国家/地区	公司	日期
流感病毒感染	澳大利亚	Sanofi-Aventis Australia Pty Ltd.	2020-07-31

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研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


NCT01666782 (IMMUNE, CTgov)	临床2期	肿瘤 \| 流感病毒感染	105	High-Dose Influenza Vaccine (High-Dose Influenza Vaccine)	鹹衊簾觸鹽鹽艱衊獵範(顧淵齋蓋製鬱積簾簾窪) = 製觸齋構糧鏇範繭獵網獵鏇鬱憲範齋獵廠鹽壓 (壓夢網鹹鏇製餘齋繭壓, 鏇繭鑰繭鬱簾餘廠齋獵 ~ 鑰築繭夢壓範鏇餘積選) 更多	-	2016-05-24
				Standard Trivalent Influenza Vaccine (Standard Trivalent Influenza Vaccine)	鹹衊簾觸鹽鹽艱衊獵範(顧淵齋蓋製鬱積簾簾窪) = 醖窪衊鹹製淵鑰製膚餘獵鏇鬱憲範齋獵廠鹽壓 (壓夢網鹹鏇製餘齋繭壓, 鹽艱襯蓋糧襯獵築顧願 ~ 願選鏇顧鑰蓋積繭艱夢) 更多