婴儿脊灰母传抗体对Sabin株脊髓灰质炎灭活疫苗不同序贯免疫接种程序效果的影响
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摘要
目的探讨婴儿脊髓灰质炎(简称脊灰)母传抗体对Sabin株脊髓灰质炎灭活疫苗(Sabin inactivated poliovirus vaccine,s IPV)与不同剂型脊髓灰质炎减毒活疫苗(oral poliovirus vaccine,OPV)采用不同序贯免疫程序接种效果的影响。方法选取柳州市600名2月龄无脊髓灰质炎疫苗免疫史的常住健康婴儿,分为6个序贯免疫组,其中1剂s IPV+2剂b OPV 2组:s IPV+2b OPV(糖丸)组、s IPV+2b OPV(液体)组;2剂s IPV+1剂b OPV 2组:2s IPV+b OPV(糖丸)组、2s IPV+b OPV(液体)组;2剂s IPV+1剂t OPV 2组:2s IPV+t OPV(糖丸)组,2s IPV+t OPV(液体)组。每组100人。按照0、28、56 d程序,分别在婴儿2、3、4月龄时接种相应疫苗。检测免前、全程免后28 d血清中脊灰中和抗体滴度,计算阳转率及GMT。结果 6个序贯免疫组免前各项指标分布均匀,各型脊灰抗体阳性率、抗体水平及分布均无明显差异。共有518例免前和免后配对血清抗体检测结果的研究对象进入免疫原性分析。s IPV+2b OPV组与2s IPV+b OPV组Ⅱ型抗体、2s IPV+t OPV(糖丸)组Ⅲ型抗体免前阴性和免前阳性者接种疫苗后阳转率差异均有统计学意义;s IPV+2b OPV(糖丸)组Ⅲ型抗体,2s IPV+b OPV(糖丸)组与2s IPV+b OPV(液体)组Ⅱ型抗体,2s IPV+t OPV(糖丸)组Ⅰ、Ⅱ型抗体的免前阳性与免前阴性者接种疫苗后的GMT差异均有统计学意义;2s IPV+t OPV(糖丸)Ⅰ型抗体组与2s IPV+t OPV(液体)Ⅱ型抗体组中,免前8~<32、≥32两种滴度水平的免后GMT差异均有统计学意义。结论脊灰疫苗序贯免疫效果受脊灰母传抗体干扰。
Objective To investigate the effect of poliomyelitis associated maternal-transferred antibodies on the efficacy of Sabin inactivated poliovirus vaccine( s IPV) and different formulations of Oral poliovirus vaccine( OPV) in different sequential immunization procedures. Methods A total of 600 residential healthy infants of 2 month age without a history of poliomyelitis vaccination were selected from Liuzhou City. They were divided into 6 sequential immunization groups,including 2 groups of 1 dose s IPV + 2 doses b OPV( 1 s IPV + 2 b OPV( Drug Candy,DC) group,the s IPV + 2 b OPV( liquid) group); 2 groups of 2 doses s IPV + 1 dose b OPV( the 2 s IPV + 1 b OPV( DC) group,the 2 s IPV+1 b OPV( liquid) group); and 2 groups of 2 doses s IPV+1 dose t OPV( the 2 s IPV+1 t OPV( DC)group,the 2 s IPV+1 t OPV( liquid) group). There were 100 infants in each group. The vaccine was inoculated at 2,3 and4 months age after birth,respectively. The titer of poliomyelitis neutralization antibody in serum was detected before immunization and 28 days after the whole process of immunization. The positive rate and GMT were calculated. Results The distribution of each indexes before immunization were uniform in the 6 sequential immunization groups,and there was no a statistical difference in the positive rate,level and the distribution of antibody among poliomyelitis types. A total of 518 subjects with paired serum antibody test results before and after immunization were enrolled in the immunogenicity analysis.Statistical difference was found in the positive conversion rate between the s IPV+2 b OPV group and the 2 s IPV+b OPV type II antibody group and the 2 s IPV+t OPV( DC) type III antibody group. There was a statistical difference in GMT between the s IPV+2 b OPV( DC) type III antibody group,the 2 s IPV+b OPV( DC) group and the 2 s IPV+b OPV( liquid) type II antibody group and the 2 s IPV+t OPV( DC) type I+II antibody group. Moreover,statistical difference was found in the postimmunization GMT between the2 s IPV+t OPV( DC) type I antibody group and the 2 s IPV+t OPV( liquid) type II antibody group with two levels of titer before immunization( 8-< 32 and ≥32). Conclusion The sequential immune effect of the poliomyelitis vaccination was interfered with maternal-transferred antibodies.
Objective To investigate the effect of poliomyelitis associated maternal-transferred antibodies on the efficacy of Sabin inactivated poliovirus vaccine( s IPV) and different formulations of Oral poliovirus vaccine( OPV) in different sequential immunization procedures. Methods A total of 600 residential healthy infants of 2 month age without a history of poliomyelitis vaccination were selected from Liuzhou City. They were divided into 6 sequential immunization groups,including 2 groups of 1 dose s IPV + 2 doses b OPV( 1 s IPV + 2 b OPV( Drug Candy,DC) group,the s IPV + 2 b OPV( liquid) group); 2 groups of 2 doses s IPV + 1 dose b OPV( the 2 s IPV + 1 b OPV( DC) group,the 2 s IPV+1 b OPV( liquid) group); and 2 groups of 2 doses s IPV+1 dose t OPV( the 2 s IPV+1 t OPV( DC)group,the 2 s IPV+1 t OPV( liquid) group). There were 100 infants in each group. The vaccine was inoculated at 2,3 and4 months age after birth,respectively. The titer of poliomyelitis neutralization antibody in serum was detected before immunization and 28 days after the whole process of immunization. The positive rate and GMT were calculated. Results The distribution of each indexes before immunization were uniform in the 6 sequential immunization groups,and there was no a statistical difference in the positive rate,level and the distribution of antibody among poliomyelitis types. A total of 518 subjects with paired serum antibody test results before and after immunization were enrolled in the immunogenicity analysis.Statistical difference was found in the positive conversion rate between the s IPV+2 b OPV group and the 2 s IPV+b OPV type II antibody group and the 2 s IPV+t OPV( DC) type III antibody group. There was a statistical difference in GMT between the s IPV+2 b OPV( DC) type III antibody group,the 2 s IPV+b OPV( DC) group and the 2 s IPV+b OPV( liquid) type II antibody group and the 2 s IPV+t OPV( DC) type I+II antibody group. Moreover,statistical difference was found in the postimmunization GMT between the2 s IPV+t OPV( DC) type I antibody group and the 2 s IPV+t OPV( liquid) type II antibody group with two levels of titer before immunization( 8-< 32 and ≥32). Conclusion The sequential immune effect of the poliomyelitis vaccination was interfered with maternal-transferred antibodies.
引文
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[2]胡逢蛟,张思敏,楼丽波.婴儿胎传脊髓灰质炎抗体的检测与分析[J].中国疫苗和免疫,2000,6(2):75-76.
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[4]WASSILAK S,PATE M A,WANNEMUEHLER K,et al.Outbreak of type 2 vaccine-derived poliovirus in Nigeria:emergence and widespread circulation in an underimmunized population[J].J Infect Dis,2011,203(7):898-909.
[5]BURNS C C,DIOP O M,SUTTER R W,et al.Vaccine-derived polioviruses[J].J Infect Dis,2014,210(Suppl 1):S283-S293.
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[7]英志芳,王剑锋,李艳萍,等.中国婴儿中脊灰母传抗体水平对两种疫苗免疫效果的影响[J].微生物学免疫学进展,2011,39(1):7-9.
[8]卢莉,李晓梅,刘东磊,等.脊髓灰质炎灭活疫苗和减毒活疫苗不同序贯免疫程序的基础免疫效果研究[J].中华预防医学杂志,2012,46(6):510-513.
[9]VOYSEY M,KELLY D F,FANSHAWE T R,et al.The influence of maternally derived antibody and infant age at vaccination on infant vaccine responses:an individual participant meta-analysis[J].JAMA Pediatr,2017,171(7):637-646.
[10]MOON S S,GROOME M J,VELASQUEZ D E,et al.Prevaccination rotavirus serum Ig G and Ig A are associated with lower immunogenicity of live,oral human rotavirus vaccine,in South African infants[J].Clin Infect Dis,2016,62(2):157-165.
[11]崔敏,姜德玉,贺晴,等.产妇与婴儿脊髓灰质炎中和抗体水平变化特征分析[J].中国公共卫生,2016,32(7):889-892.
[12]耿丽娜,储凯,孙光卫,等.母传抗体对婴儿口服脊髓灰质炎减毒疫苗免疫效果影响的研究[J].现代预防医学,2017,44(8):1503-1506.
[13]叶慧,黄腾,英志芳,等.Sabin株脊髓灰质炎灭活疫苗与不同剂型Ⅰ+Ⅲ型脊髓灰质炎减毒活疫苗序贯接种的免疫原性和安全性比较[J].中华预防医学杂志,2018,52(1):43-49.
[2]胡逢蛟,张思敏,楼丽波.婴儿胎传脊髓灰质炎抗体的检测与分析[J].中国疫苗和免疫,2000,6(2):75-76.
[3]DUINTJER TEBBENS R J,PALLANSCH M A,KIM J H,et al.Oral poliovirus vaccine evolution and insights relevant to modeling the risks of circulating vaccine-derived polioviruses(c VDPVs)[J].Risk Anal,2013,33(4):680-702.
[4]WASSILAK S,PATE M A,WANNEMUEHLER K,et al.Outbreak of type 2 vaccine-derived poliovirus in Nigeria:emergence and widespread circulation in an underimmunized population[J].J Infect Dis,2011,203(7):898-909.
[5]BURNS C C,DIOP O M,SUTTER R W,et al.Vaccine-derived polioviruses[J].J Infect Dis,2014,210(Suppl 1):S283-S293.
[6]JENSON H B.Polio vaccines:WHO position paper,January 2014[J].Wkly Epidemiol Rec,2014,89(9):73-92.
[7]英志芳,王剑锋,李艳萍,等.中国婴儿中脊灰母传抗体水平对两种疫苗免疫效果的影响[J].微生物学免疫学进展,2011,39(1):7-9.
[8]卢莉,李晓梅,刘东磊,等.脊髓灰质炎灭活疫苗和减毒活疫苗不同序贯免疫程序的基础免疫效果研究[J].中华预防医学杂志,2012,46(6):510-513.
[9]VOYSEY M,KELLY D F,FANSHAWE T R,et al.The influence of maternally derived antibody and infant age at vaccination on infant vaccine responses:an individual participant meta-analysis[J].JAMA Pediatr,2017,171(7):637-646.
[10]MOON S S,GROOME M J,VELASQUEZ D E,et al.Prevaccination rotavirus serum Ig G and Ig A are associated with lower immunogenicity of live,oral human rotavirus vaccine,in South African infants[J].Clin Infect Dis,2016,62(2):157-165.
[11]崔敏,姜德玉,贺晴,等.产妇与婴儿脊髓灰质炎中和抗体水平变化特征分析[J].中国公共卫生,2016,32(7):889-892.
[12]耿丽娜,储凯,孙光卫,等.母传抗体对婴儿口服脊髓灰质炎减毒疫苗免疫效果影响的研究[J].现代预防医学,2017,44(8):1503-1506.
[13]叶慧,黄腾,英志芳,等.Sabin株脊髓灰质炎灭活疫苗与不同剂型Ⅰ+Ⅲ型脊髓灰质炎减毒活疫苗序贯接种的免疫原性和安全性比较[J].中华预防医学杂志,2018,52(1):43-49.