流感病毒裂解疫苗临床安全性和免疫原性研究

目的了解流感病毒裂解疫苗的安全性和免疫原性。方法按整群随机抽样原则,对上海市200名18~60岁健康成人进行疫苗接种后临床安全性指标(局部反应、全身反应)的监测。用微量血凝抑制试验检测血清HI抗体,比较血清抗体阳转率、抗体几何平均滴度(GMT)和增长倍数。结果接种疫苗72 h内局部反应率为7.00%;全身反应率为12.00%,其中发热反应率为7.50%,其他全身反应率为4.50%;均以轻度反应为主。H1N1、H3N2和B型免疫后抗体阳转率分别为63.49%、74.07%和56.08%,抗体GMT分别为1∶170.10、1∶128.85和1∶446.79,免疫后比免疫前分别增长到6.93倍、8.72倍和4.90倍。结论此流感病毒裂解疫苗的临床安全性和免疫原性均较好。     

建立膜抗原荧光抗体试验评价北京株冻干水痘疫苗免疫效果

为了建立用于水痘疫苗接种后血清中特异性抗体检测的膜抗原荧光抗体(FAMA)法,并对接种水痘疫苗后儿童血清中水痘特异性抗体进行检测,评价北京株水痘疫苗的免疫效果。以水痘带状疱疹病毒(VZV)感染细胞作为抗原制备成固定抗原玻片,以异硫氰酸荧光素(FITC)标记的羊抗人IgG作为二抗建立FAMA法,并对该法的敏感性、特异性进行验证。运用此法对不同剂量北京株水痘疫苗接种后儿童血清中特异性抗体进行检测,分析儿童血清中水痘特异性抗体水平以及免后抗体阳转率,并与Oka株水痘疫苗进行比较。结果显示,FAMA法敏感性可达0.0196IU/ml,特异性好。应用此法检测300名观察者免前免后双份血清样本中抗VZVIgG,易感者中北京株水痘疫苗原苗(39810PFU/0.5ml)、2000PFU/0.5ml、500PFU/0.5ml接种组儿童血清免后抗体阳转率分别为100%、98.77%、85.42%,抗体几何平均滴度(GMT)分别为36.4、34.3、18.6,原苗与2000PFU间的抗体阳转率和GMT均无显著性差异(P>0.05),但原苗与500PFU、2000PFU与500PFU间的抗体阳转率和GMT均有显著性差异(P<0.05)。对照国产、进口Oka株水痘疫苗接种后抗体阳转率分别为95.35%、96.97%,抗体GMT分别为13.3、16.0,不同剂量北京株疫苗抗体阳转率与国产、进口Oka株疫苗相比,差别无显著性(P>0.05),但北京株疫苗原?     

国产重组酵母乙型肝炎疫苗接种小学生的五年免疫效果观察

为了解国产重组酵母乙肝疫苗的免疫持久性,对接种2批国产酵母疫苗（5μg/Dose),1批进口酵母疫苗（A;10μg/Dose)和另1批进口酵母疫苗（M;5μg/Dose)的268名小学生,进行了免后5年（T60）效果随访观察。结果表明,T60时接种A疫苗组抗体GMT（几何平均滴度）（197．53）显著高于M疫苗组（110．66）和2批国产疫苗（9312645GMT78．48,9312623GMT56．06）。抗体阳转率A疫苗组（85．71％）显著高于M疫苗组及国产两批疫苗（61．76％、65．26％、63．83％）（P＜0．05）。而国产两批疫苗与M疫苗组无显著性差异（P＞0．05）。本次随访结果表明,虽然国产酵母疫苗免后5年的抗体阳转率和抗体GMT与剂量相同的进口酵母疫苗的水平相当,但抗体阳转率已降至70％以下,应考虑加强接种。     

一种新的麻疹(AIK-C株)、腮腺炎(Hoshino株)和风疹(Takahashi株)三价联合活疫苗

<正>在实际应用中,接种麻疹—腮腺炎—风疹三联疫苗有明显的简化儿童免疫程序、降低费用和减少医生病人间接触等优点,并经证实安全有效。美国实际使用三联疫苗已有十多年,受试者的抗体应答并未提示一种疫苗与另一种疫苗间有相互干扰,接种联合疫苗也未增加副反应发生率和严重程度。但也有研究者报告,将腮腺炎活疫苗与其它活疫苗同时接种与单独接种单价疫苗相比,前者导致较低的腮腺炎血清阳转率。     

风疹减毒活疫苗主种子批毒种(松叶株)的安全性和免疫原性检测

评价兰州生物制品研究所用风疹病毒松叶株主种子批毒种制备的冻干风疹减毒活疫苗的安全性和免疫原性。采用自身对照、开放性的免疫原性临床观察试验,对100名8～10月龄筛选后符合条件的健康易感儿童,皮下接种1剂风疹减毒活疫苗,观察其免疫后的局部和全身反应并采集每个受试者免前和免后35d的血清标本,检测风疹HI抗体,计算阳转率和几何平均滴度。试验中所有受试者在系统观察期内均未观察到注射部位局部的不良反应;总的发热率为5%,且均为轻度发热;有1例在观察期内出现腹泻和咳嗽并持续5d,发生率为1%,属中度全身反应;血清风疹病毒抗体(HI)阳转率为100%,GMT为1:638.7±1.7。该疫苗与国内、外其它种类的风疹疫苗一样具有良好的安全性和免疫原性。     

注射第二剂MMR疫苗后麻疹、腮腺炎和风疹抗体模式的持久性及下降率

正麻疹、腮腺炎和风疹的抗体平均每年下降3%,并且具有高度的个体差异。然而,人们对抗原差异和个体差异的理解还不清楚。为了更好地理解对个体的潜在影响及其群体易感性,作者重新分析了纵向数据以确定血清阳性和持续性的模式。将4～6岁时接种第二剂麻疹、腮腺炎、风疹疫苗(MMR2)的儿童在接种后随访12年。使用回归模型评估抗体下降率,计算受试者之间和受试者本身的差异。302名受试者中的大部分受试者在随访期间均     

潍坊市健康人群麻疹、风疹、流行性腮腺炎抗体水平调查

目的了解潍坊市健康人群麻疹、风疹、流行性腮腺炎血清抗体水平,为消除麻疹、控制风疹及腮腺炎疫情提供依据。方法 2011年8月,采集昌乐、潍城2个县区<2、2～5、5～8、8～11、11～15、15～20、20～40、>40岁健康人群血标本,应用酶联免疫吸附试验检测麻疹、风疹、腮腺炎IgG抗体。结果检测总数320人,其中昌乐县健康人群的麻疹抗体阳性率为98.75%、潍城为96.25%;风疹抗体阳性率昌乐县健康人群为89.38%、潍城区为91.88%。昌乐、潍城两地区健康人群麻疹、风疹的抗体阳性率差异均无统计学意义(χ2=1.15、0.59,P>0.05);昌乐县健康人群腮腺炎抗体阳性率为84.38%、潍城区健康人群为66.25%,两者差异有统计学意义(χ2=14.14,P<0.01);8组不同年龄健康人群的麻疹抗体阳性率为92.50%～100%,风疹抗体阳性率为87.50%～92.50%,腮腺炎抗体阳性率为67.50%～85.00%,各年龄组间均无统计学意义(χ2=13.49、1.58、5.23,P>0.05)。结论潍坊市麻疹抗体阳性率较高,风疹、腮腺炎抗体阳性率相对偏低,今后须要积极开展学龄儿童麻腮风三联疫苗的查漏补种工作。     

儿童2剂水痘疫苗不同间隔免疫程序的比较

目的了解水痘疫苗2剂不同间隔时间免疫程序的安全性及免疫原性。方法按照随机、双盲的原则,选择符合条件的1~3岁、4~6岁、7~12岁儿童各200名,每个年龄组按照2剂间隔3个月和6个月的免疫程序,分别接种2剂冻干水痘减毒活疫苗。观察各组接种后的不良反应率,用膜抗原荧光抗体法(FAMA)检测疫苗接种前、后血清抗体阳转率、GMT水平和平均增长倍数。结果接种2剂水痘疫苗后,总体不良反应率在4%~13%;同年龄组不同间隔时间接种2剂疫苗后,不良反应发生率差异无统计学意义;不同年龄组间不良反应发生率差异无统计学意义。同年龄组不同间隔时间免前及接种2剂后,血清GMT水平差异均无统计学意义;同年龄组接种1剂与2剂水痘疫苗的血清GMT水平,两者间差异有显著性统计学意义。接种2剂水痘疫苗的GMT增长倍数高于接种1剂。不同间隔时间接种第2剂水痘疫苗后抗体阳转率差异无统计学意义;同年龄组接种2剂后抗体阳转率高于接种1剂,两者差异有统计学意义。结论间隔3个月和6个月接种第2剂水痘疫苗,在安全性及免后GMT水平、增长倍数及抗体阳转率等4个方面,两者差异均无统计学意义。     

冻干A+C群脑膜炎球菌多糖疫苗安全性和免疫原性观察

为了评价冻干A+C群脑膜炎球菌多糖疫苗(MPV)的安全性和免疫原性,按随机、盲法的原则,评价疫苗免疫后不良反应发生率、抗体阳转率及抗体几何平均滴度(GMT)。将606名健康观察者分为2～5岁、6～12岁、13～17岁、18～60岁四个年龄组,结果显示,该疫苗全身反应发生率2.64%,局部反应发生率1.32%,四个年龄组疫苗免疫后杀菌抗体阳性率分别为100%、100%、99.3%和100%,免疫后A群杀菌抗体GMT分别为1:250.47、1:190.61、1:144.22和1:205.79,免疫后C群杀菌抗体GMT分别为1:273.33、1:551.18、1:788.26和1:809.81,冻干A+C群多糖疫苗在≥2岁人群中具有良好的安全性和免疫原性,建议推广使用A+C群MPV。     

国产b型流感嗜血杆菌结合疫苗免疫原性观察

目的:了解兰州生物制品研究所研制的b型流感嗜血杆菌结合疫苗的免疫原性。方法:采用单纯随机抽样方法对柳州市709名3～59月龄婴幼儿按照规定的免疫程序接种兰州所(或巴斯德)Hib疫苗,2年内在不同时段采集血清样本,采用ELISA方法检测Hib-PRP抗体滴度。结果:基础免疫后血清Hib-PRP抗体含量平均水平为18.043μg/ml,抗体阳转率为97.19%,1年后血清Hib-PRP抗体含量为7.575μg/ml,抗体阳转率为93.75%。加强免疫后血清Hib-PRP抗体含量为130.330μg/ml,抗体阳转率为100.00%,加强免疫1年后血清Hib-PRP抗体含量为51.723μg/ml,抗体阳转率为100.00%。基础免疫后接种巴斯德Hib疫苗组血清Hib抗体含量高于接种兰州所Hib疫苗组,抗体阳转率则没有差别;免后1年,接种兰州所Hib疫苗儿童体内Hib抗体含量平均水平高于接种法国巴斯德Hib疫苗儿童;其余各时段两组儿童血清Hib-PRP抗体含量及抗体阳转率均无差别。结论:兰州所Hib疫苗有较好的免疫原性和免疫持久性。     

国产腮腺炎和进口麻风腮疫苗免后腮腺炎HI抗体比较

报道了用国产流行腮腺炎减毒活疫苗和美国产麻－风－腮减毒活疫苗接种８～９岁小学生后,采血进行ＨＩ抗体测定比较,其抗体阳转率均在８０％左右,ＧＭＴ为７．３５～１０．０３,说明两种疫苗均有较好的免疫应答     

Immune response to the mumps component of the MMR vaccine in the routine of immunisation services in the Brazilian National Immunisation Program

A non-controlled longitudinal study was conducted to evaluate the combined vaccine against measles, mumps and rubella (MMR) immunogenicity in 150 children vaccinated in the routine of three health units in the city of Rio de Janeiro, Brazil, 2008-2009, without other vaccines administered during the period from 30 days before to 30 days after vaccination. A previous study conducted in Brazil in 2007, in 1,769 children ranging from 12-15 months of age vaccinated against yellow fever and MMR simultaneously or at intervals of 30 days or more between doses, had shown low seroconversion for mumps regardless of the interval between administration of the two vaccines. The current study showed 89.5% (95% confidence interval: 83.3; 94.0) seroconversion rate for mumps. All children seroconverted for measles and rubella. After revaccination, high antibody titres and seroconversion rates were achieved against mumps. The results of this study and others suggest that two MMR doses confer optimal immunoresponses for all three antigens and the possible need for additional doses should be studied taking into account not only serological, but also epidemiological data, as there is no serological correlate of protection for mumps.     

Interference between strains in live virus vaccines. II: Combined vaccination with varicella and measles-mumps-rubella vaccine

A combined vaccine against varicella and measles-mumps-rubella made by mixing two commercially available products (Varilrix and Pluserix SK-RIT) has proved to be only partially successful in early trials. Although the seroconversion rates with the MMR components were comparable with those usually achieved, the varicella take was depressed to 77%. A new low dose measles-mumps-rubella vaccine was prepared in which the measles virus content was reduced to 1/5 and the mumps virus content to 1/8. Commercial varicella vaccine was added to the low dose MMR vaccine. The seroconversion rates for measles was 98.2%, for mumps 100%, for rubella 99.4% and for varicella 98%. This product seemed to be well balanced in respect of a possible interference between the four different virus vaccine strains.     

Recent mumps outbreaks in vaccinated populations: no evidence of immune escape

Recently, numerous large-scale mumps outbreaks have occurred in vaccinated populations. Clinical isolates sequenced from these outbreaks have invariably been of genotypes distinct from those of vaccine viruses, raising concern that certain mumps virus strains may escape vaccine-induced immunity. To investigate this concern, sera obtained from children 6 weeks after receipt of measles, mumps, and rubella (MMR) vaccine were tested for the ability to neutralize a carefully selected group of genetically diverse mumps virus strains. Although the geometric mean neutralizing antibody titer of the sera was lower against some virus strains than others, all viruses were readily neutralized, arguing against immune escape.     

Abnormal measles-mumps-rubella antibodies and CNS autoimmunity in children with autism

Autoimmunity to the central nervous system (CNS), especially to myelin basic protein (MBP), may play a causal role in autism, a neurodevelopmental disorder. Because many autistic children harbor elevated levels of measles antibodies, we conducted a serological study of measles-mumps-rubella (MMR) and MBP autoantibodies. Using serum samples of 125 autistic children and 92 control children, antibodies were assayed by ELISA or immunoblotting methods. ELISA analysis showed a significant increase in the level of MMR antibodies in autistic children. Immunoblotting analysis revealed the presence of an unusual MMR antibody in 75 of 125 (60%) autistic sera but not in control sera. This antibody specifically detected a protein of 73-75 kD of MMR. This protein band, as analyzed with monoclonal antibodies, was immunopositive for measles hemagglutinin (HA) protein but not for measles nucleoprotein and rubella or mumps viral proteins. Thus the MMR antibody in autistic sera detected measles HA protein, which is unique to the measles subunit of the vaccine. Furthermore, over 90% of MMR antibody-positive autistic sera were also positive for MBP autoantibodies, suggesting a strong association between MMR and CNS autoimmunity in autism. Stemming from this evidence, we suggest that an inappropriate antibody response to MMR, specifically the measles component thereof, might be related to pathogenesis of autism.     

Surveillance of antibody to measles,mumps, and rubella by age.

Before the introduction of measles, mumps, and rubella vaccine a survey was carried out to measure antibody prevalence to the three viruses by age. A total of 8716 samples of serum collected by five public health laboratories in different parts of England during 1986-7 were tested. Despite the current measles vaccination programme 60% of children aged 1-2 years did not have measles antibody and over 80% did not have antibodies to mumps and rubella. In the 3-4 year age group 17% of the children were susceptible to measles, 55% to mumps, and 73% to rubella. The results suggest that vaccinating children early in the second year of life will be necessary to eliminate the three diseases. The survey provides baseline data for continuing surveillance of the immediate and long term effects of the new vaccination strategy.     

Seroprevalence of measles-, mumps- and rubella-specific IgG antibodies in german children and adolescents and predictors for seronegativity

We have undertaken a seroprevalence study with more than 13,000 children, who had been included in the German KIGGS survey, a representative sample of children and adolescents 0-17 years of age. The IgG titres against measles, mumps and rubella were determined in 1 to 17 year olds While 88.8% of the children were MMR-vaccinated at least once, 76.8% of children aged 1 to 17 years showed prevalence of antibodies to MMR. The highest seronegativity was seen with respect to mumps. Gender differences were most pronounced with regard to rubella IgG titres: girls aged 14 to 17 years were best protected, although seronegativity in 6.8% of this vulnerable group still shows the need of improvement. Search for predictors of missing seroprevalence identified young age to be the most important predictor. Children living in the former West and children born outside of Germany had a higher risk of lacking protection against measles and rubella, while children with a migration background but born in Germany were less often seronegative to measles antibodies than their German contemporaries. An association of seronegativity and early vaccination was seen for measles but not for mumps and rubella. A high maternal educational level was associated with seronegativity to measles and rubella. In vaccinated children, seronegativity was highest for mumps and lowest for rubella. For mumps, high differences were observed for seronegativity after one-dose and two-dose vaccination, respectively. Seronegativity increases as time since last vaccination passes thus indicating significant waning effects for all three components of MMR.     

Evaluation of live trivalent vaccine of measles AIK-C strain, mumps Hoshino strain and rubella Takahashi strain, by virus-specific interferon-gamma production and antibody response

A trivalent measles-mumps-rubella live virus vaccine, containing measles AIK-C strain, mumps Hoshino strain, and rubella Takahashi strain, was evaluated in 229 children, aged 1 to 5 years. The vaccine induced a high seroconversion rate: 221 (98.7%) out of 224 subjects initially seronegative for measles virus, 167 (93.3%) out of 179 initially seronegative for mumps virus, and 212 (99.1%) out of 214 initially seronegative for rubella virus. It also induced a sufficient cellular immunity against each of the three viruses in over 90% of the subjects, as judged by virus-specific interferon-gamma (IFN-gamma) production. Virus-specific IFN-gamma production was observed 10 days after vaccination by stimulation with measles virus and rubella virus and 14 days after vaccination by stimulation with mumps virus. Mumps-virus-specific IFN-gamma production was observed in 7 out of 12 recipients without seroconversion for mumps virus. And measles-virus-specific IFN-gamma production was demonstrated in one out of three recipients without seroconversion for measles virus. A significant correlation was observed between the serum antibody and IFN-gamma production six weeks after vaccination for measles virus (r = 0.201, P less than 0.01) and for mumps virus (r = 0.174, P less than 0.05) but not for rubella virus (r = -0.045, P less than 0.05). The incidence of febrile reactions of greater than or equal to 37.5 C was quite low, 14.4%, and that of greater than or equal to 39 C occurred in only 1.3% of the recipients. These results suggested that the trivalent vaccine induced sufficient humoral and cellular immunity and yet resulted in no more untoward reaction than observed from the measles vaccine alone.     

Studies on live rubella vaccine. V. Quantitative aspects of interference between rubella, measles and mumps viruses in their trivalent vaccine

Rubella vaccine combined with measles and mumps vaccines was administered in a single injection to children of 1 to 5 years of age. All three vaccines were serologically effective, and the clinical reactions caused by measles vaccine were considerably alleviated, when 6 x 10(3) PFU of rubella and 10(4) TCD50 per dose of mumps vaccines were combined with 5 x 10(4) TCD50 of measles vaccine. When a larger amount of mumps vaccine (3 x 10(5) TCD50/dose) was used, it caused interference with the rubella and measles viruses, i.e., the antibody response to rubella virus became poor and the incidence of clinical reactions to measles virus decreased. On the other hand, when 5 x 10(5) TCD50/dose of measles vaccine was combined with 10(4) TCD50/dose of mumps vaccine, the clinical reactions to measles virus were decreased but were almost the same as those induced by this vaccine alone.