新生儿乙型肝炎疫苗免疫的远期效果考核(11年随访结果)  

Long- term efficacy study of hepatitis Bvaccination in newborns- results of 11 years’follow - up

作　　者：林曦敏[1] 徐志一[1] 欧阳佩英[1] 吴维寿 邵志萍 应庆茹 曹惠霖[3] 刘崇柏[3] 

机构地区：[1]上海医科大学流行病学教研室,200032 [2]上海市南市区卫生防疫站 [3]中国预防医学科学院病毒学研究所

出　　处：《中华流行病学杂志》1999年第3期174-177,共4页Chinese Journal of Epidemiology

摘　　要：目的　研究新生儿乙型肝炎（ 乙肝） 疫苗接种的远期效果和加强免疫的必要性。方法　对上海市南市区１９８６ 年出生时接种乙肝疫苗的儿童至少隔年随访一次，抽血检测ＨＢｓＡｇ、抗－ ＨＢｃ 和抗－ ＨＢｓ。在第５ 年，对同年出生但未接种过乙肝疫苗的邻近行政区儿童进行调查，以此作为外对照计算疫苗的远期保护效果。结果　１１ 年ＨＢｓＡｇ 阳性率在０ ．４６ ％ ～０．９８ ％ 之间，平均０．７０ ％ （２５／３ ５７８） ，大大低于免前本底对照和外对照，而且没有随免后时间的延长而升高的趋势。同外对照相比首针接种后５ 年的保护效果为８５ ．４２ ％ （９５％ 可信区间：７０ ．１１ ％ ～１００％ ）。结论　新生儿首针接种后１１ 年内无加强免疫的必要，是否或何时加强，尚需进一步随访。Objective To evaluatethelong - term efficacy of hepatitis B(HB) vaccination in newborns and the need for a booster dose. This research is one ofthelongest HBvaccinefollow - up studies in the world with its subjects came from a program of universal infant HBvaccination . Methods Children who were born in 1986 and im munized with hepatitis Bvaccine at birth were followed up atleastonce a year.Serum HBsAg,anti- HBcand anti- HBs weretested .Atthe 5th year afterthefirst dose the prevalence of hepatitis Binfection in the children in other district who were also bornin 1986 and remained unvaccinated was surveyed as external controls. Random sampling was applied andthe possible bias was analyzed.Thetrendsofthe positiverates ofserum HBsAg,anti- HBs and anti- HBcin theim munized cohort werestudied. With externalcontrol,thelong -term efficacy of HBvaccination was calculated. Results The positive rates of HBsAg in the vaccine group from the firstto eleventh year were 0.46 % - 0 .98 % and way below than those of baselineand externalcontrol. HBsAg ratesin thecohortat different ages were similar with an average of 0 .70 % (25/3 578) . The long- term efficacy ofnewborn vaccination was 85 .42 % (95 % confidantinterval:70 .11 % - 100 % ) . Conclusions Theefficacy of HBvaccine waslong -lasting and a booster dose was notnecessary atleast up to age 11 years.

关 键 词：乙肝疫苗 新生儿 乙型肝炎 表面抗原 免疫接种 

分 类 号：R725.126.2[医药卫生—儿科]