首剂脊髓灰质炎灭活疫苗纳入儿童基础免疫程序效果评价  

Immunogenicity of sequential polio vaccination schedules that use inactivated polio vaccine as the first dose

作　　者：王青[1] 张圆圆 徐佳薇[1] Wang Qing;Zhang Yuanyuan;Xu Jiawei(Chongqing Municipal Center for Disease Control and Prevention,Chongqing 400010,China)

机构地区：[1]重庆市疾病预防控制中心

出　　处：《中国疫苗和免疫》2019年第4期378-382,392,共6页Chinese Journal of Vaccines and Immunization

基　　金：重庆市卫生计生委2016年医学科研计划项目(2016ZDXM034)

摘　　要：目的 评价首剂脊髓灰质炎(脊灰)灭活疫苗(IPV)与二价口服脊灰减毒活疫苗(bOPV)序贯基础免疫程序的效果。方法 采用分层随机抽样方法选取重庆市脊灰基础免疫适龄儿童,分为实验1组(SG1)、实验2组(SG2)、对照组(CG),分别按Salk株IPV(IPVSalk)-bOPV-bOPV、Sabin株IPV(IPVSabin)-bOPV-bOPV、三价口服脊灰减毒活疫苗(tOPV)-bOPV-bOPV序贯程序完成3剂脊灰疫苗基础免疫,其中SG1和SG2组IPV从2018年8月1日开始接种,CG组tOPV于2016年4月1-30日接种,在基础免疫完成后1-3个月检测儿童血清脊灰中和抗体。结果 SG1、SG2、CG组分别纳入儿童335名、358名、334名。完成脊灰疫苗基础免疫后,各组I型脊灰抗体保护率分别为99.70%、99.70%、98.50%(Fisher精确概率法,SG1与CG:P=0.12;SG2与CG:P=0.11;SG1与SG2:P=1.00),II型分别为83.28%、74.58%、98.80%(χ^2=49.34,P=0.00;χ^2=85.59,P=0.00;χ^2=7.84,P=0.01),III型分别为99.40%、100%、97.90%(Fisher精确概率法,P=0.11;P=0.01;P=0.23)。结论 实验组儿童I型和III型脊灰中和抗体保持较高水平,首剂IPV与bOPV序贯免疫程序效果良好。Objective To evaluate the immunogenicity of inactivated polio vaccine(IPV)-first sequential vaccination schedules.Methods We used stratified random sampling to select age-eligible children for primary polio immunization in Chongqing,and divided them into three study groups:Group 1(SG1),Group 2(SG2),and a control group(CG)to receive 3-dose sequential polio vaccine schedules of Salk strain IPV(IPVSalk)-bOPV-bOPV,Sabin strain IPV(IPVSabin)-bOPV-bOPV,and trivalent oral polio attenuated live vaccine(tOPV)-bOPV-bOPV,respectively.We administered the IPV dose for SG1 and SG2 after August 1,2016,and the tOPV dose for CG during April 1-30,2016.We tested for serum polio neutralizing antibodies 1-3 months after primary vaccination.Results We recruited 335,358,and 334 subjects into SG1,SG2,and CG.In the three groups,seropositivity rates against poliovirus type Ⅰ were 99.70%,99.70%,and 98.50%(Fisher's exact test,SGI vs CG:P=0.12;SG2 vs CG:P=0.11;SG1 vs SG2:P=1.00),respectively;against poliovirus type Ⅱ were 83.28%,74.58%,and 98.80%(χ^2=49.34,P=0.00;χ^2=85.59,P=0.00;χ^2=7.84,P=0.01),respectively;and against poliovirus type III were 99.40%,100%,and 97.90%(Fisher's exact test,P=0.11;P=0.01;P=0.23),respectively.Conclusion Seropositivity rates against poliovirus type Ⅰ and type Ⅲ were high among children of study groups,showing a good immune effect of IPV and bOPV sequential schedules.

关 键 词：脊髓灰质炎灭活疫苗 脊髓灰质炎减毒活疫苗 免疫效果 

分 类 号：R186[医药卫生—流行病学]