2012—2018年免疫策略调整前后北京市Ⅰ和Ⅲ型脊髓灰质炎疫苗免疫效果及疫苗效价监测分析  

Surveillance of immunization effectiveness and titer of typeⅠand type Ⅲ polio vaccine in Beijing before and after the adjustment of immunization strategy in 2012-2018

作　　者：李娟 张朱佳子 潘静彬 张合润 李仁清 李茂中 卢莉 黄芳 吴疆 Li Juan;Zhang Zhujiazi;Pan Jingbin;Zhang Herun;Li Renqing;Li Maozhong;Lu Li;Huang Fang;Wu Jiang(Beijing Municipal Center for Disease Control and Prevention/Beijing Research Center for Preventive Medicine,Beijing 100013,China)

机构地区：[1]北京市预防医学研究中心,北京市疾病预防控制中心免疫预防所,100013

出　　处：《中华预防医学杂志》2020年第7期779-783,共5页Chinese Journal of Preventive Medicine

摘　　要：目的分析脊髓灰质炎(脊灰)疫苗免疫程序策略调整前后北京市2012、2014、2016和2018年脊灰疫苗免疫效果和疫苗效价。方法按照方便抽样的方法,于2012年选择朝阳区和延庆区,2014选择丰台区和大兴区,2016年选择通州区和平谷区,2018年选择东城区和顺义区的预防接种门诊作为监测点,选取在监测点内完成3剂脊灰疫苗基础免疫后4~8周的儿童为监测对象,共292名,其中2012和2014年为策略调整前,免疫程序为3剂3价脊灰病毒减毒活疫苗(tOPV)全程免疫;2016和2018年为策略调整后,免疫程序为1剂脊灰病毒灭活疫苗(IPV)与2剂2价脊灰病毒减毒活疫苗(bOPV)序贯免疫。采集1.0 ml静脉血,检测Ⅰ和Ⅲ型脊灰病毒中和抗体滴度。采用随机数字法,从监测点随机抽取疫苗标本,每年9份(2012年为8份),检测疫苗效价并进行比较。结果292名儿童的年龄[M(P25,P75)]为5(5,6)月龄,男女比为1.04(149/143)。2012、2014、2016和2018年监测对象分别为66、72、68和86名,基础免疫后,除2014年Ⅰ型脊灰病毒中和抗体阳性率为98.61%(71名),其余年份Ⅰ和Ⅲ型均为100%;2016和2018年Ⅰ和Ⅲ型脊灰病毒中和抗体滴度整体高于2012和2014年(P值均<0.001)。2012和2014年tOPV的效价为(6.05±0.15)和(6.16±0.12)lgCCID50/粒,2016和2018年bOPV的效价为(6.88±0.21)和(6.26±0.14)lgCCID50/100μl(P<0.001)。结论北京市脊灰疫苗免疫策略调整前后,tOPV全程免疫和IPV‑bOPV序贯免疫程序的疫苗基础免疫抗体阳性率相当,IPV‑bOPV序贯免疫程序产生的脊灰抗体水平更高,调整后2016年bOPV效价高于调整前tOPV效价,但2018年bOPV效价下降。Objective To analyze the changing trend of polio vaccine immunization effectiveness and vaccine titer in Beijing in 2012,2014,2016 and 2018 before and after the adjustment of polio vaccine immunization program strategy.Methods According to the convenient sampling method,the vaccination clinics of Chaoyang and Yanqing Districts in 2012,Fengtai and Daxing Districts in 2014,Tongzhou and Pinggu Districts in 2016,Dongcheng and Shunyi Districts in 2018 were selected as monitoring points.A total of 292 children were selected 4-8 weeks after the completion of 3 doses polio vaccine basic immunization which were 3 doses of trivalent oral poliovirus vaccine(tOPV)schedule before the strategy adjustment in 2012-2014 and 1 dose of inactivated poliovirus vaccine(IPV)following 2 doses of bivalent oral poliovirus vaccine(bOPV)sequential schedule after the adjustment in 2016-2018.About 1.0 ml blood samples were collected to detect typeⅠandⅢneutralizing poliovirus antibody.A total of 9 oral poliovirus vaccines(8 vaccines in 2012)were selected from different sources of vaccine storage every year to test the vaccine titer using random number method.Results The[M(P25,P75)]age of 292 children was 5(5,6)months,and the ratio of male to female was 1.04(149/143).In 2012,2014,2016 and 2018,66,72,68 and 86 children were investigated respectively.After basic immunization,antibody positive rates for typeⅠandⅢpoliovirus were 100%,except 98.61%(71)for typeⅠpoliovirus in 2014.The neutralizing antibody titer of typeⅠandⅢpoliovirus was higher in 2016 and 2018 than that in 2012 and 2014(P<0.001).The average titer of tOPV were(6.05±0.15)and(6.16±0.12)lgCCID50 per dose in 2012 and 2014.The average titer of bOPV were(6.88±0.21)and(6.26±0.14)lgCCID50 per 100μl in 2016 and 2018(P<0.001).Conclusion Before and after the adjustment of polio vaccine immunization strategy in Beijing,the basic immunization success rate of the IPV‑bOPV sequential immunization schedulewas good aswell as full tOPV schedule.The level of polio antibody produced

关 键 词：脊髓灰质炎 脊髓灰质炎病毒疫苗 口服 疫苗效果 疫苗效价 

分 类 号：R186[医药卫生—流行病学]