威海市新生儿乙肝疫苗初免和低/无应答者再免疫效果分析

Analysis on Immunization Effect to Infant and the Booster Immunization Effect to Non-and-low Infants after 3 Dose HepB Immunization in Weihai City

[目的]了解新生儿接种乙肝疫苗后的免疫效果和对全程免后低/无应答者的再免疫效果。[方法]2009年,在威海市3个市(区)抽取7～12月龄儿童1 102名,按"0,1,6"程序接种3剂次5μg啤酒酵母重组乙肝疫苗(HepB-SC),对其中低/无应答者分别按上述程序再次接种不同种类和剂量的乙肝疫苗,检测调查对象血清抗-HBs水平,观察变化情况。[结果]检测儿童1 102名,3剂乙肝疫苗接种后,抗-HBs阳性率为98.19%(正常应答率为84.66%、低应答率为13.52%),无应答率为1.81%;GMC为800.94mIU/ml。检测再免疫的低/无应答儿童127名(17名无应答、110名低应答),抗-HBs的GMC,再免疫前为45.72mIU/ml,1剂次再免疫后为1 373.50mIU/ml(P<0.01);3剂次再免疫后检测其中100名(14名无应答、86名低应答),抗-HBs的GMC上升为1 763.33mIU/ml,与1剂次后的差异无统计学意义(P>0.05)。[结论]按现行免疫程序乙肝疫苗全程免疫后,可以取得良好的免疫应答。对低/无应答者按相同免疫程序再次接种3针后,抗-HBs水平有较大幅度提高。

[Objective]To evaluate the immunization effect to infant and the booster immunization effect to non-and-low infants after 3 dose HepB immunization.[Methods]A total of 1 102 infants aged 7-12 months were sampled from three cities of Weihai and administered 3 dose 5μg hepatitis B vaccine made by recombinant dexyribonucleic acid techniques in saccharomyces Cerevisiae（HepB-SC）in 0,1,and 6 month.The non-and-low response infants were boosted 3 doses of two different types and dose of HepB in 0,1,and 6 month.The serum anti-HBs level was detected and the change trends was observed.[Results]A total of 1 102 infants were surveyed,the Anti-HBs positive rate was 98.16%（the protection rate was 84.66%,the low response rate was 13.53%）,non-response rate was 1.81%.The Geometric Mean Concentration（GMC） was 800.94 mIU/ml.The GMC of 127 non-and low response infants（17 low response and 110 non response infants） was 45.72mIU/ml,1 373.50 mIU/ml respectively before booster and after 1 dose（P0.01）.The GMC of 100 non-and low response infants（14 low response and 86 non response infants） was 1 763.33 mIU/ml after 3 dose booster.There was no statistically significant difference between booster 1 dose and three doses（P0.05）.[Conclusion]A good immune response can achieve under the current hepatitis B vaccine immunization program.The level of anti-HBs will sustantially increase after boosting 3 dose HepB in 0,1,6 months.