甲型肝炎减毒活疫苗和灭活疫苗不同免疫程序效果对比研究

Comparative Study of Immune Efficacy of Live Attenuated Hepatitis A Vaccine and Inactivated Hepatitis A Vaccine of Different Schedules

为了探索国产甲型肝炎 (甲肝 )减毒活疫苗不同剂量、不同免疫程序的免疫效果 ,并与甲肝灭活疫苗进行比较 ,在河北省正定县某乡 3个村筛选 3～ 13岁的甲肝易感儿童 2 11名 ,按年龄分层随机分为甲肝减毒活疫苗A组(0、6、12个月 )、B组 (0、6个月 )和甲肝灭活疫苗C组 (0、6个月 )。这 3个组按不同免疫程序减毒活疫苗或灭活疫苗免疫后 1、6、7、12、13、2 4个月采血 ,检测抗甲肝病毒抗体 (抗 -HAV)。结果显示 :A、B、C 3个组在首剂疫苗免疫后 1个月时抗 -HAV阳转率均较低 (33 87%～ 42 2 2 % ) ;第 2剂疫苗免疫后 1个月抗体水平均有大幅度提高 ,抗-HAV阳转率为 97 6 7%～ 10 0 0 0 % ,几何平均滴度 (GMT)为 110 7 16mIU/ml～ 2 477 5 2mIU/ml,升高 2 0倍以上 ;首剂免疫后 12个月抗 -HAV阳性率均为 10 0 0 0 % ,但GMT下降了 6 4 9%～ 5 7 0 %。仅A组首剂免疫后 12个月时注射了第 3剂减毒活疫苗 ,1个月后抗体GMT呈 5 7倍增长。首剂免疫后 2 4个月时 ,3个组抗 -HAV阳性率为 92 98%～ 98 11% ,GMT为 2 13 87～ 6 42 6 9mIU/ml。

The work of this paper was to understand the protective efficacy of live attenuated hepatitis A vaccine of different doses and schedules,and to compare it with the inactivated hepatitis A vaccine(Havrix) In 1997 in Zhengding County,Hebei Province, 211 HAV susceptible children of 3～13 years old were randomly assigned into three groups Group A was vaccinated with live attenuated hepatitis A vaccine by 0,6,12 months schedule,group B was by 0,6 months schedule,and group C was vaccinated with inactivated vaccine by 0,6 months schedule Their serum samples were detected for anti-HAV at the different times after vaccination The results showed that positive rates in three groups were 33 87%～42 22% after the first dose vaccination The anti-HAV levels of each group increased significantly at 1 month after re-vaccination,then declined The anti-HAV positive rates in all three groups were 100% at 6 months after a booster dose,but GMT values decreased significantly at that time The anti-HAV positive rates in all groups were still higher than 90%,and GMT values of three groups were higher than 200 mIU/ml at the 24th month So,one or two booster doses of live attenuated hepatitis A vaccine can satisfactorily induce secondary immune response;and its immune efficacy after booster dose is the same as that of inactivated hepatitis A vaccine It is better to delay the re-vaccination when the anti-HAV level is still high