吸附无细胞百白破联合疫苗加强免疫与水痘减毒活疫苗联合接种的效果观察

Immunogenicity of booster immunization of absorbed diphtheria,tetanus and acellular pertussis combined vaccine administered simultaneously with immunization of varicella attenuated live vaccine

目的评价吸附无细胞百白破联合疫苗(Diphtheria,tetanus and acellular pertussis combined vaccine,DTaP)加强免疫单独接种和同时接种水痘减毒活疫苗(Varicella attenuated live vaccine,VarV)的免疫效果。方法选取满18月龄且已完成DTaP基础免疫的健康儿童218名,其中110人接种DTaP,108人同时接种DTaP和VarV。采用酶联免疫吸附试验(Enzyme-linked immunosorbent assay,ELISA)检测免疫前、后抗百日咳毒素抗体(Antibody to pertussis toxin,Anti-PT)、抗丝状血凝素抗体(Antibody to filamentous hemagglutmin,Anti-FHA)、抗白喉毒素抗体(Antibody to diphtheria toxin,Anti-DT)和抗破伤风毒素抗体(Antibody to tetanus toxin,Anti-TT),计算抗体几何平均浓度(Geometric Mean Concentration,GMC)和抗体阳转率(Seroconversion rate,SCR)。结果单独接种组和同时接种组免疫后Anti-PT、Anti-FHA、Anti-DT和Anti-TT的SCR分别为43.64%、81.48%(x^2=33.26,P=0.000),72.73%、85.19%(x^2=0.84,P=0.358),90.00%、85.18%(x^2=1.16,P=0.281),13.64%、11.11%(x^2=0.32,P=0.571);GMC分别为94.74IU/ml、98.86IU/ml(t=1.15,P=0.251),39.59IU/ml、44.10IU/ml(t=1.90,P=0.059),1.89IU/ml、1.47IU/ml(t=3.83,P=0.000),3.85IU/ml、2.72IU/ml(t=5.51,P=0.000)。两组Anti-PT、Anti-FHA免疫前阴性者免疫后SCR高于免疫前阳性者。同时接种组免疫后Anti-PT、Anti-FHA的GMC增长高于单独接种组,而免疫后Anti-DT、Anti-TT的GMC增长低于单独接种组。结论 DTaP加强免疫对预防百日咳的保护力有限,对预防白喉、破伤风的加强免疫时间可以延长,同时接种DTaP和VarV对DTaP的免疫原性无影响。

Objective To evaluate the immunogenicity of the booster dose of absorbed diphtheria, tetanus and aeellular pertussis combined vaccine （DTaP） co-administered with varieella attenuated live vaccine （VarV）. Methods We selected 218 healthy children aged 18 months who completed their primary se- ries of DTaP vaccine; 110 were vaccinated with DTaP, and 108 with both DTaP and VarV. Enzyme- linked immunosorbent assay （ELISA） was used to detect antibodies for pertussis toxin （Anti-PT）, fila-mentous hemagglutinin （ Anti-FHA）, diphtheria toxin （ Anti-DT）, and tetanus toxin （Anti-TF） before and after the vaccination for calculating seroeonversion rates （SCR） and geometric mean concentrations （GMC）. Results The respective SCRs of Anti-PT, Anti-FHA, Anti-DT and Anti-TF after immuniza- tion in DTaP group and DTaP ＋ VarV group were 43.64% and 81.48% （x2 = 33.26, P = 0. 000）, 72.73% and 85.19% （x2 =0. 84,P =0. 358） ,90. 00% and 85.18% （x2 = 1.16,P =0. 281） ,13.64% and 11.11% （x2 = 0.32,P = 0. 571 ） ; the respective GMCs were 94. 74IU/ml and 98.86IU/ml （t=1.15,P =0. 251） ,39.59IU/m1 and 44. 10 IU/ml （ t = 1.90, P = 0. 059 ） , 1.89IU/ml and 1.47IU/ ml （t = 3.83, P = 0. 000） ,3.85 IU/ml and 2.72 IU/ml （t =5.51 ,P =0. 000）. The SCRs of Anti- PT and Anti-FHA after vaccination were higher among subjects who were pre-vaccination antibody negative than among those who were pre-vaccination antibody positive. GMC increases of Anti-PT and Anti-FHA after vaccination in the DTaP ＋ VarV group were higher than in the DTaP group, while the GMC increases of Anti-DT and Anti-TY after vaccination in DTaP ＋ VarV group were lower than that in DTaP group. Conclusions Protection from pertussis using booster immunization with DTaP is limited, and the interval between primary series and booster immunization may be able to be prolonged for prevention of diphtheria and tetanus. The co-immunization of DTaP and VarV has no impact on immunogenicity of DTaP.