农村新生儿乙型肝炎疫苗普种后14年免疫效果考核

A 14-year Survey for Hepatitis B Vaccine Immune Efficacy in Newborns in Rural Area after Universal Immunization

观察了正定县吴兴乡新生儿实施乙型肝炎 (乙肝 )疫苗普种后 14年的免疫学效果。该乡自 1986年开始对所有新生儿结合农村计划免疫 ,按 0、1、6个月程序接种 3剂乙肝疫苗 ,在 1986～ 1996年用血源乙肝疫苗 ,1997～ 1999年用重组 (CHO细胞 )乙肝疫苗。全程接种率 1986～ 1996年为 87 16 %,1997～ 1999年为 93 74%。于 1999年普查采血 ,用固相放射免疫试剂检测乙肝病毒表面抗原 (HBsAg)与抗体 (抗 -HBs)以及乙肝病毒核心抗体 (抗 -HBc) ,并与本地免疫前同龄儿童HBsAg阳性率进行比较 ,计算乙肝疫苗的免疫效果。结果显示 :乙肝疫苗免疫后 ,1～ 14岁儿童保护性抗 -HBs阳性率为 94 74%～ 10 2 7%,S/N值几何平均滴度 (GMT)为 76 72～ 5 6 2 ,随着免疫年限的延长而逐渐降低 ;HBsAg在 10岁以前无升高趋势 ,1～ 14岁儿童的HBsAg总阳性率 1 2 7%,与免疫前同龄儿童的 10 5 %相比 ,保护率为 87 9%(95 %可信限 83 18%～ 93 38%)。抗 -HBc阳性率为 2 2 6 %,与免疫前同龄儿童的 35 1%相比 ,降低了 93 5 6 %。新生儿乙肝疫苗免疫后随年龄的增长保护性抗体水平逐年下降 ,HBsAg阳性率 10～ 14岁开始出现升高趋势 ,而在 10岁以前未见升高趋势 ,说明免疫后 10年间效果良好 ,无需加强免疫。

For understanding the long-term immune efficacy of hepatitis B(HB)vaccine from 1986～1999, the newborns in Wuxing town of Zhengding County of Hebei Province integrated with EPI Program were universally vaccinated by 0,1,6 month schedule after their birth.The plasma-derived HB vaccine was used in 1986～1996,while the CHO cell recombinant HB vaccine was used in 1997～1999. The vaccine coverage rate were 87.16% during 1986～1999 and 93.74% during 1997～1999. The serum samples were collected in 1999 to detect HBsAg,anti-HBs and anti-HBc by SPRIA kit and compared them with that of the children of the same age and the same place before immunization.The results showed that after universal immunization of HB vaccine,the anti-HBs protective positive rate in 1～14 year old children was 94.7%～10.27%,the GMT(S/N value)was 76.72～5.62 which gradually decreased following growth of age,level of HBsAg did not rise before 10 years old.The total positive rate of HBsAg in 1～14 year old children was 1.27%,the protective rate 87.9% when compared with 10.5% in children of the same age and same town before immunization(95%IC 83.18%～93.38%). The positive rate of anti-HBc was 2.28%, it decreased about 93.56% as compared with in children of the same age and same town before immunization,and a rising ten dency in 10～14 year old children about 4.59%～2.74% was noticed.The data above indicated that the immune efficacy of HB vaccine within 10 years is satisfactory,the supplementary immunization is not necessary within this period