甲型肝炎灭活疫苗及减毒活疫苗对不同人群免疫效果的研究

A Study on Immune Effects of Hepatitis A Vaccines to Different Persons with Different Schedules

为了对不同种类甲型肝炎 (甲肝 )疫苗的免疫效果进行系统观察 ,确定最佳免疫方案 ,在北京市顺义区及北京铁路局系统 ,采用流行病学试验方法对 4～ 6岁儿童和 13～ 18岁青少年进行了观察。观察对象随机分组 ,分别用甲肝减毒活疫苗和甲肝灭活疫苗 (72 0 EU、36 0 EU)按不同程序进行免疫 ,于免疫后 2周～ 2 4个月采血检测甲肝病毒IgG抗体 (抗 HAV IgG)。结果显示 :抗 HAV IgG在免疫后 6～ 9个月达高峰 ;免疫后 9～ 2 4个月儿童组抗体几何平均滴度 (GMT)变化不大 ,青少年组抗体GMT大幅度下降 ;甲肝减毒活疫苗免疫 6个月时加强免疫 1针组 ,抗体阳转率及GMT均优于未加强免疫组 ;甲肝灭活疫苗 36 0 EU3针 (0、1、6个月 )组与 72 0 EU2针 (0、6个月 )组 ,近期36 0 EU组抗体阳转率及GMT明显优于 72 0 EU组 ,远期两组差异无显著的统计学意义。甲肝减毒活疫苗免疫后 2周抗体阳转率及GMT显著高于甲肝灭活疫苗。甲肝减毒活疫苗及灭活疫苗均有较好的免疫效果 ;0、6个月注射 2针甲肝减毒活疫苗的免疫效果明显优于仅注射 1针组 ;0、1、6个月注射 3针 36 0 EU 与 0、6个月注射 2针 72 0 EU甲肝灭活疫苗 ,两者免疫效果的差异无显著的统计学意义。

In order to define a better immune programme for two kinds of hepatitis A(HA)vaccines,we selected 417 children of 3-6 years old and 189 youngsters of 13-18 years old,all negative for anti-HAV antibody,from Shunyi District of Beijing.Children and youngsters were randomly divided into groups by themselves and were immunized with live attenuated and inactivated HA vaccines of different schedules.The serum samples were collected at 2 weeks,2,6,9,12 and 24 months after immunization for detecting anti-HAV-IgG.The results showed that anti-HAV-IgG reached its peak at 6-9 months after vaccination.The positive rate of anti-HAV-IgG was above 90% in children,85% in youngsters,the GMT was between 48.54IU/L～179.44IU/L. The GMT kept relative stable in children within 9-24 months after immunization while it decreased greatly in youngsters.The effect of live attenuated HA vaccine of 0,6 month schedule was much more better than only with one dose.The effect of inactivated HA vaccine 360 EU with 0,1,6 month schedule was better than 0,6 month schedule of 720 EU HA vaccine in the early time(2-6 months),but there showed no difference after 9 months of immunization.The HAV antibody positive seroconversion rate and GMT of HA live attenuated vaccine was significantly higher than that of inactivated HA vaccine 2 weeks after immunization,so live attenuated HA vaccine has a better emergent protective effect in the time of HA epidemic.