Epidemic management in a measles outbreak in 2023,the return of vaccine-preventable diseases:A single center,retrospective observational study

Objective:To investigate the importance of immunization in preventing measles infection and to determine the most useful laboratory tests for confirmation of measles.Methods:This study included pediatric cases evaluated with a presumed diagnosis of measles between December 2022 and June 2023,at Marmara University Pendik Training and Research Hospital.The effects of vaccination status and underlying disease on the clinical course,treatments,and complications were evaluated.Results:In total,117 patients were enrolled in the study with a median age of 80 months(IQR:32.5-125.0).Twelve patients with contact history were asymptomatic and had an underlying disorder,and intravenous immunoglobulin was given to them for post-exposure prophylaxis.Fifty-one patients had confirmed measles diagnosis.Ribavirin treatment was given to three patients(a newborn,a girl with rhabdomyosarcoma,and a healthy boy)with respiratory distress.Seventy-eight percent of confirmed measles cases were unvaccinated,and all hospitalized cases were unvaccinated or under-vaccinated.Four full-vaccinated children had confirmed measles infection.Measles PCR from nasopharyngeal swabs was negative in all of them,and their diagnosis was established with anti-measles IgM positivity.Conclusions:The measles vaccine is the most effective way to protect from measles and measles-related complications.Although measles can also occur in fully vaccinated patients,the disease is milder than in unvaccinated patients.Using ELISA and RT-PCR tests together may be beneficial in patients with high clinical suspicion for early diagnosis.

Measles Virus IgG Avidity Assay for Use in Identification of Measles Vaccine Failures in Tianjin, China

Objective To identify measles vaccine failures in Tianjin, China using a measles virus Ig G avidity assay.Methods The China Information System for Disease Control and Prevention(CISDCP) was used to collect information about measles cases and blood specimens in Tianjin from 2013 to 2015. Measlesspecific Ig M and Ig G antibodies were detected using Enzyme-Linked Immunosorbent Assay(ELISA).Avidity testing for measles Ig G was performed using a commercial enzyme immunoassay(EIA).Results A total of 284 confirmed measles cases were identified. Of this total, 262(92.25%) were in patients aged ≥ 20 years. High avidity was exhibited in 172(60.56%) cases, while 80(28.17%) cases demonstrated low avidity. High avidity was detected in only 21.43% of cases in patients aged < 1 year.The proportion of high avidity increased with age, and was significantly higher in patients aged 30–39 years at 70.07%(χ~2 = 17.27, P = 0.002). Of the 52 measles cases in patients with a history of vaccinations,41(78.85%) cases showed high avidity, indicating secondary vaccine failures(SVF). In these vaccinations,there was no significant difference(P > 0.05) in clinical severity between high avidity and low avidity cases. However, regardless of vaccination status, clinical severity was significantly lower in high avidity cases(P < 0.001) than in low avidity cases. The percentages of positive measles Ig M results in high avidity and low avidity cases were 66.28% and 91.25%, respectively. Geometric Mean Concentration(GMC) was significantly lower in high avidity cases at 33.73 U/m L, compared to 166.07 U/m L in low avidity cases.Conclusions Low clinical severity and inconclusive Ig M antibody results are more likely in high avidity measles cases. Measles cases were more common in adults. Therefore, a further dose of vaccines should be recommended for 30–39 years in Tianjin.

Knowledge and associated factors of healthcare workers on measles vaccine and cold chain management at health institutions in Gondar,Ethiopia

Objective:To assess the knowledge of healthcare workers on the measles vaccine and its cold chain management.Method:An institutional-based cross-sectional study was conducted from February 1 to March 30,2022 in Gondar City Administration public health institutions among 165 healthcare workers.Data were collected using a structured questionnaire.In addition,an on-spot observation checklist was used to assess the availability,status and management of the cold chain.A logistic regression model was used to assess the relationship between the outcome and predictor variables.Crude and adjusted odds ratios were calculated with 95%confidence intervals.Results:Overall,87(52.7%;95%CI 44.8%-60.5%)of the healthcare workers had unsatisfactory knowledge regarding the measles vaccine and its cold chain management.One hundred thirty-six(82.4%)healthcare workers correctly mentioned the recommended range of temperature(2-8℃)for measles vaccine storage.Healthcare workers aged 18-29 years(P=0.001)and 30-44 years(P=0.014)were observed as determinants of unsatisfactory knowledge on the measles vaccine and its cold chain management.One hundred and five(63.6%)of the healthcare workers did not correctly mention the type of measles vaccine used in routine immunization.More than one-third(36.4%)of the healthcare workers perceived that the measles vaccine is not safe and could cause measles.Conclusions:More than half of the healthcare workers in the study area had unsatisfactory knowledge on the measles vaccine and its cold chain management.It is necessary to provide technical support and in-service training for healthcare workers to ensure optimal immunization effectiveness.

Vaccination and Measles Epidemic in the Republic of Congo

Measles is a highly infectious, vaccine-preventable viral disease. Often forgotten, it is potentially fatal. Its main symptoms are: fever, cough, conjunctivitis, rhinitis and skin rash. Serological diagnoses by ELISA test based on the detection of anti-measles virus immunoglobulins M and G (IgM and IgG), are used respectively for the confirmation of suspected cases notified by means of clinical signs of the disease in health structures of the twelve departments of the Republic of Congo involved in the epidemiological surveillance of the disease, and for the evaluation of the immunity conferred by vaccination. During 2021, 459 suspected cases of measles were reported and sampled throughout the country, despite the administration under the Expanded Routine Immunization Program (EPI), of 2 doses of the combined measles-rubella vaccine (RR1 and RR2) in 2020. The notification rate was higher in the south of the country, more precisely in the health structures of the departments of Pointe-Noire (42%) and Brazzaville (11%). During the year 2021, 459 suspected cases of measles were notified and sampled throughout the country with a high notification rate in the south of the country, more precisely in the health structures of the Pointe-Noire departments (42%) and Brazzaville (11%). The samples consisting of human blood (serum) were sent to the National Public Health Laboratory and analyzed by various ELISA tests for the detection of anti-measles immunog-lobulins M and G. The analysis of the results obtained shows that the measles virus circulated in all departments of the country. 154 cases (33.55%) were confirmed positive by IgM ELISA and 98 positive cases (63.63%) were patients vaccinated against measles. Vaccination coverage in RR1 of [50%-95% [(first dose) as well as the lowest RR2 < 50% (second dose) undoubtedly because the COVID-19 pandemic could be the cause of the high frequency of cases positive vaccinated. The non-detection of IgG immunoglobulins in vaccinated patients observed by IgG ELISA tests revealed that 63.26% of vaccinated patients were not immunized against the measles virus. These results confirm those obtained during the Elisa IgM analysis and make it possible to deduce that the quality, the number of doses not properly administered, the individual characteristics of the people as well as the poor conservation of the administered vaccine (non-compliance with the cold chain) would explain the high proportion of positive cases of vaccinated measles observed.

Primary Research of Immunological Mechanism of Combined Hepatitis A-Measles-Varicella Vaccine

To explore the primary humoral and cellular immunological mechanism of the combined hepatitis A-measles-varicella vaccine, the mice were inoculated with hepatitis A-measles-varicella vaccine by intraperitoneally and two weeks later, blood was collected to observe the mice＇s immunological status. Antibody level was measured to appraise the humoral immunity. At the same time, T lymphocyte surface marker, NK cell activity, LAK cell activity, delayed type hypersensitivity of skin, Mφ phagocytic function, mRNA level of cytokine IL-2 and IFN-γ plus lymphocyte transformation test were used to analyze the cellular immunity. The humoral immunity results show that the combined hepatitis A-measles-varicella vaccine produce the same antibody level as their corresponding univalent vaccine, and maintained fine immunogenicity and security. The result of cellular immunity shows that the combined vaccine could activate physical immunocyte, increase the regulative ability of cytokine, enhance the physical immune function and immune defense ability. The present research proved the security and better humoral and cellular immunity of combined hepatitis A-measles-varicella vaccine from the immunological point of view, which laid good foundation for further study and development.

Clinical Trial of Measles and Rubella Combined Vaccine Produced by POLYVAC in Vietnam

A clinical trial of measles and rubella combined vaccine (MR: MRVAC) produced by POLYVAC was conducted in Vietnam in 2016. A total of 756 subjects were enrolled, and 504 were allocated to MRVAC and 252 to control MR vaccine groups. Paired sera were obtained in 733, and the number of subjects was 403 aged 1 - 2 years, 164 aged 2 - 18 years, and 166 aged 18 - 45 years. Antibodies against measles and rubella viruses were evaluated by EIA. Most subjects had been immunized with a single dose of Expanded Programme on Immunization (EPI) measles vaccine at 9 months of age. Only 41 of 403 subjects aged 1 - 2 years were negative for measles antibody before vaccination, and all became seroconverted. A serological response of more than a 2-fold increase against measles was noted in 214 (47%, 95% CI;42.4% - 51.6%) of 458 initially seropositive individuals immunized with MRVAC and 65 (28%, 95% CI;22.3% - 33.8%) of 234 in the control group, and geometric mean titer (GMT) after vaccination was 25.49-5.60 in MRVAC and 25.03-5.24 in control group. Seroconversion against rubella virus after immunization with MRVAC was noted in 267 (98.5%, 95% CI;97.1% - 100%) of 271 initially seronegative subjects, similar to that after immunization with control group. GMT after immunization with MRVAC was 24.88-5.11 significantly lower than that after immunization with control vaccine (25.59-5.80). Most subject ≥ 2 years of age had rubella antibody because of MR vaccination campaign and no significant serological response was observed in initially seronegatives. MRVAC was highly immunogenic and safe vaccine and the domestic production of MR vaccine would contribute to realizing the goal of eliminating measles and rubella.

Epidemic Outbreaks in Plovdiv Region (Bulgaria) of Vaccine-Preventable Diseases: Measles, Mumps, Hepatitis A

Aim: To analyze the reasons for epidemic outbreaks of measles, mumps and viral hepatitis A and to propose measures to prevent them in future. Materials and methods: Тhe incidence of measles, mumps and hepatitis A in Plovdiv region was studied for the period 2006-2010. An analysis of the age structure of the patients was made, while taking into account the time for routine immunization performed against measles and mumps (first and second dose). Results: In 2006-2009 single cases of measles were found occasionally, but in 2010 they were 2787 (incidence 395/100,000). Most of them (51%) were for ages 13 months-12years, 27%-0-13 months and 11%-13 to 18 years. The incidence of mumps for 2006-2010 varied widely, and has increased significantly in 2007 (130/100,000) and 2008 (169/100,000). The majority of patients (over 34%) during the epidemics were aged 13 months-12years, and over 26% of them-13-19 years. For the period 2006-2010 the incidence of hepatitis A ranged from 2.98/100, 000 (2009) to 426/100,000 (2006). Over 50% of the cases involved children aged up to 9 years. For the three diseases over 80% of patients were individuals of Roma origin. Conclusions: 1. Epidemic spread of measles in 2010 was mainly due to shortcomings in the routine immunization carried as a prevention of the disease. 2. There are two reasons for the outbreak of mumps: А) Failure to administer the second vaccine dose at 12 years in Bulgaria until 2001. B) Shortcomings in routinely performed immunization. 3. The extremely high incidence of hepatitis A in 2006 (and in the rest of the years) is due to the lack of routine immunization. 4. Essential for the outbreaks in all three diseases are the poor hygienic living conditions, the low social status and the lack of health promotion of the population at risk 5. To prevent future outbreaks of the diseases hereby in question, we suggest it is appropriate: А) To introduce compulsory immunization against hepatitis A;B) To carry out periodic catch-up vaccination campaigns against measles and mumps.

Correlates of first dose of measles vaccination delivery and uptake in Indonesia

Objective:To determine health systems-related,familial,and cultural factors which influence the delivery and uptake of measles vaccination in Indonesia.Methods:Logistic regression analysis of data collected during the 2007 Indonesian Demographic and Health Survey was undertaken by the authors to investigate these factors.The 2007 Indonesian Demographic and Health Survey dataset is a nationally representative,randomly sampled survey containing 15 065 children aged between 9 and 59 months.Results:72.8%of children had received the measles vaccine.Vaccination coverage was similar for males and females;however,coverage was higher amongst urban children,80.1%,compared to 68.5%in rural areas.The key findings of the regression analysis were congruent with the results of previous research targeting vaccination coverage.After controlling for all other factors,maternal age,maternal education,wealth, the use of a skilled birth attendant,and postnatal check-ups were positively and significantly (P【 0.01) correlated with measles vaccination.The number of children per household was negatively correlated(P【0.01).Conclusions:In order to enhance measles vaccination coverage in Indonesia,delivery to,and uptake by,rural and low socio-economic populations require substantial improvements.Mass health education and health systems improvements are also required.

Relationship between Self-Reported Vaccination History and Measles and Rubella Antibody Titers in Medical and Nursing Students

In hospitals, infection control for measles and rubella is important. Medical and nursing students as well as healthcare workers must have immunity against these diseases. Many countries have adopted requirements for healthcare workers’ documented vaccination history or laboratory tests as evidence of their immunity. Evaluating a written vaccination history is difficult in many cases. Therefore, we compared measles and rubella antibody titers with self-reported vaccination history and we evaluated the association between the history and measles and rubella antibody titers, using the medical and nursing students’ data. We analyzed 564 data for measles and 558 data for rubella. Vaccination history was requested to be completed as accurately as possible. Students with one or more measles or rubella vaccinations had high positive ratios of titer, and the ratio was significantly higher than that of the students without vaccinations. The positive ratio between the two-dose and one-dose vaccination groups was not significantly different for measles or rubella (measles: p = 0.534, rubella: p = 0.452). Although it should be requested that the history is complete by using other resources, such as referring to maternity passbooks or proof of vaccination, self-reported history may be useful to confirm immunity, even if there is a possibility that the history is not accurate.

Safety and Antibody Responses to Aerosolized MMR II Vaccine in Adults: An Exploratory Study

Background: There have been no reported studies involving aerosol immunization with 2 of the 3 components of MMR II vaccine—Attenuvax measles vaccine and Jeryl-Lyn mumps vaccine. Objective: To evaluate the safety and antibody responses to aerosolized Attenuvax measles strain, Jeryl Lynn mumps strain and RA 27/3 rubella component of an MMR vaccine in adults, before assessing the booster administration of this vaccine in children. Methods: A pilot study to evaluate safety and antibody responses of MMR II (Merch Sharp & Dhome Corp., Whitehouse Station, NJ 08889, USA) components administered by aerosol was carried out in 27 healthy adults of 21 to 38 years of age. All participants were followed-up during 28 days following immunization for detection of clinical adverse events. Immune response was evaluated by plaque reduction neutralization test for measles, and commercial ELISA kits for rubella and mumps. Results: Only mild clinical adverse events were noted. Despite high levels of baseline seropositivity to all vaccine components, seroresponses to measles, rubella and mumps occurred in 44%, 15% and 41%, respectively. Conclusions: These outcomes compare favorably with earlier studies of other MMR vaccines given by aerosol. Further evaluations on safety and booster immune response should be performed in children.

Contributions of the Measles Follow-Up Vaccination Campaign to Improving the Vaccination Coverage of Children Aged 6 - 59 Months in the Democratic Republic of the Congo in 2019

Background: In accordance with its measles elimination strategic plan 2012-2020, the Democratic Republic of the Congo (DRC) organized a follow-up vaccination campaign against measles from October to December 2019 in 26 provinces. This study aims to establish the contribution of this supplementary vaccination campaign to protecting children against measles. Methods: The survey was carried out in November 2020 among households of the DRC, according to the 2018 revised version of the World Health Organization’s stratified cluster sampling method, using multiple stage sampling. It targeted 280 children aged 6 - 59 months per stratum or province, with 10 children in each of the 28 selected clusters. Data collection using tablets with centralized and real-time data processing was preceded by enumeration to refine the household sampling frame. Clusters and households were selected by random draw. Data collected with CS Pro 7 software were analyzed with SPSS, Epi info 7 and Excel software to determine indicators and make before-after comparisons using the McNemar test, at a precision threshold of 5%. Results: Of the 8535 surveyed children, 89.5% were vaccinatedduring the follow-up campaign and 81.6% were vaccinated before. Only 3.7% had correctly completed campaign vaccination cards. Estimated vaccination coverage increased from 80.8% before the campaign to 92.6% after the campaign (p 0.001). Vaccination coverage after campaign against measles improved in all provinces (p < 0.001) except Bas-Uele and Maniema. Thirteen provinces reached the national coverage target of 95%, compared to five before the campaign. The proportion of zero-dose children dropped significantly after this campaign from 19.2% to 7.4% (p 0.001), and even fell below 1% in six provinces. Conclusion: This measles vaccination campaign improved overall vaccination coverage by 10% and reached more unvaccinated children. Efforts must continue to improve the retention of vaccination card, the adherence of unvaccinated children and the effectiveness of routine vaccination.

Measles in a Neonatal Unit during Epidemic Period in 2011

The incident of the measles has diminished in the last decades thanks to the widespread use of the vaccine in The United States and Europe. Nevertheless, recently we are seeing new epidemics of measles due to the lack of coverage in some social areas. Measles during pregnancy is associated with high maternal morbidity and mortality, being a frequent cause of abortion in preterm deliveries. We report two cases of measles attended in the Unit of Neonatology held coinciding with the epidemic lived in this area during the last year.

Progress in rubella control initiated through measles elimination strategies:the Malaysian experience

Objective:To analyse the laboratory surveillance data from 2004 till 2008 to examine the changing trend of rubella cases in Malaysia.Methods:Samples for this study were either received through the measles case based surveillance program or were hospital cases received for sero-diagnosis of congenital rubella syndrome(CRS). Specific rubella IgM antibody test was carried out on all samples that were negative for measles IgM antibody and for sero-diagnosis of CRS.Results:Through the surveillance program for measles,the samples received for rubella had increased five fold from 365 in 2004 to 1 522 in 2007.Positive rubella cases detected had also increased from 4.1%in 2004 to 33.2%in 2007.The age group 11 to 20 years accounted for 73.6%of rubella cases confirmed in 2008,with a higher incidence among males than females.Positive rubella IgM was detected in 25 CRS cases during the 6 year period between January 2003 and December 2008.Conclusion:The measles elimination program had contributed to significant progress in the control of rubella,with the majority of rubella cases detected through this strategy.Since rubella is not notifiable in Malaysia,this integrated measles and rubella surveillance should be continued.However,to enhance the progress,specific targets should also be established in the national program to eliminate rubella and CRS.

陕西省渭南市麻疹流行病学特征调查研究

目的:调查分析渭南市麻疹流行病学特征,为麻疹防控提供科学依据。方法:采用描述流行病学方法分析2009—2022年渭南市麻疹疫情监测资料。结果:2009—2022年渭南市累计报告麻疹病例274例,年均发病率0.37/10万。发病呈明显季节性,主要集中在4~6月,占总病例数的61.31%。年平均发病率前三位的区县依次为韩城市(0.78/10万)、潼关县(0.64/10万)和华州区(0.53/10万)。发病年龄主要为0~1岁,占全部病例数的50.73%。发病人群以散居儿童为主(57.30%)。含麻疹成分疫苗(MCV)接种0剂次、1剂次、≥2剂次以及免疫史不详占比依次为34.31%、8.76%、1.82%、55.11%。结论:渭南市近年来麻疹发病率显著降低,2022年发病率达到历史最低水平,但MCV首针及时率及2剂次覆盖率仍需进一步提升。

真实世界12岁以下儿童接种麻腮风联合减毒活疫苗后30天内单纯性热性惊厥发生风险分析

目的分析甘肃省12岁以下儿童接种麻腮风联合减毒活疫苗(MMR)后30 d内发生单纯性热性惊厥(SFS)特征。方法筛选甘肃省2021年1月1日至2023年12月31日电子病历库中诊断为“热性惊厥”个案,利用病例身份信息匹配甘肃省免疫规划信息系统中该病例的接种信息,采用观察性流行病学方法分析12岁以下儿童出现SFS的流行特征及接种MMR 30 d内SFS发生风险。结果共纳入10614例SFS儿童患者,12岁以下儿童SFS总体发生率为92.42/10万,其中12~24月龄儿童发生率最高,为297.67/10万,男性儿童发生SFS风险高于女性儿童(RR值为1.61,P<0.001)。接种MMR后30 d内发生SFS风险较未接种该疫苗的高(RR值为2.66,P<0.001)。接种第1剂次的发生率(27.98/10万)较第2剂次(18.48/10万)高,12~24月龄儿童在接种第1剂次MMR 6~14 d SFS发生风险较<12月、25月~6岁组高(RR值分别为4.06和2.64,P<0.001)。结论12~24月龄儿童在接种MMR后6~14 d SFS发生风险增加,以12~24月龄儿童最为常见,应高度关注高风险人群并加强对SFS监测。

Modeling measles transmission in adults and children:Implications to vaccination for eradication

Despite the availability of successful vaccines,measles outbreaks have occurred frequently in recent years,presumably due to the lack of proper vaccination implementation.Moreover,measles cases in adult groups,albeit small in number,indicate that the previously neglected adult group may need to be brought into vaccine coverage to achieve WHO's goal of measles eradication from the globe.In this study,we develop a novel transmission dynamics model to describe measles cases in adults and children to evaluate the role of adult infection in persistent measles cases and vaccination programs for eradication.Analysis of our model,validated by measles cases from outbreaks in Nepal,provides the vaccination reproduction number(conditions for measles eradication or persistence)and the role of contact network size.Our results highlight that while children are primary targets for measles outbreaks,a small number of infections in adults may act as a reservoir for measles,causing obstacles to eradication.Furthermore,our model analysis shows that while impactful controls can be achieved by children-focused vaccines,a combined adult-child vaccination program may help assert eradication of the disease.

Laboratory response to an infant with suspected measles vaccine associated fever and rash in Sri Lanka

Background:Measles is a highly contagious illness.Sri Lanka(SL)has eliminated the measles in 2019.The coun-try is at risk of importation of measles and there could be vaccine-associated measles like illnesses.Therefore,it is important to investigate patients with fever,rash to differentiate the wild-type from vaccine-type exclud-ing other suspected pathogens to direct infection prevention and control strategies.The objective is to describe the laboratory investigation procedure in an immunocompetent child,developed fever,rash following measles containing vaccine in post-measles eliminated period,SL.Methods:This laboratory based investigation was carried out in National Measles Laboratory,SL.Blood and throat swab were received from a patient with fever,rash,cough and coryza developed at tenth day of receiving the measles containing live-attenuated vaccine.Samples were tested for measles,rubella,and other relevant pathogens according to the laboratory testing algorithm for an immunocompetent child with fever,rash and flu like symptoms.Results:Measles vaccine type A,Edmonston-strain virus was detected after sequencing in throat swab and measles IgM and IgG were positive at sixth-week of illness-onset.In addition,influenza A RNA was detected in throat swab at day-three with detectable parvoB19 IgM in blood sample received at sixth-week of post-onset symptoms.Conclusions:Measles like illness of this immunocompetent child who received measles containing vaccine could be due to measles vaccine-type A or influenza infection.In a measles eliminated,resource-limited setting in SL,there should be a well-defined,testing algorithm to exclude prevalent possible pathogens according to epidemiological and clinical information.

麻疹疫苗免疫持久性研究──初免后24-25年追踪观察

目的 对1973年在浙江省诸暨县（市）建立的麻疹免疫持久性观察基地进行麻疹疫苗初免后24～25年的血清抗体追踪观察。方法 对各年份血清学资料完整的326名观察对象采集微量血，测定HI抗体，同时对HI＜1：2的对象用细胞中和法（SN）进行复测。结果 初免后24-25年抗体阳性率为53．66%-84．48%。不同剂量免后HI的GMT和累积阴转率差异无显著意义。不同免疫途径免疫的抗体持久性均与野病毒感染基本一致，但HI＜1：2者用SN法复测抗体阳性率可达92．23%。结论 麻疹疫苗HI抗体阳性率随免疫时间推移降低，但细胞中和抗体阳性率仍较理想。

国产冻干麻疹腮腺炎风疹联合减毒活疫苗的接种反应和免疫原性观察

目的观察冻干麻疹腮腺炎风疹联合减毒活疫苗的接种反应和免疫原性。方法分Ⅰ、Ⅱ、Ⅲ期进行,分别选择7～15岁和8～18月龄儿童接种国产MMR疫苗,同时设进口MMR疫苗、单价麻疹、腮腺炎、风疹疫苗对照,进行接种反应和免疫原性观察。结果Ⅰ期7～15岁接种国产MMR疫苗的11人中,仅3人发生局部弱反应,反应率为27.3%;8～11月龄接种国产MMR疫苗的26人中,发热率和皮疹反应率分别为11.5%、15.4%,其中高热率为3.8%。Ⅱ、Ⅲ期观察的1188名8～18月龄儿童中,接种国产MMR疫苗发热率为10.69%,皮疹反应率为3.64%,局部反应率为0.44%,其他反应率为0.22%。与对照疫苗比较,仅发热率高于腮腺炎疫苗及风疹疫苗,且差异有统计学意义,其他反应差异均无统计学意义。接种国产MMR疫苗后,麻疹、腮腺炎、风疹HI抗体阳转率和抗体GMT分别为99.5%、85.9%、100%和1∶57、1∶4.2、1∶890。与对照疫苗比较,麻疹抗体GMT国产MMR疫苗高于进口MMR疫苗和麻疹疫苗,抗体阳转率国产MMR疫苗高于进口MMR疫苗,且差异有统计学意义;腮腺炎抗体GMT国产MMR疫苗低于进口MMR疫苗,且差异有统计学意义,其他各疫苗组差异均无统计学意义。结论国产MMR疫苗具有良好的安全性和免疫原性。

麻疹胎传抗体的跟踪观察及初免月龄的探讨

目的 通过了解婴儿胎传抗体衰减情况和不同月龄婴儿对麻疹疫苗的免疫应答情况 ,探讨减少小月龄麻疹病例的对策。方法 采用ELESA方法测定血清中麻疹IgG抗体水平。结果 通过对胎传抗体追踪观察发现 ,新生儿抗体水平不高 ,3月龄时降低 5 0 % ,6月龄和 8月龄降到 15 %左右 ,几乎无保护作用 ,且 6月龄和 8月龄婴儿接种疫苗后免疫成功率间无差别。结论 目前新生儿麻疹抗体水平低 ,到 6月龄时大部分婴儿胎传抗体已降到保护水平以下。因此 ,为实现消灭麻疹的总目标 ,在小月龄麻疹发病率高的地区可考虑将麻疹初免月龄从8月龄提前到