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.

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.

Epidemiological Characteristics of Measles-Mumps-Rubella in China’s Mainland during 2014-2021

Objective To analyze the epidemiological characteristics of measles,mumps,and rubella(MMR)between 2014 and 2021 and identify potential strategies and measures for the prevention and control of MMR in China.Methods Data on MMR was obtained from China’s National Notifiable Disease Reporting System for the period from 2014 to 2021.Spatiotemporal distributions were analyzed using SaTScan;temporal trends were analyzed using JoinPoint;and clusters were visualized using ArcGIS.Results A total of 1,808,067 cases of MMR were reported from 2014 to 2021 in China’s mainland,most of which were children and students under the age of 20.The incidence of measles declined during 2014-2021,whereas that of mumps and rubella peaked in 2019.MMR-reported cases generally peaked from March to July;however,high numbers of mumps cases were reported from September to November in 2020-2021.Measles and rubella clusters predominantly occurred in Western China,whereas clusters of mumps were generally found in the southern region.Conclusion The relatively heterogeneous epidemiological characteristics of MMR have highlighted the weaknesses and gaps in surveillance and timely control of MMR transmission in China’s mainland.Real-time and intelligent monitoring data should be collected for evidence-based early interventions。

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.

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.

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。

2019-2022年开封市健康人群麻疹、风疹和流行性腮腺炎抗体水平监测分析

目的了解开封市健康人群麻疹、风疹、流行性腮腺炎抗体水平,评价疫苗免疫效果,为科学防控及相关疾病传播风险评估提供依据。方法采用多阶段分层抽样的方法采集开封市4个监测点0~79岁共计1983名健康人群血清标本,利用ELISA方法分别对血清中麻疹、风疹、流行性腮腺炎IgG抗体进行检测。结果1983份血清样本中,麻疹、风疹、腮腺炎的抗体阳性率分别为90.97%、83.16%、90.42%。不同性别间麻疹、风疹、流行性腮腺炎抗体阳性率没有显著性差异(P>0.05)。不同年龄组、不同监测点间的抗体阳性率具有显著性差异(P<0.01)。不同免疫史及距末次疫苗接种不同时间的麻疹、风疹抗体阳性率具有显著性差异(P<0.01),流行性腮腺炎抗体阳性率无显著性差异(P>0.05),但3种抗体阳性率均随免疫剂次的增加而升高。结论开封市存在麻疹、风疹、流行性腮腺炎免疫规划薄弱环节,应关注8月龄幼儿首剂疫苗的及时接种,对育龄期妇女进行宣传教育,及时开展抗体水平监测,积极开展查漏补种工作。

2010—2019年我国麻疹、流行性腮腺炎和风疹流行病学特征浅析

目的:分析2010—2019年全国麻疹、流行性腮腺炎和风疹的流行病学特征,以期为疾病的管理和控制提供依据。方法:利用中国疾病预防控制中心公共卫生科学数据中心收集2010—2019年全国麻疹、流行性腮腺炎和风疹的发病数据,描述性分析3种疾病的发病率和发病特征。结果:麻疹报告发病率在2012年年底开始反弹并于2014年到达高峰,2014年报告发病率为3.88/10万,较2013年上升90%,2015年后逐年下降。流行性腮腺炎在2011年和2012年高发,报告发病率分别为33.89/10万和35.59/10万,2012—2016年报告病率呈下降趋势,2017—2019年又开始持续上升。风疹报告发病率从2010年开始逐年降低,并于2017年达到历史最低水平,但在2018年后发病率显著回升并于2019年再次达到高峰。总体来看我国西部地区3种疾病的报告发病率要高于东部和中部地区。从年龄分布来看,麻疹和风疹病例中1岁以下儿童占比最高,均超过50%,流行性腮腺炎病例以2岁以上儿童为主。结论:2010—2019年我国麻疹、流行性腮腺炎和风疹疾病得到了有效地控制,但仍有未接种或仅接种一剂疫苗的适龄儿童存在,建议3种疾病联合防治的同时,各地区需因地制宜,制定科学合理的政策,继续加强免疫接种覆盖率;根据疾病的年龄分布情况,建议继续维持适龄儿童2剂次的预防接种方案,加强免疫接种覆盖率。同时可考虑为5~9岁儿童补充接种含流行性腮腺炎成分的疫苗,以减少学校聚集性疫情的发生。

甘肃口岸出入境留学生麻疹、风疹、腮腺炎、水痘抗体水平监测

目的了解甘肃口岸出入境留学生的麻疹、腮腺炎、风疹、水痘免疫状况,为甘肃口岸疾病防控提供依据。方法收集甘肃口岸2022—2023年出入境留学生血清301份,使用酶联免疫吸附法(ELISA)检测麻疹、腮腺炎、风疹、水痘IgG抗体水平,并对结果进行统计学分析。结果麻疹、腮腺炎、风疹、水痘抗体总体阳性率分别为93.4%,95.7%,94%,94.6%,抗体平均浓度分别为0.61IU/ml,147.17AU/ml,9.84IU/ml,2.116IU/ml。女性麻疹抗体平均浓度明显高于男性(P<0.05)。不同年龄段水痘抗体平均浓度有明显差异(P<0.05)。出境留学生与入境留学生水痘、麻疹、腮腺炎抗体平均浓度有明显差异(P<0.05)。不同地区水痘及风疹抗体平均浓度有明显差异(P<0.05)。结论甘肃口岸出入境留学生麻疹、风疹、腮腺炎、水痘抗体阳性率总体较高,但入境留学生的抗体浓度水平明显低于出境留学生,来自不同地区入境留学生的抗体浓度水平也有差异,这提醒我们要加强出入境留学生的健康监测、免疫监测及国际旅行健康服务,建议在适当的情况下选择补种疫苗等有效的措施,避免疫苗可预防性疾病在高校暴发的风险。

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。

上海市麻疹、流行性腮腺炎、风疹抗体水平调查分析

[目的 ] 了解本市健康人群麻疹、腮腺炎、风疹的抗体水平。 [方法 ] 采集 0～ 5 0岁健康人群血标本 5 43份 ,检测麻疹、腮腺炎、风疹抗体。 [结果 ] 小于 8月龄组麻疹抗体GMT最低 ,接种麻疹疫苗后抗体GMT显著升高 (P<0 .0 0 1) ;小于 8月龄组及 8月龄组风疹抗体水平最低 ,1岁接种疫苗后风疹抗体显著升高 (P <0 .0 0 1) ,但随着年龄的增长抗体水平有所下降 ,抗体阳性率维持在 85 %以上 ;小于 8月龄组及 8月龄组流行性腮腺炎抗体水平最低 ,1岁以上各年龄组抗体水平显著上升 (P <0 .0 0 1)。 [结论 ] 上海市现阶段实行麻疹疫苗、MMR疫苗的接种程序比较合理和有效 ,但应该进一步开展上海市育龄期妇女风疹抗体水平调查和MMR疫苗免疫持久性观察 ,研究预防未及龄儿童麻疹疫苗免疫策略、育龄期妇女接种风疹疫苗免疫策略 。

麻疹、腮腺炎、风疹三联减毒活疫苗的安全性和免疫原性研究

为了评价国产麻疹、腮腺炎、风疹三联减毒活疫苗(MMR)的安全性和免疫原性,按整体随机抽样原则,以进口同类疫苗和国产各单价疫苗作为对照,开展现场临床观察;比较不同疫苗组免疫后的反应率、抗体阳转率、保护率及几何平均滴度(GMT)。试验组与对照组接种后,除了试验疫苗的中、强发热反应率高于进口对照疫苗的发热反应率(8.60%与2.00%)外,未见其它有显著差异的不良反应。试验组麻疹免后抗体阳转率高于进口对照疫苗(99.5%与94.6%),麻疹抗体GMT也高于单价麻疹对照疫苗的GMT;试验疫苗与进口MMR疫苗的风疹抗体阳转率、腮腺炎抗体阳转率相比,均无显著性差异。实验研究结果显示,试验MMR疫苗与进口MMR疫苗具有相似的临床反应及良好的免疫原性。

单价风疹、腮腺炎疫苗初种后的免疫持久性

目的 :评价国产单价风疹、腮腺炎疫苗初种 3年后的免疫效果。方法 :利用前瞻性的研究方法 ,以辖区内血清抗体阴性的 0～ 4岁小儿作为研究对象 ,根据是否接种腮腺炎和风疹疫苗分为接种组和对照组。在疫苗接种前和三年后各抽血一次 ,然后用 EL ISA方法检测接种前后血清中特异性抗体的浓度 ,并观察接种组和对照组这两种传染病的发病情况。结果 :腮腺炎接种组 10 2人 ,对照组 5 6人经过三年两个流行期后发病率分别为 0 .98% (1/10 2 )和 7.14 % (4/5 6 ) ;风疹接种组 95人 ,对照组 6 3人经过三年一个流行期后发病率分别为 3.16 % (3/95 )和 11.11% (7/6 3) ,均是接种组低于对照组 ,两组差异有显著性 (χ2 =4 .31,11.2 4 ,P均 <0 .0 5 ) ,腮腺炎和风疹疫苗的保护率分别为 86 .2 7%和 71.5 6 %。未接种组自然感染 (包括显性感染和隐性感染 )率较高 ,腮腺炎为 71.4 3%、风疹为 6 0 .32 %。结论 :国产单价腮腺炎和风疹疫苗有较好的免疫原性和三年以上的免疫持久性 ,可以作为目前我国 (包括广大农村 )预防腮腺炎和风疹的有利措施。其长期的免疫持久性和复种程序有待进一步研究。

风疹和麻疹疫苗同时或分别接种的免疫效果

风疹和麻疹疫苗同时或分别接种8～11月龄婴儿，并对免疫效果进行比较，结果同时接种与分别接种的婴儿风疹或麻疹抗体阳转率及GMT差异均无显著意义，表明此两种疫苗可以同时接种。

营山县2014年健康人群麻疹、风疹、腮腺炎抗体水平监测结果分析

目的：了解营山县健康人群麻疹、风疹、腮腺炎抗体水平,评价疫苗接种效果和人群免疫状况,为制定免疫规划策略和相应传染病防制措施提供依据。方法：按照分层随机抽样的原则,分〈1岁、1岁~、3岁~、5岁~、7岁~、15岁~、≥20岁7个年龄组,每个年龄组随机抽取30人作为监测对象,共210人,采用酶联免疫吸附实验（enzyme-linked immunosorbent assay,ELISA）法检测麻疹IgG、风疹IgG、腮腺炎IgG。结果：共检测210份血清标本,麻疹IgG阳性率为86.19%,风疹IgG阳性率为80.48%,腮腺炎IgG阳性率为63.81%。结论：营山县健康人群麻疹IgG抗体水平1岁以上年龄组人群均达到《预防接种规范》要求的85%免疫成功率指标,建立了有效免疫屏障。风疹IgG抗体和腮腺炎IgG抗体水平较低,不足以达到有效免疫屏障,提示我们要加强风疹、腮腺炎接种率和接种质量。

扩大国家免疫规划对辽宁省流行性腮腺炎发病率的影响

目的评估麻疹-腮腺炎-风疹联合减毒活疫苗(MMR)纳入扩大国家免疫规划(NEPI)对流行性腮腺炎发病趋势的影响。方法收集辽宁省2005年至2019年流行性腮腺炎发病数据,利用中断时间序列分析方法,分析疫苗接种前后发病率变化趋势。结果MMR接种前,流行性腮腺炎月发病率呈上升趋势,均值为2.33/10万,平均逐月增加0.0146/10万(P=0.001)。MMR接种后,月发病率均值为0.8841/10万,发病率立即下降(β2=-1.3065,P<0.0001)。干预后流行性腮腺炎月发病率的斜率为-0.0154,相比干预前下降了0.03,干预前与干预后斜率差异有统计学意义(P<0.0001)。结论MMR纳入NEPI对降低辽宁省流行性腮腺炎的发病率发挥了积极作用。

口服轮状病毒减毒活疫苗与麻疹-风疹联合减毒活疫苗联合接种的免疫原性和安全性研究

目的:探讨口服轮状病毒减毒活疫苗(oral live attenuated rotavirus vaccine,ORV)与麻疹-风疹联合减毒活疫苗(measles and rubella combined attenuated live vaccine,MR)联合接种的可行性,为制定免疫规划程序提供可靠的科学依据。方法:设两种疫苗同时接种组和单苗接种组,观察疑似预防接种异常反应(AEFI)发生情况,接种前后、联合接种与单独接种组之间抗体几何平均滴度/浓度(GMT/GMC)、抗体阳性率和阳转率的差异。结果:各接种组临床反应都轻微,实验组与各对照组免前免后同种抗体GMT/GMC、阳性率,以及免后抗体阳转率,其差异均无显著意义(P>0.05)。结论:ORV与MR同时接种未发现严重异常反应和相互干扰免疫应答,可以同时接种。

腮腺炎疫苗分别与甲肝、白破、风疹疫苗联合免疫的效果观察

目的 :观察腮腺炎疫苗分别与甲肝、白破、风疹疫苗同时接种的临床反应和免疫效果。方法 :设两种疫苗同时接种组和单苗接种组 ,比较其副反应和血清抗体水平。结果 :各接种组临床反应都轻微 ,两苗同时接种组与相应的单苗接种组免前免后同种抗体阳性率或保护率和 GMT,以及免后抗体阳转率 ,其差异均无显著意义 (均 P>0 .0 5 )。结论 :腮腺炎疫苗与甲肝、白破、风疹减毒活疫苗之一同时接种未发现加重反应和相互干扰免疫应答 ,可以同时接种。

麻疹、流行性腮腺炎二联活疫苗中量试制

用麻疹沪191株和流腮S79株中量试制麻疹、流腮二联活疫苗，对疫苗原液的配制比例、二联疫苗与单价疫苗的病毒滴度和稳定性进行比较。结果提高流腮疫苗原液的比例可获得较好效果；9批麻腮二联疫苗全部达到现行单价疫苗规程要求；二联疫苗在4～8℃保存18个月的稳定性与单价疫苗基本一致。