Prevention and Nursing of Adverse Reactions of Novel Coronavirus Inactivated Vaccine (Vero Cells)

Objective:To discuss and analyze the causes of adverse reactions caused by the inactivated novel coronavirus vaccine(Vero cells),and to propose methods of prevention and care.Methods:A questionnaire was used to randomly select 229 adults who were vaccinated with the inactivated novel coronavirus vaccine(Vero cells)at Xi’an People’s Hospital(Xi’an Fourth Hospital).The adverse reactions were statistically analyzed.Results:Among the 229 adults vaccinated with the inactivated novel coronavirus vaccine(Vero cells),30 experienced vaccination reactions.The main reaction was local induration at the inoculation site,and dizziness was the primary systemic symptom.Conclusion:To reduce the incidence of adverse reactions to the inactivated novel coronavirus vaccine(Vero cells),it is necessary to effectively evaluate the health status of adults before vaccination,select the correct vaccination site,and strictly implement the rules of 3-inspections,7-checks,and 1-verification.Standardizing the operation process and providing thorough health education after vaccination can effectively reduce the occurrence of adverse reactions.

Pilot-Scale Production of Lyophilized Inactivated Rabies Vaccine Candidate in Vero Cells under Fully Animal Component-Free Conditions Using Microcarrier Technology and Laboratory Animal Trials

The upstream process was carried out in an animal component-free medium on Cytodex 1 microcarriers. Recombinant trypsin is a non-animal derived protease used as an alternative to animal-derived trypsin. To inactivate recombinant trypsin, a soybean trypsin inhibitor (STI) should be added to the medium. A protocol was first tested in T-flasks and then passaged to 500 mL and 3 L spinner flasks. Cell detachment was completed in 10 - 12 min, and 0.4 g/L STI was added to a 3L spinner, and cells were transferred into a 30 L stirred tank bioreactor. On day 5, the cell density had reached its maximum (around 1.8 × 106 cells/mL). At an MOI of 0.3 with serum-free medium conditions, cell infection yielded a maximal rabies virus titer of 1.82 × 107 FFU/mL at 5 days. All cell culture conditions and virus growth kinetics in serum-free media were investigated. In conclusion, Vero cells were grown on Cytodex 1 with serum-free media and a high amount of rabies virus was obtained. A mouse challenge was used to determine the immune response to an inactivated rabies virus vaccine candidate. Also, we evaluated inactive rabies vaccine candidate safety, and immunogenicity in mice, sheep, horses, and cattle. We found that no horses, sheep, or cattle who were given vaccine IM at 3.2 IU/dose exhibited any clinical sign of disease and all developed high VNA titers (up to 10.03 IU/mL) by 3 - 4 WPI. After the accelerated stability studies, the lyophilized inactivated rabies vaccine candidate showed enough antigenic potency (2.6 IU/mL) in the mouse challenge test. Also, 18-month long-term stability studies showed enough immune response (1.93 IU/mL) on day 14. The activity of the vaccine candidate showed a good immune response and safety criteria that meet WHO requirements. This is the first pilot-scale mammalian cell-based viral rabies vaccine production study in Türkiye that used microcarriers.

新型冠状病毒灭活疫苗(Vero细胞)内毒素检查方法比较

目的为新型冠状病毒(简称新冠病毒)灭活疫苗(Vero细胞)的细菌内毒素检查和质量控制提供技术支持和理论基础。方法利用凝胶法、光度测定法[包括动态浊度(TKA)法、微量动态显色(mKCA)法]测定并比较新冠病毒灭活疫苗(Vero细胞)原液和成品中内毒素浓度。结果3种方法测得的供试品内毒素浓度均符合规定(原液为不超过5 EU/600 SU,成品为每剂≤5 EU),且后2种方法既能用于定性检测也能用于定量检测,特别是mKCA法下鲎试剂用量更少。结论mKCA法是检查该疫苗内毒素浓度的最适宜方法,具有灵敏度高、稳定性强、鲎试剂用量少、数据完整和可追溯、人为操作误差较小的特点。

A Case of Investigation and Diagnosis of Immune Thrombocytopenic Purpura After Vaccination of COVID-19 Inactivated Vaccine

Objective:Analyze the relationship between inoculating one case of the COVID-19 inactivated vaccine(Vero cell)and immune thrombocytopenic purpura to provide a reference for the standardized handling of adverse events following immunization.Methods:According to the"National Monitoring Program for Suspected Adverse Reactions to Vaccinations,"an on-site investigation,data collection and analysis,expert group diagnosis,and medical association assessment were conducted on a case of immune thrombocytopenic purpura in District A of Chongqing after vaccination with the inactivated COVID-19 vaccine.The assessment report was delivered to the three relevant parties,the case was reviewed,and the experience was summarized.Results:The investigation and diagnosis by the district-level vaccination abnormal reaction expert group concluded that the disease that occurred after vaccination with the COVID-19 inactivated vaccine was secondary immune thrombocytopenic purpura,an abnormal reaction to the vaccination.The medical damage was classified as Level II Grade B.The vaccine production enterprise raised objections to this conclusion.After re-assessment by the municipal-level medical association,the conclusion was consistent with that of the district-level medical association.The vaccine production enterprise did not raise any further objections.Conclusion:Through active collaboration among district and municipal-level medical associations,disease control institutions,and vaccination units,the recipients have been promptly and effectively treated,providing financial support for their subsequent treatment and safeguarding their rights.The investigation and disposal procedures for adverse events following immunization in Chongqing are clear,and the mechanism is sound.It is necessary to continue strengthening the monitoring of adverse events following immunization according to the existing plan and to ensure timely and standardized handling.Simultaneously,it is crucial to strengthen vaccine management and vaccination management.

Acute motor axonal neuropathy following anti-rabies human diploid cell vaccine:A rare case and review

Rationale:Guillain Barre syndrome(GBS)is an acute neurological illness leading to quadriparesis with respiratory involvement.It can be triggered by infections,vaccinations,surgery,trauma,transplantation and drugs.Anti-rabies cell culture vaccines introduced to overcome the high rate of neurological complications associated with tissue based rabies vaccine,can be very rarely associated with GBS.Patient concerns:A 50-year-old female presented with acute severe upper back pain evolving into pure motor quadriparesis following administration of human diploid cell vaccine for rabies.Diagnosis:Acute motor axonal neuropathy variant of GBS following anti-rabies human diploid cell vaccine.Interventions:Intravenous high dose steroids.Outcomes:Patient recovered completely within 1 month.Lessons:Although anti-rabies cell culture vaccines are highly immunogenic and safe,they are rarely associated with GBS.Clinicians should be aware of this link because prompt diagnosis and treatment can result in complete recovery and avoid complications.

Agranulocytosis following injection of inactivated Japanese encephalitis vaccine(Vero cell):A case report

BACKGROUND Japanese encephalitis virus(JEV),a mosquito borne flavivirus,is the leading cause of viral encephalitis in Asia,in terms of frequency and severity.JEV infection is thought to confer lifelong immunity.With the near eradication of poliomyelitis,JEV is now the continent’s leading cause of childhood viral neurologic infection and disability.The most common clinical manifestation of JEV infection is acute encephalitis,and currently there is no specific antiviral therapy.Japanese Encephalitis Vaccine(JE-VC)is an effective prevention measure,including JE-VC,Live(JE-MB),and Inactivated JE-VC.CASE SUMMARY A 9-mo-old girl received injection of Inactivated JE-VC(Vero cell)(Liaoning Chengda,batch number 201611B17)on August 31,2017.On that night,she developed a fever with the body temperature up to 38.5°C,for which Ibuprofen Suspension Drops 1.25 mL was given as antipyretic treatment.On September 1,the patient developed apocleisis,and her parents noticed herpes in her oral cavity.The patient was sent to our hospital on September 3.Physical examination led to a diagnosis of herpetic stomatitis,for which Stomatitis Spray 1 puff,tid,Kangfuxin Liquid 2 mL,tid,and vitamin B20.5 tablet,tid,were prescribed.Routine blood tests for low fever on September 6,2017 revealed an absolute neutrophil count(ANC)of 0.62×109/L,hemoglobin(Hb)of 109 g/L,and platelet count(PLT)of 308×10^(12)/L,and the tests were monitored regularly thereafter.The patient was followed until July 26,2020,when routine blood tests revealed ANC 1.72×109/L,Hb 138 g/L,and PLT 309×1012/L,indicating that the neutropenia count had normalized.CONCLUSION This report attempts to bring to clinical attention that Inactivated JE-VC(Vero cell)might cause prolonged granulocytopenia or even agranulocytosis.

The Growth Study of Vero Cells in Different Type of Microcarrier

The fact of microcarrier (MC) culture introduces new possibilities and makes possible the practical high-yield culture of anchorage-dependent cells has generated a considerable focus in this study. The objective of this research was to study the comparison of Vero cell growth on different types of commercial microcarriers;Cytodex-1, Cytodex-3, Hil-lex? II and Plastic Plus in spinner vessel and two liters bioreactor cultured for 96 hours. Biological performance of the microcarrier in RPMI media showed the preference of Vero cell grew on Cytodex 3 microcarriers with highest maximum viable cell number (2.4 × 105 cells/ml) followed by Cytodex 1, Hillex and Plustic Plus. Vero cell on Cyto-dex-3 data in spinner flask was compared in bioreactor and result showed higher viable cell number in biorector. Thus, this dextran-crosslink gelatin microcarrier (Cytodex 3) provided the best surface for cell attachment and fast proliferation. At the end of this cell growth improvement will be used for virus transfection producing a vaccine in bioreactor.

国产冻干人用狂犬病疫苗(Vero细胞)的接种反应及其免疫原性

目的观察国产冻干人用狂犬病疫苗(Vero细胞)的接种反应及其免疫原性。方法观察组200例和对照组50例暴露后,按照0、3、7、14、28d免疫程序,分别接种国产、进口冻干人用狂犬病疫苗(Vero细胞)。观察组接种疫苗后,观察全身和局部反应情况。采用快速荧光灶抑制试验(RFFIT)检测观察组和对照组接种后的血清中和抗体水平。结果观察组疫苗接种后,局部红肿、硬结、疼痛、瘙痒发生率分别1.4%、0.8%、17.1%和2.4%;全身反应发热、皮疹、头痛、疲劳乏力和其他反应发生率分别为1.2%、0.4%、2.4%、4.2%和0.3%,且在第7天完全消失。观察组与对照组疫苗首剂接种后7d,抗体阳转率分别为40.3%和37.0%,14d分别为95.5%和97.7%,差异无统计学意义;且首剂接种后45d,抗体阳转率均为100%。观察组和对照组疫苗首剂接种后7、14、45d,血清中和抗体GMT差异无统计学意义,14、45d血清中和抗体GMT均大于0.5IU/ml。结论国产冻干人用狂犬病疫苗(Vero细胞)接种反应轻微,并具有良好的免疫原性。

国产无佐剂人用Vero细胞狂犬病疫苗接种反应及免疫效果

目的观察国产无佐剂人用Vero细胞狂犬病疫苗接种反应及免疫效果。方法对93名观察对象采用0、3、7、14和28 d程序进行暴露后免疫,观察免后30 min的即时反应及72 h内的局部和全身副反应,并于第1针免疫后3、7、14和45 d采血,检测血清抗体水平。结果疫苗接种后均无异常反应,局部及全身一般反应率分别为5.8%和4.5%。免后7 d,血清抗体阳转率达22.58%,14 d达100%;免后7、14和45 d的GMT差异有显著意义;不同性别间免后14和45 d的GMT差异均无显著意义;不同年龄组间GMT14 d差异有显著意义,45 d差异无显著意义。结论国产无佐剂人用Vero细胞狂犬病疫苗安全,免疫效果好。

用微载体系统培养Vero细胞生产高滴度狂犬病毒液

目的 采用生物反应器微载体培养Vero细胞生产高滴度狂犬病毒液。方法 用 5L生物反应器培养Vero细胞 ,培养至 4d时接种CTN株狂犬病毒 ,在培养全程对细胞生长所消耗的营养物质及代谢产物进行监测及分析。结果 培养 4d后细胞浓度可达 1 2× 10 7cells ml,培养 3周后的病毒液经ELISA检测A值可达 0 2 1～1 0 6。病毒滴度达 10 - 6 0 ～ 10 - 8 0 LogLD50 ml。病毒液可连续收获 5次。结论 用微载体系统培养Vero细胞可生产高滴度的狂犬病毒液。

人用Vero细胞狂犬病纯化疫苗安全性观察及免疫效果分析

目的 观察杭州市新引进的常州延申生物技术有限公司生产的人用纯化Vero细胞狂犬病疫苗与法国安万特巴斯德公司生产的狂犬病纯化疫苗(维尔博)的接种安全性和血清学免疫效果。方法 在杭州市疾病预防控制中心犬伤门诊选择于2 0 0 3年7月7～19日间接受狂犬病暴露后免疫者共176人作为观察对象,按接种疫苗类别分为常州狂苗组与维尔博组。按照《预防接种手册》判定标准,国家药品临床管理规定和中国生物制品规程(2 0 0 0年版)狂犬病疫苗免疫检测标准观察免疫接种后全身、局部反应和抗体水平。结果 两组疫苗接种后均无异常反应,常州狂苗组与维尔博组轻度全身反应分别为3 4 1%和3 5 7% ,IgG抗体阳转率均为10 0 % ,GMT分别为4 8 0 9IU/ml和5 2 2 2IU/ml。两组间安全性及免疫学效果差异无显著性。结论 两类人用Vero细胞狂犬疫苗使用安全、无异常反应,副反应率低。

狂犬病毒CTN-1株在Vero细胞上的适应传代研究

本文报导了用我国狂犬病毒固定毒人二倍体细胞适应株（ＣＴＮ－１）进行Ｖｅｒｏ细胞适应传代研究。通过连续传代培养，滴度可达８．０ｌｏｇＬＤ_（５０）ｍｌ，达到了ＷＨＯ规定的不需浓缩的标准。病毒用０．０１ＭＯＩ感染细胞其产量与１Ｍｏｌ感染量相仿。病毒增殖高峰在４－５天，维持达１５天无明显下降，且可连续收获４－５次。因此，该毒种符合ＷＨＯ提出的疫苗生产毒种要求，可用于狂犬病疫苗生产。

斑点杂交法测定Vero细胞DNA残留量的探针选择

目的:为精确检测以Vero细胞为基质的生物制品中宿主细胞残余DNA含量。方法:将提取的Vero细胞DNA分别用不同时间的超声波和 HindⅢ内切酶进行断链处理,电泳和序列分析并确定DNA片段长度,地高辛标记后制备成检测探针,测定已知的不同浓度的样品DNA和疫苗中DNA残留量。结果:HindⅢ内切酶处理断链后产生172 bp、344 bp、516 bp、688 bp不同长度的DNA,并选取172bp长度的DNA片断和超声波处理30 s的DNA长度为500～750 bp的DNA片断作为检测用探针。结论:两种方法处理的DNA探针检测DNA的灵敏度可达0.1 pg,重复性均较好,超声波处理的探针特异性优于酶切探针,并能成功的应用于疫苗产品中残余宿主细胞DNA的检测。

精制Vero细胞狂犬病疫苗的灭活和纯化

通过狂犬病病毒灭活和纯化试验 ,试制精制Vero细胞狂犬病疫苗。疫苗经检测残余小牛血清白蛋白含量、Vero细胞残余DNA含量、疫苗效价、安全试验均能达到WHO规程要求。

流感病毒在Vero细胞上的适应性

目的研究WHO指定流感疫苗生产用毒株在Vero细胞上的适应性,为用Vero细胞制备流感疫苗奠定基础。方法优化不同培养基、胰酶浓度、pH值等培养病毒的条件及收毒时间,将流感疫苗生产用毒株在Vero细胞上连续传代,并进行血凝效价检测及RT-PCR分析。结果在病毒维持液为F12+DMEM、pH为7.5、胰酶含量为1.5μg/ml、培养3 d收获病毒时,可获得较高的病毒血凝效价,连续传4代,病毒血凝效价降为0,RT-PCR检测结果为阴性。结论WHO推荐的流感疫苗生产用毒株在Vero细胞上连续传代,病毒血凝效价逐渐降低。

用微载体培养Vero细胞制备狂犬疫苗

目的研究微载体培养Vero细胞生产狂犬疫苗。方法搅拌式生物反应器培养Vero细胞,待细胞在微载体上长成单层后,用狂犬病毒aG株感染细胞。培养5d后,开始灌流收获病毒液,每天取样测定病毒滴度。经灭活后制备成试验疫苗,进行效力试验。结果3次培养,细胞密度均达到1×106/ml以上,病毒滴度都在106LD50以上,3批试验疫苗的效价分别达到5.88、6.49和5.98IU/ml。结论在生物反应罐中用微载体培养Vero细胞制备狂犬疫苗工艺合理,所获免疫原性良好,适用于工业化生产,有较好的应用前景。

人用精制Vero细胞狂犬病疫苗的研制

目的 应用Ｖｅｒｏ细胞研制人用精制狂犬病疫苗。方法应用Ｖｅｒｏ细胞经转瓶或生物反应器培养制备人用精制江大病疫苗。结果各项质控指标均符合ＷＨＯ和中国生物制品规程标准，经Ｉ期临床观察疫苗是安全的。结论用Ｖｅｒｏ细胞生产的狂犬病疫苗产量大，效价高，不良反应少，且能进行工业化生产。

Vero细胞在人用狂犬病疫苗中的研究和应用进展

Vero细胞是WHO认可的疫苗生产用细胞,已成为全世界疫苗生产推荐的细胞基质。因其易于生长、可在微载体的发酵罐中大规模扩增、可模式化培养且在限定代次内细胞性状比较稳定的特点,受到疫苗研发与生产工作者的青睐。Vero细胞正式用于人用狂犬病疫苗的生产也有40多年的时间,对狂犬病疫苗的推广使用和狂犬病的预防发挥了重要的作用。本文旨对Vero细胞在人用狂犬病疫苗中的研究和应用进行总结回顾。

人用狂犬病纯化疫苗(Vero细胞)临床观察及免疫学效果研究

目的 研究人用狂犬病纯化疫苗的安全性和保护性。方法 采用狂犬病疫苗暴露后免疫程序接种受试人群 ,I期临床接种 2 0人 ,II、III期临床接种 30 4人 ,观察注射后反应 ,采用小鼠脑内中和试验法测定其中 6 2人中和抗体水平。结果 全部受试者有 13.2 7%出现轻度副反应 ,无中强度副反应 ,中和抗体阳转率为 10 0 % ,中和抗体GMT为 11.89IU/ml。

冻干人用狂犬病疫苗(Vero细胞)对大鼠的生殖毒性

目的:观察不同剂量冻干人用狂犬病疫苗(Vero细胞)对大鼠的胚胎-胎仔发育毒性,为评价冻干狂犬病疫苗的安全性提供依据。方法:雌性SD大鼠60只,随机分为4组:低剂量疫苗组(1剂/次)、高剂量疫苗组(2剂/次)、阴性对照组和辅料对照组,于交配前第0、3、7、14天免疫,21天合笼交配后,妊娠第7和14天再次免疫,分别观察各项生殖毒性指标。结果:各剂量组孕鼠生殖能力及胎仔生长发育各项指标均未见明显差异。结论:高剂量冻干人用狂犬病疫苗(Vero细胞)对大鼠无生殖毒性作用。