MMWR Recomm Rep. 1999 May 14;48(RR-5):1-14.
An increasing number of new and improved vaccines to prevent childhood diseases are being introduced. Combination vaccines represent one solution to the problem of increased numbers of injections during single clinic visits. This statement provides general guidance on the use of combination vaccines and related issues and questions. To minimize the number of injections children receive, parenteral combination vaccines should be used, if licensed and indicated for the patient's age, instead of their equivalent component vaccines. Hepatitis A, hepatitis B, and Haemophilus influenzae type b vaccines, in either monovalent or combination formulations from the same or different manufacturers, are interchangeable for sequential doses in the vaccination series. However, using acellular pertussis vaccine product(s) from the same manufacturer is preferable for at least the first three doses, until studies demonstrate the interchangeability of these vaccines. Immunization providers should stock sufficient types of combination and monovalent vaccines needed to vaccinate children against all diseases for which vaccines are recommended, but they need not stock all available types or brandname products. When patients have already received the recommended vaccinations for some of the components in a combination vaccine, administering the extra antigen(s) in the combination is often permissible if doing so will reduce the number of injections required. To overcome recording errors and ambiguities in the names of vaccine combinations, improved systems are needed to enhance the convenience and accuracy of transferring vaccine-identifying information into medical records and immunization registries. Further scientific and programmatic research is needed on specific questions related to the use of combination vaccines.
越来越多预防儿童疾病的新型改良疫苗正在投入使用。联合疫苗是解决单次门诊就诊时注射次数增多这一问题的一种方法。本声明就联合疫苗的使用及相关问题和疑问提供一般性指导。为尽量减少儿童接受的注射次数，若有适用于患者年龄的许可并指明的肠外联合疫苗，应使用联合疫苗，而非其等效的单组分疫苗。来自同一或不同制造商的单价或联合剂型的甲型肝炎、乙型肝炎和b型流感嗜血杆菌疫苗，在疫苗接种系列中序贯接种时可相互替换。然而，至少前三剂最好使用同一制造商生产的无细胞百日咳疫苗产品，直至研究证明这些疫苗具有互换性。免疫接种提供者应储备足够种类的联合疫苗和单价疫苗，以便为儿童接种针对所有推荐疫苗疾病的疫苗，但无需储备所有可用种类或品牌产品。当患者已经接种了联合疫苗中某些组分的推荐疫苗时，如果这样做能减少所需注射次数，通常允许接种联合疫苗中的额外抗原。为克服疫苗组合名称记录错误和含糊不清的问题，需要改进系统，以提高将疫苗识别信息转入病历和免疫接种登记处的便利性和准确性。关于联合疫苗使用的具体问题，还需要进一步开展科学和规划研究。
