早产儿出生后不久同时接种重组乙型肝炎疫苗和灭活脊髓灰质炎疫苗免疫反应的对照试验。
Controlled trial of immune response of preterm infants to recombinant hepatitis B and inactivated poliovirus vaccines administered simultaneously shortly after birth.
作者信息
Linder N, Handsher R, German B, Sirota L, Bachman M, Zinger S, Mendelson E, Barzilai A
机构信息
Department of Neonatology, Schneider Children's Medical Center of Israel, 14 Kaplan St, Petah Tikva 49202, Israel.
出版信息
Arch Dis Child Fetal Neonatal Ed. 2000 Jul;83(1):F24-7. doi: 10.1136/fn.83.1.f24.
AIM
The study was conducted to evaluate the immunogenicity of an early, extra dose of enhanced inactivated poliovirus vaccine (IPV) administered simultaneously with recombinant hepatitis B vaccine (HBV) to preterm infants shortly after birth.
METHODS
Three groups were studied. Fifty preterm infants received IPV intramuscularly within 24 hours of birth, in addition to routine recommended childhood immunisations. Fifty two preterm infants and 35 full term infants received routine immunisations only (routine vaccination timing: HBV at birth, 1 and 6 months of age; IPV at 2 and 4 months; oral polio vaccine (OPV) at 4 and 6 months; diphtheria-tetanus-pertussis (DTP) at 2, 4, and 6 months; and Haemophilus influenzae B vaccine at 2 and 4 months). Blood samples were taken at birth, 3 and 7 months of age from all infants, and at 1 month of age from preterm infants only.
RESULTS
At birth, a lower percentage of both study and control preterm infants had antipoliovirus type 3 titres >/= 1:8 than full term infants. At 1 and 3 months of age significantly more early IPV infants had antipoliovirus type 3 titres >/= 1:8 than routinely vaccinated preterm infants (p < 0.05). At 7 months of age there were no significant differences in percentage of antipoliovirus titres >/= 1:8 or geometric mean times (GMTs) between the early IPV group and the routinely vaccinated preterm group. At 3 and 7 months of age, the percentage of positive antihepatitis B titres (>/= 1:10) and the GMT of the early IPV preterm group did not differ significantly from those of preterm controls. There was no significant difference in percentage of positive antihepatitis B titres between the early IPV group and full term controls at any time. GMTs for hepatitis B antibodies were significantly lower in the early IPV preterm group than in full term controls at 3 and 7 months of age.
CONCLUSIONS
Administration of an additional dose of IPV simultaneously with routine HBV to preterm infants shortly after birth provides early protection from poliovirus and hepatitis B infection, and does not interfere with poliovirus antibody production at the age of 7 months.
目的
本研究旨在评估出生后不久给早产婴儿同时接种一剂早期额外剂量的强化灭活脊髓灰质炎病毒疫苗（IPV）和重组乙型肝炎疫苗（HBV）的免疫原性。
方法
研究分为三组。50名早产婴儿在出生后24小时内接受了IPV肌肉注射，此外还进行了常规推荐的儿童免疫接种。52名早产婴儿和35名足月婴儿仅接受常规免疫接种（常规接种时间：出生时接种HBV，1个月和6个月时接种；2个月和4个月时接种IPV；4个月和6个月时接种口服脊髓灰质炎疫苗（OPV）；2个月、4个月和6个月时接种白喉-破伤风-百日咳（DTP）；2个月和4个月时接种B型流感嗜血杆菌疫苗）。在出生时、所有婴儿3个月和7个月时以及仅早产婴儿1个月时采集血样。
结果
出生时，研究组和对照组早产婴儿中抗脊髓灰质炎病毒3型滴度≥1:8的百分比均低于足月婴儿。在1个月和3个月时，早期接种IPV的婴儿中抗脊髓灰质炎病毒3型滴度≥1:8的比例明显高于常规接种的早产婴儿（p<0.05）。在7个月时，早期接种IPV组与常规接种早产组之间抗脊髓灰质炎病毒滴度≥1:8的百分比或几何平均倍数（GMT）没有显著差异。在3个月和7个月时，早期接种IPV早产组抗乙型肝炎抗体阳性百分比（≥1:10）和GMT与早产对照组没有显著差异。在任何时候，早期接种IPV组与足月对照组之间抗乙型肝炎抗体阳性百分比没有显著差异。在3个月和7个月时，早期接种IPV早产组乙型肝炎抗体的GMT明显低于足月对照组。
结论
出生后不久给早产婴儿在常规接种HBV的同时额外接种一剂IPV可提供针对脊髓灰质炎病毒和乙型肝炎感染的早期保护，且不影响7个月时脊髓灰质炎病毒抗体的产生。
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