Chokephaibulkit Kulkanya
Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2002 Aug;85 Suppl 2:S694-9.
Recently multiple individual vaccines were put together into one syringe. This is ideal to simplify the administration of vaccines and reduce emotional distress from multiple injections. However, combination of many vaccines may interfere with the properties of each individual antigen and complicate the schedule. From earlier studies, most of the combinations of diphtheria-tetanus-pertussis (whole-cell) vaccine (DTPw), Haemophilus influenzae type b vaccine (Hib), hepatitis B vaccine (HBV), and inactivated polio vaccine (IPV) were safe and adequately immunogenic. On the other hand, there was a notable reduction in anti-PRP when Hib was combined with acellular pertussis vaccine (DTPa). Combination of hepatitis A vaccine and HBV was safe and effective. Those coming soon in the pipeline are DTPa-Hib-HBV, MMR-varicella, pneumococcal-meningococcal. With the increase in demand, health-care providers need to be acquainted to these combination vaccines. The bottom line is to make sure that the children get vaccination appropriately.
最近,多种单苗被组合在一支注射器中。这对于简化疫苗接种流程、减轻多次注射带来的情绪困扰而言堪称理想之选。然而,多种疫苗的组合可能会干扰每种单一抗原的特性,并使接种程序变得复杂。早期研究表明,白喉-破伤风-百日咳(全细胞)疫苗(DTPw)、b型流感嗜血杆菌疫苗(Hib)、乙肝疫苗(HBV)和灭活脊髓灰质炎疫苗(IPV)的大多数组合都是安全的,且具有足够的免疫原性。另一方面,当Hib与无细胞百日咳疫苗(DTPa)联合使用时,抗PRP出现了显著下降。甲型肝炎疫苗和乙肝疫苗的组合是安全有效的。即将推出的有DTPa-Hib-HBV、麻腮风-水痘、肺炎球菌-脑膜炎球菌疫苗。随着需求的增加,医护人员需要熟悉这些联合疫苗。关键是要确保儿童得到适当的疫苗接种。