Paunio Mikko, Hedman Klaus, Davidkin Irja, Peltola Heikki
Ministry of Social Affairs and Health, PO Box 33, (00023 Government), Finland.
Expert Opin Pharmacother. 2003 Aug;4(8):1215-25. doi: 10.1517/14656566.4.8.1215.
The nearly 40-year long debate on the relevance of secondary measles vaccination failure has been inconclusive because a feasible method for the assessment of the duration of immunity has been lacking. Even if a two-dose measles vaccination policy is now universally endorsed, WHO still officially adheres to the view that a single successful measles vaccination, without natural boosters, induces a lifelong immunity and deems secondary failures epidemiologically irrelevant - in the belief that the latter are rare and do not participate in the transmission chain. A recently published study on measles-IgG avidity, which allows for separation of secondary from primary vaccination failures, tentatively showed that the official view does not necessarily hold true. The results may have wide implications on global measles eradication efforts. The potential of IgG avidity measurement in complex postvaccination measles epidemiology is discussed.
关于二次麻疹疫苗接种失败相关性的近40年长期争论尚无定论，因为一直缺乏评估免疫持续时间的可行方法。即使现在普遍认可两剂次麻疹疫苗接种政策，但世界卫生组织仍正式坚持认为，单次成功的麻疹疫苗接种，在没有自然增强剂的情况下，可诱导终身免疫，并认为二次接种失败在流行病学上无关紧要——理由是二次接种失败很少见，且不参与传播链。最近发表的一项关于麻疹-IgG亲和力的研究，该研究能够区分二次接种失败和初次接种失败，初步表明官方观点不一定正确。这些结果可能对全球麻疹消除工作产生广泛影响。本文讨论了IgG亲和力检测在复杂的接种后麻疹流行病学中的潜力。
