Wong-Chew Rosa María, Islas-Romero Rocío, García-García María de Lourdes, Beeler Judy A, Audet Susette, Santos-Preciado Jose Ignacio, Gans Hayley, Lew-Yasukawa Linda, Maldonado Yvonne A, Arvin Ann M, Valdespino-Gómez José Luis
Departamento de Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Dr. Balmis # 148, Colonia Doctores, 06726 Mexico City, México.
Vaccine. 2006 Jan 30;24(5):683-90. doi: 10.1016/j.vaccine.2005.08.045. Epub 2005 Aug 24.
Aerosol measles vaccination has been found to be more immunogenic than subcutaneous administration as a booster in school aged children, and immunogenic in 12-month-old children as a primary dose. The objective of the study was to evaluate immunogenicity to aerosol measles vaccine in 9-month-old children.
Nine-months-old infants received Edmonston-Zagreb measles vaccine by aerosol (10(3.58) CCID50/0.1 mL, estimated retained dose 10(2.81) CCID50 or subcutaneous route (10(4.28) CCID50/0.5 mL); cellular and humoral immunity and adverse events were assessed.
Measles-specific T cell proliferative responses developed in 42% of children given aerosolized vaccine compared with 67% of those who received subcutaneous vaccine (p = 0.01); the mean stimulation index (SI) was 4.4+/-0.7 versus 6.9+/-1, respectively, (p = 0.05). Seroconversion rates were 33 and 92% after aerosol or subcutaneous immunization (p < 0.001). Among infants who developed serologic responses, measles geometric mean titers (GMT; 95% CI) by neutralizing antibody assay were 215 mIU/mL (115-400) in aerosol vaccine recipients and 411 mIU/mL (345-490) in those given subcutaneous vaccine (p = 0.06).
The proportion of 9-month-old infants who developed cellular and/or humoral immunity to measles was lower in the aerosol group but measles antibody and T cell responses were comparable among those who developed measles immunity. Differences in response rates are attributable to the lower aerosol dose. Improving aerosol delivery or increasing the dose may enhance immunogenicity of primary aerosol measles vaccination in this age group.
已发现气雾剂型麻疹疫苗作为加强剂在学龄儿童中比皮下注射更具免疫原性，并且作为首剂在12个月大的儿童中具有免疫原性。本研究的目的是评估9个月大儿童对气雾剂型麻疹疫苗的免疫原性。
9个月大的婴儿通过气雾途径（10(3.58) CCID50/0.1 mL，估计留存剂量10(2.81) CCID50）或皮下途径（10(4.28) CCID50/0.5 mL）接种埃德蒙斯顿- Zagreb麻疹疫苗；评估细胞免疫、体液免疫和不良事件。
接种气雾剂型疫苗的儿童中42%出现麻疹特异性T细胞增殖反应，而接种皮下疫苗的儿童中这一比例为67%（p = 0.01）；平均刺激指数（SI）分别为4.4±0.7和6.9±1（p = 0.05）。气雾免疫或皮下免疫后的血清转化率分别为33%和92%（p < 0.001）。在产生血清学反应的婴儿中，通过中和抗体测定，气雾剂型疫苗接种者的麻疹几何平均滴度（GMT；95%可信区间）为215 mIU/mL（115 - 400），皮下疫苗接种者为411 mIU/mL（345 - 490）（p = 0.06）。
气雾剂型疫苗组中对麻疹产生细胞和/或体液免疫的9个月大婴儿比例较低，但在产生麻疹免疫力的婴儿中，麻疹抗体和T细胞反应相当。反应率的差异归因于气雾剂量较低。改善气雾给药方式或增加剂量可能会增强该年龄组首剂气雾剂型麻疹疫苗的免疫原性。
