Kieny Marie Paule, LaForce F Marc
Initiative for Vaccine Research, World Health Organization, Av Appia 20, 1211 Geneva 27, Switzerland.
Vaccine. 2007 Sep 3;25 Suppl 1:A108-10. doi: 10.1016/j.vaccine.2007.05.001. Epub 2007 May 21.
Capsular polysaccharide (PS) vaccines against Neisseria meningitidis and Streptococcus pneumoniae have proven safe and effective. Moreover, experience with N. meningitidis, Haemophilus influenzae type b (Hib) and S. pneumoniae conjugate vaccines has demonstrated that immunogenicity of PS vaccines can be greatly improved by chemical conjugation to a protein carrier. These vaccines have been shown to stimulate B cell- and T cell-dependent immune responses, to induce immunological memory and to confer herd immunity. Their introduction has had a dramatic impact on the incidence of the diseases caused by these bacterial pathogens, but questions remain on the optimal schedules for immunization. The current schedule recommended by the World Health Organization (6, 10 and 14 weeks) was developed in the early 1980s and does not take into consideration the crucial role of herd immunity in interrupting transmission. A review of the evidence in order to analyse how to optimize immunization schedules for conjugate vaccines is warranted.
针对脑膜炎奈瑟菌和肺炎链球菌的荚膜多糖（PS）疫苗已被证明是安全有效的。此外，脑膜炎奈瑟菌、b型流感嗜血杆菌（Hib）和肺炎链球菌结合疫苗的使用经验表明，通过与蛋白质载体进行化学偶联，PS疫苗的免疫原性可得到极大提高。这些疫苗已被证明能刺激B细胞和T细胞依赖性免疫反应，诱导免疫记忆并产生群体免疫。它们的引入对这些细菌病原体所引起疾病的发病率产生了巨大影响，但关于最佳免疫程序仍存在疑问。世界卫生组织推荐的现行免疫程序（6周、10周和14周）制定于20世纪80年代初，并未考虑群体免疫在阻断传播中的关键作用。因此，有必要对相关证据进行综述，以分析如何优化结合疫苗的免疫程序。
