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白喉、破伤风类毒素、无细胞百日咳、乙型肝炎和灭活脊髓灰质炎疫苗与7价肺炎球菌结合疫苗及b型流感嗜血杆菌结合疫苗联合接种的免疫原性和安全性。

Immunogenicity and safety of a combination diphtheria, tetanus toxoid, acellular pertussis, hepatitis B, and inactivated poliovirus vaccine coadministered with a 7-valent pneumococcal conjugate vaccine and a Haemophilus influenzae type b conjugate vaccine.

作者信息

Pichichero Michael E, Bernstein Henry, Blatter Mark M, Schuerman Lode, Cheuvart Brigitte, Holmes Sandra J

机构信息

University of Rochester Medical Center, Rochester, New York 14642, USA.

出版信息

J Pediatr. 2007 Jul;151(1):43-9, 49.e1-2. doi: 10.1016/j.jpeds.2007.02.013.

Abstract

OBJECTIVE

To evaluate the immunogenicity and safety of a diphtheria and tetanus toxoids, acellular pertussis, hepatitis B, and inactivated poliovirus-containing vaccine (DTaP-HepB-IPV) coadministered with pneumococcal 7-valent conjugate vaccine (PCV-7) and Haemophilus influenzae type b vaccine (Hib), with separate vaccines concurrently, or staggered (delayed) administration of PCV-7.

STUDY DESIGN

At 2, 4, and 6 months of age, infants received either DTaP-HepB-IPV plus PCV-7 and Hib (n = 199), separate vaccines (n = 188), or DTaP-HepB-IPV plus Hib with PCV-7 administered 2 weeks later (n = 188). Blood was drawn before and after vaccination. Parents reported symptoms for 4 days after each dose and adverse events throughout the entire study.

RESULTS

Immunogenicity in the Combination Vaccine Group was noninferior to that of the Separate and Staggered Vaccine Groups with respect to seroprotective rates for diphtheria, tetanus, and poliovirus and to geometric mean concentrations for pertussis. Seroprotective rates for HepB and Hib were not different between groups. Seropositivity for PCV-7 was high in all groups. Administration of combination vaccine appeared to be associated with higher rates of irritability, fever > or = 100.4 degrees F (38.0 degrees C) and some local symptoms compared with separate vaccines (exploratory P < .05). No group differences were observed in rates of symptoms for which parents sought medical advice.

CONCLUSIONS

DTaP-HepB-IPV was highly immunogenic and well tolerated when coadministered with Hib and PCV-7 at 2, 4, and 6 months of age.

摘要

目的

评估白喉破伤风类毒素、无细胞百日咳、乙型肝炎和含灭活脊髓灰质炎病毒疫苗(DTaP-HepB-IPV)与7价肺炎球菌结合疫苗(PCV-7)和b型流感嗜血杆菌疫苗(Hib)同时接种、分别接种或PCV-7错时(延迟)接种的免疫原性和安全性。

研究设计

在婴儿2、4和6月龄时,分别给予DTaP-HepB-IPV加PCV-7和Hib(n = 199)、单独接种疫苗(n = 188)或DTaP-HepB-IPV加Hib,2周后接种PCV-7(n = 188)。在接种前后采集血液样本。父母报告每次接种后4天的症状以及整个研究期间的不良事件。

结果

联合疫苗组在白喉、破伤风和脊髓灰质炎病毒的血清保护率以及百日咳的几何平均浓度方面,免疫原性不低于单独接种和错时接种疫苗组。各疫苗组之间乙型肝炎和b型流感嗜血杆菌的血清保护率没有差异。所有组中PCV-7的血清阳性率都很高。与单独接种疫苗相比,联合疫苗接种后出现烦躁、发热≥100.4°F(38.0°C)及一些局部症状的发生率似乎更高(探索性P < 0.05)。在父母寻求医疗建议的症状发生率方面,未观察到组间差异。

结论

在2、4和6月龄时,DTaP-HepB-IPV与Hib和PCV-7同时接种时具有高度免疫原性且耐受性良好。

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