Lang Jean, Feroldi Emmanuel, Vien Nguyen Cong
Sanofi Pasteur, Marcy L'etoile, France.
J Trop Pediatr. 2009 Feb;55(1):26-31. doi: 10.1093/tropej/fmm100. Epub 2007 Nov 29.
Children have a high risk of exposure to rabies in countries where the disease is endemic. This prospective, 5-year study followed two groups of children who had received diphtheria, tetanus, whole-cell pertussis and inactivated poliomyelitis vaccine (DTP-IPV) at 2, 3, 4 months and 1 year (Group B) or concomitant with three doses of purified Vero cell rabies vaccine (PVRV), given at 2, 4 months and 1 year (Group A). Antibody determinations were made annually for 5 years. Data were available from a total of 72 subjects; 30 in Group A and 32 in Group B. In Group A, the percentage of patients immunized against rabies (anti-rabies > or = 0.5 IU/ml) decreased from 100% after the third vaccination to 63%, 5 years later. After 5 years, 93.8% in Group A and 96.7% in Group B had seroprotective diphtheria antibody titers > or = 0.01 IU/ml, and all subjects had anti-polio (type 1, 2 and 3) seroprotective titers > or = 5 1:dil. We conclude that co-administration of PVRV with DTP-IPV elicited protective antibody concentrations to all antigens that persist for at least 5 years, with continued protection against rabies in over 60% of subjects. These results are consistent with integration of pre-exposure rabies vaccination into the Expanded Program on Immunization (EPI) in countries where rabies is endemic.
在狂犬病流行的国家,儿童面临着很高的狂犬病暴露风险。这项前瞻性的5年研究跟踪了两组儿童,一组儿童在2、3、4月龄以及1岁时接种了白喉、破伤风、全细胞百日咳和灭活脊髓灰质炎疫苗(DTP-IPV)(B组);另一组儿童在2、4月龄以及1岁时同时接种了三剂纯化的Vero细胞狂犬病疫苗(PVRV)(A组)。连续5年每年进行抗体检测。共有72名受试者的数据可供分析,其中A组30名,B组32名。在A组中,接种狂犬病疫苗后(抗狂犬病抗体>或 = 0.5 IU/ml)的患者比例从第三次接种后的100%降至5年后的63%。5年后,A组93.8%的受试者和B组96.7%的受试者白喉抗体滴度>或 = 0.01 IU/ml,具有血清保护作用,并且所有受试者的抗脊髓灰质炎(1型、2型和3型)抗体滴度>或 = 5 1:稀释度,具有血清保护作用。我们得出结论,PVRV与DTP-IPV联合接种可引发针对所有抗原的保护性抗体浓度,且这些抗体浓度至少持续5年,超过60%的受试者持续受到狂犬病的保护。这些结果与在狂犬病流行国家将暴露前狂犬病疫苗接种纳入扩大免疫规划(EPI)相一致。