Gagneur Arnaud, Pinquier Didier, Aubert Marie, Balu Laurent, Brissaud Olivier, De Pontual Loïc, Gras Le Guen Christèle, Hau-Rainsard Isabelle, Mory Olivier, Picherot Georges, Stephan Jean-Louis, Cohen Bernard, Caulin Evelyne, Soubeyrand Benoît, Reinert Philippe
CHU Brest, Brest, France.
Clin Vaccine Immunol. 2008 Dec;15(12):1845-50. doi: 10.1128/CVI.00229-08. Epub 2008 Sep 24.
The optimal age for measles vaccination is an important health issue, since maternal antibodies may neutralize the vaccine antigen before a specific immune response develops, while delaying vaccination may increase the risk of complicated diseases in infants. However, measles vaccination impacts the duration of protection afforded by transplacental transfer of maternal antibodies: vaccination-induced maternal antibodies disappear faster than disease-induced antibodies. In order to maintain protection against measles in infants, it is important to monitor the dynamics of this phenomenon in vaccinated populations. To assess the current situation in France, a multicenter, prospective seroepidemiological study was conducted in seven French hospitals between October 2005 and January 2007. Maternal measles antibody concentrations from 348 infants 0 to 15 months old were measured using the plaque reduction neutralization assay. Geometric mean concentrations and the percentage of infants with maternal measles antibody concentrations above the protection threshold (>or=120 mIU/ml) were assessed according to age. Results show that after more than 20 years of routine measles vaccination in France, maternal measles-neutralizing antibodies decrease dramatically in French infants by 6 months of age, from 1,740 mIU/ml for infants 0 to 1 month old to 223 mIU/ml for infants 5 to 6 months old, and that 90% of infants are not protected against measles after 6 months of age. Infant protection against measles could be optimized both by increasing herd immunity through an increased vaccine coverage and by lowering the age of routine vaccination from 12 to 9 months.
麻疹疫苗接种的最佳年龄是一个重要的健康问题,因为母体抗体可能在特异性免疫反应产生之前中和疫苗抗原,而推迟接种疫苗可能会增加婴儿患复杂疾病的风险。然而,麻疹疫苗接种会影响母体抗体经胎盘转移所提供的保护持续时间:疫苗诱导产生的母体抗体比疾病诱导产生的抗体消失得更快。为了维持婴儿对麻疹的免疫力,监测接种疫苗人群中这一现象的动态变化很重要。为评估法国的现状,于2005年10月至2007年1月在法国七家医院开展了一项多中心、前瞻性血清流行病学研究。采用蚀斑减少中和试验测量了348名0至15个月大婴儿的母体麻疹抗体浓度。根据年龄评估几何平均浓度以及母体麻疹抗体浓度高于保护阈值(≥120 mIU/ml)的婴儿百分比。结果显示,在法国进行了20多年的常规麻疹疫苗接种后,法国婴儿的母体麻疹中和抗体在6个月大时急剧下降,从0至1个月大婴儿的1740 mIU/ml降至5至6个月大婴儿的223 mIU/ml,并且90%的婴儿在6个月大后对麻疹没有免疫力。通过提高疫苗接种覆盖率增强群体免疫力以及将常规接种年龄从12个月降至9个月,均可优化婴儿对麻疹的保护。