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A群和C群脑膜炎球菌多糖疫苗免疫接种活动在控制C群脑膜炎球菌病暴发中的效果

[Effectiveness of an immunization campaign with group A and C meningococcal polysaccharide vaccine in controlling an outbreak of group C meningococcal disease].

作者信息

Gong Jian, Li Cui-Yun, Dong Bai-Qing, Huang Jing-Zhi, Quan Yi, Lu Wan-Zhuan, Luo Cheng-Hui, Mao Wei-Cheng, Liao He-Zhuang, Fang Jin-Song, Cui Xuan-Lin, Xie Gui-Lin, Wu Xing-Hua, Lan Rong-Wei

机构信息

Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2008 Jun;29(6):552-5.

Abstract

OBJECTIVE

To assess the safety, immunogenicity and efficacy of group A and C meningococcal polysaccharide vaccine (A/C MPV) in response to an outbreak of group C meningococcal disease.

METHODS

A vaccination campaign with A/C MPV was prompted 6 weeks after the use of group A MPV in Laibin city, Guangxi, where an outbreak of group C meningococcal meningitis occurred in 2002. Vaccinees were observed for local and systemic reactions after the vaccination and followed up for the meningococcal disease for 5 years. Blood samples were collected from 71 people in the epidemic and 43 in the non-epidemic areas before and 1 month after the vaccination and examined by ELISA to detect IgG antibodies to group A and C polysaccharides.

RESULTS

The vaccination coverage was 97%. No significant adverse reactions were observed. The positive rates of group C antibodies after vaccination was between 97.67% and 100% among the populations in the epidemic and non-epidemic areas, as well as among those negative and positive for group C antibodies prior to the vaccination. The geometric mean anti-C concentrations ranged 30.81 microg/ml to 37.44 microg/ml, showing no significant difference between groups. The incidence rate of meningococcal disease in students with timely immunization (218.58/100,000) dropped by 69.02%, when compared to that in those with delayed immunization (705.72/100,000). No clinical cases were identified during the follow-up period of 15,760 person-years.

CONCLUSION

The vaccination campaign with the Chinese group A/C MPV seemed successful in controlling the group C meningococcal outbreak. The vaccine was shown to be safe even administered after the group A vaccine only 6 weeks apart. It could induce high levels of antibodies in vulnerable population and significantly increase antibody levels in seropositive individuals, thus providing a protection of at least 5 years.

摘要

目的

评估A群和C群脑膜炎球菌多糖疫苗(A/C MPV)在应对C群脑膜炎球菌病暴发时的安全性、免疫原性和有效性。

方法

在广西来宾市于2002年发生C群脑膜炎球菌性脑膜炎暴发后,在使用A群MPV 6周后开展了A/C MPV预防接种活动。对接种者接种后观察局部和全身反应,并对脑膜炎球菌病进行了5年随访。在流行区的71人和非流行区的43人接种疫苗前及接种后1个月采集血样,采用ELISA法检测A群和C群多糖的IgG抗体。

结果

接种率为97%。未观察到明显不良反应。在流行区和非流行区人群中,以及接种前C群抗体阴性和阳性人群中,接种后C群抗体阳性率在97.67%至100%之间。几何平均抗C浓度在30.81μg/ml至37.44μg/ml之间,各群体间无显著差异。及时免疫的学生中脑膜炎球菌病发病率(218.58/10万)与延迟免疫的学生(705.72/10万)相比下降了69.02%。在15760人年的随访期内未发现临床病例。

结论

中国的A/C MPV预防接种活动在控制C群脑膜炎球菌暴发方面似乎是成功的。该疫苗即使在仅间隔6周接种A群疫苗后接种也显示安全。它能在易感人群中诱导高水平抗体,并显著提高血清阳性个体的抗体水平,从而提供至少5年的保护。

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