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三剂口服五价轮状病毒疫苗与白喉-破伤风-无细胞百日咳-乙型肝炎-灭活脊髓灰质炎- b型流感嗜血杆菌疫苗三剂基础免疫程序同时接种:免疫原性和反应原性。

Concomitant use of the 3-dose oral pentavalent rotavirus vaccine with a 3-dose primary vaccination course of a diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated polio-Haemophilus influenzae type b vaccine: immunogenicity and reactogenicity.

作者信息

Ciarlet Max, He Su, Lai Sherry, Petrecz Maria, Yuan Guojun, Liu Guanghan F, Mikviman Elena, Heaton Penny M, Panzer Falko, Rose Thomas, Koller Dieter Y, Van Damme Pierre, Schödel Florian

机构信息

Vaccine Biologics-Clinical Research, Merck Research Laboratories, North Wales, PA 19454, USA.

出版信息

Pediatr Infect Dis J. 2009 Mar;28(3):177-81. doi: 10.1097/INF.0b013e31818c0161.

Abstract

BACKGROUND

The pentavalent rotavirus vaccine (PRV), RotaTeq, can be concomitantly administered with most routine childhood vaccines. This study evaluated the immunogenicity and reactogenicity of PRV when used concomitantly with a hexavalent vaccine containing diphtheria, tetanus, acellular pertussis, hepatitis B, inactivated poliovirus, and Haemophilus influenzae type b.

METHODS

Healthy infants (N = 403) received hexavalent vaccine concomitantly with either PRV or placebo at 2, 3, and 4 months of age. Antibody responses were measured immediately before and 42 +/- 3 days after vaccination. Parents/legal guardians recorded all adverse events for 14 days after vaccination.

RESULTS

Seroprotective titers for hepatitis B (hepatitis B surface antigen > or =10 mIU/mL) were achieved by 97.8% of subjects in both vaccine treatment groups. Seroprotective titers to H. influenzae type b (polyribosylribitol phosphate > or =0.15 microg/mL) were achieved by 91.4% of subjects receiving both vaccines and 95.1% of subjects receiving only hexavalent vaccine. Seroprotective titers to diphtheria, tetanus, and poliovirus were also comparable between the vaccine treatment groups, as were geometric mean antibody titers to the pertussis antigens. Among PRV recipients, 92% had a > or =3-fold rise in serum antirotavirus immunoglobulin A levels. Concomitant administration was well tolerated. The incidence of adverse events was similar for both groups, with no statistically significant increases in fever, vomiting, diarrhea, or irritability.

CONCLUSIONS

In this study, concomitant administration of PRV with hexavalent vaccine was well tolerated and the immune responses to the antigens of the hexavalent vaccine were noninferior when compared with those of the control group. In addition, PRV was immunogenic when administered concomitantly with hexavalent vaccine.

摘要

背景

五价轮状病毒疫苗(PRV),即Rotateq,可以与大多数常规儿童疫苗同时接种。本研究评估了PRV与包含白喉、破伤风、无细胞百日咳、乙型肝炎、灭活脊髓灰质炎病毒和b型流感嗜血杆菌的六价疫苗同时使用时的免疫原性和反应原性。

方法

403名健康婴儿在2、3和4月龄时同时接种六价疫苗和PRV或安慰剂。在接种前和接种后42±3天测量抗体反应。父母/法定监护人记录接种后14天内的所有不良事件。

结果

两个疫苗治疗组中97.8%的受试者实现了乙型肝炎的血清保护滴度(乙型肝炎表面抗原≥10 mIU/mL)。同时接种两种疫苗的受试者中有91.4%以及仅接种六价疫苗的受试者中有95.1%实现了对白喉、破伤风、无细胞百日咳、乙型肝炎、灭活脊髓灰质炎病毒和b型流感嗜血杆菌的六价疫苗同时使用时的免疫原性和反应原性。

方法

403名健康婴儿在2、3和4月龄时同时接种六价疫苗和PRV或安慰剂。在接种前和接种后42±3天测量抗体反应。父母/法定监护人记录接种后14天内的所有不良事件。

结果

两个疫苗治疗组中97.8%的受试者实现了乙型肝炎的血清保护滴度(乙型肝炎表面抗原≥10 mIU/mL)。同时接种两种疫苗的受试者中有91.4%以及仅接种六价疫苗的受试者中有95.1%实现了对b型流感嗜血杆菌的血清保护滴度(多聚核糖醇磷酸≥0.15μg/mL)。两个疫苗治疗组对白喉、破伤风和脊髓灰质炎病毒的血清保护滴度以及对百日咳抗原的几何平均抗体滴度也具有可比性。在接种PRV的受试者中,92%的受试者血清抗轮状病毒免疫球蛋白A水平升高≥3倍。同时接种耐受性良好。两组不良事件的发生率相似,发热、呕吐、腹泻或易激惹均无统计学显著增加。

结论

在本研究中,PRV与六价疫苗同时接种耐受性良好,与对照组相比,对六价疫苗抗原的免疫反应不劣。此外,PRV与六价疫苗同时接种时具有免疫原性。

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