Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea.
J Korean Med Sci. 2010 Jan;25(1):90-6. doi: 10.3346/jkms.2010.25.1.90. Epub 2009 Dec 26.
A meta-analysis was performed on the immunogenicity of Haemophilus influenzae type b (Hib) conjugate vaccines after 2 (2 and 4 months) and 3 doses (2, 4, and 6 months) in Korean infants. A database search of MEDLINE, KoreaMed, and Korean Medical Database was done. The primary outcome measure was the proportion of infants with anti-polyribosylribitol phosphate (PRP) concentrations > or =1.0 microg/mL. Eight studies including eleven trials were retrieved. One trial reported on the diphtheria toxoid conjugate vaccine (PRP-D) and 2 trials each on the mutant diphtheria toxin (PRP-CRM) and Neisseria meningitidis outer-membrane protein (PRP-OMP) conjugate vaccine. Heterogeneity in study designs between trials on PRP-CRM was noted and one trial reported on a monovalent and another on a combination PRP-OMP vaccine. Thus, a meta-analysis was conducted only on the tetanus toxoid conjugate vaccine (PRP-T). After a primary series of 2 doses and 3 doses, 80.6% (95% confidence interval [CI]; 76.0-85.1%) and 95.7% (95% CI; 94.0-98.0%) of infants achieved an antibody level > or =1.0 microg/mL, respectively. The immunogenic response to the PRP-T vaccine was acceptable after a primary series of 3 doses and also 2 doses. A reduced number of doses as a primary series could be carefully considered in Korean infants.
对韩国婴儿接种 Hib 结合疫苗后 2(2 和 4 个月)和 3 剂(2、4 和 6 个月)的免疫原性进行了荟萃分析。对 MEDLINE、KoreaMed 和韩国医学数据库进行了数据库检索。主要结局指标是抗多聚核糖基核糖醇磷酸(PRP)浓度>或=1.0μg/mL的婴儿比例。检索到八项研究,包括十一项试验。一项试验报告了白喉类毒素结合疫苗(PRP-D),另外两项试验各报告了突变白喉毒素(PRP-CRM)和脑膜炎奈瑟菌外膜蛋白(PRP-OMP)结合疫苗。PRP-CRM 试验之间的研究设计存在异质性,一项试验报告了单价疫苗,另一项报告了 PRP-OMP 结合疫苗。因此,仅对破伤风类毒素结合疫苗(PRP-T)进行了荟萃分析。在进行了 2 剂和 3 剂的基础系列接种后,分别有 80.6%(95%置信区间[CI];76.0-85.1%)和 95.7%(95% CI;94.0-98.0%)的婴儿达到抗体水平>或=1.0μg/mL。3 剂基础系列接种后,以及 2 剂基础系列接种后,PRP-T 疫苗的免疫应答是可以接受的。在韩国婴儿中,可谨慎考虑减少基础系列的剂量。