比较两种不同方案在南非婴儿中使用减毒活口服轮状病毒疫苗 RIX4414 与口服脊髓灰质炎疫苗联合接种的反应原性、安全性和免疫原性。

Comparison of 2 different regimens for reactogenicity, safety, and immunogenicity of the live attenuated oral rotavirus vaccine RIX4414 coadministered with oral polio vaccine in South African infants.

机构信息

MRC Diarrhoeal Pathogens Research Unit, University of Limpopo, Pretoria, Republic of South Africa.

出版信息

J Infect Dis. 2010 Sep 1;202 Suppl:S93-100. doi: 10.1086/653550.

Abstract

BACKGROUND

A phase II, randomized, double-blind, placebo-controlled study was conducted in South Africa during 2003-2004 to evaluate the safety, reactogenicity, and immunogenicity of 2 regimens of the live attenuated oral human rotavirus vaccine RIX4414 when coadministered with the Expanded Program on Immunization childhood vaccines, including oral polio vaccine.

METHODS

Healthy infants were randomized (2:2:1) to receive either 2 doses of RIX4414 (n = 190; at 10 and 14 weeks, with placebo at 6 weeks), 3 doses of RIX4414 (n = 189; at 6, 10, and 14 weeks), or 3 doses of placebo (n = 96), all with concomitant routine vaccinations. The antirotavirus IgA seroconversion rate was assessed using enzyme-linked immunosorbent assay at 2 months after the last dose of RIX4414 or placebo. Antipolio types 1, 2, and 3 antibodies were measured using a virus neutralization assay. Solicited symptoms were recorded for 15 days after each dose.

RESULTS

The antirotavirus IgA seroconversion rates were similar in the RIX4414 2- and 3-dose groups (44.3% and 44.4%, respectively; P = .544, by 1-sided Fisher exact test) and antirotavirus IgA geometric mean concentrations were also comparable. Seroprotection rates for antipolio types 1, 2, and 3 antibodies were high (93%-100%) and were not significantly different among groups. Solicited symptoms reported within 15 days after vaccination were similar in all groups.

CONCLUSIONS

The immune seroconversion response to the RIX4414 vaccine with 3 doses was not superior to the 2-dose regimen. There was no interference by either regimen with antibody response to oral polio vaccine, and RIX4414 was well tolerated when given with routine vaccinations.

摘要

背景

2003-2004 年在南非进行了一项 2 期、随机、双盲、安慰剂对照研究,以评估活减毒口服人轮状病毒疫苗 RIX4414 与扩大免疫规划儿童疫苗(包括口服脊髓灰质炎疫苗)联合使用时的安全性、反应原性和免疫原性。

方法

健康婴儿被随机(2:2:1)分为 2 剂 RIX4414 组(n = 190;在 10 周和 14 周时,在 6 周时给予安慰剂)、3 剂 RIX4414 组(n = 189;在 6、10 和 14 周时给予)或 3 剂安慰剂组(n = 96),均与常规疫苗同时接种。在最后一剂 RIX4414 或安慰剂后 2 个月,使用酶联免疫吸附试验评估抗轮状病毒 IgA 血清转化率。使用病毒中和试验测量抗脊灰病毒 1、2 和 3 型抗体。记录每次剂量后 15 天内的应征症状。

结果

RIX4414 2 剂和 3 剂组的抗轮状病毒 IgA 血清转化率相似(分别为 44.3%和 44.4%;P =.544,单侧 Fisher 确切检验),抗轮状病毒 IgA 几何平均浓度也相似。抗脊灰病毒 1、2 和 3 型抗体的血清保护率均较高(93%-100%),且各组之间无显著差异。所有组中,接种疫苗后 15 天内报告的应征症状相似。

结论

3 剂 RIX4414 疫苗的免疫血清转化率并不优于 2 剂方案。两种方案均不会干扰口服脊髓灰质炎疫苗的抗体反应,RIX4414 与常规疫苗联合使用时具有良好的耐受性。

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