一项比较成人联合肺炎球菌结合疫苗和多糖疫苗接种方案的随机研究。

A randomized study comparing combined pneumococcal conjugate and polysaccharide vaccination schedules in adults.

机构信息

Oxford Vaccine Group, University of Oxford, Oxford, UK.

出版信息

Clin Infect Dis. 2011 Mar 15;52(6):736-42. doi: 10.1093/cid/cir003.

DOI:10.1093/cid/cir003

PMID:21367726

Abstract

BACKGROUND

The widely used 23-valent plain polysaccharide vaccine (23vP) has limited effectiveness, produces short-lived immune responses, and induces attenuated antibody production after subsequent challenge with pneumococcal vaccines. Our goal was to examine whether priming with the 7-valent pneumococcal conjugate vaccine (PCV7) could enhance the immunogenicity of 23vP for the PCV7 serotypes and to investigate whether 23vP induced hyporesponsiveness could be overcome using PCV7.

METHODS

We conducted an open-label randomized study that compared 3 vaccine schedules, each of which consisted of 2 doses of PCV7 and 1 dose of 23vP (23vP-PCV7-PCV7, PCV7-23vP-PCV7, PCV7-PCV7-23vP) administered over a 1-year period in a cohort of 348 adults 50-70 years of age. All vaccines were administered intramuscularly and were given 6 months apart. Blood samples were obtained prior to and 1 month after each vaccination.

RESULTS

23vP administered after priming with 2 doses of PCV7 produced significantly higher antibody concentrations for 3 of the 7 PCV7 serotypes, compared with vaccination with a single dose of 23vP; however, the same immunogenicity could be achieved with a single dose of PCV7. Prior vaccination with 23vP attenuated the antibody response to subsequent PCV7, which was not restored by additional doses of PCV7.

CONCLUSION

In adults, vaccination schedules combining PCV7 and 23vP do not provide improved immunogenicity over the use of a single dose of 23vP for most of the serotypes contained in PCV7.

摘要

背景

广泛使用的 23 价多糖疫苗（23vP）效果有限，产生的免疫反应持续时间短，并且在随后用肺炎球菌疫苗进行挑战后诱导抗体产生减弱。我们的目标是研究用 7 价肺炎球菌结合疫苗（PCV7）进行疫苗接种能否增强 23vP 对 PCV7 血清型的免疫原性，并研究是否可以使用 PCV7 克服 23vP 引起的低反应性。

方法

我们进行了一项开放性随机研究，比较了 3 种疫苗接种方案，每种方案均由 2 剂 PCV7 和 1 剂 23vP（23vP-PCV7-PCV7、PCV7-23vP-PCV7、PCV7-PCV7-23vP）组成，在 348 名 50-70 岁的成年人中，在 1 年内完成。所有疫苗均肌内给药，间隔 6 个月。在每次接种前和接种后 1 个月采集血样。