Departamento de Epidemiologia, Escola Nacional de Saúde Pública, FIOCRUZ, Rua Leopoldo Bulhões, 1480, sala 820, Manguinhos, Rio de Janeiro 21041-210, RJ, Brazil.
Vaccine. 2011 Aug 26;29(37):6327-34. doi: 10.1016/j.vaccine.2011.05.019. Epub 2011 Jun 2.
A randomized trial was conducted to assess the immunogenicity and reactogenicity of yellow fever vaccines (YFV) given either simultaneously in separate injections, or 30 days or more after a combined measles-mumps-rubella (MMR) vaccine. Volunteers were also randomized to YFV produced from 17DD and WHO-17D-213 substrains. The study group comprised 1769 healthy 12-month-old children brought to health care centers in Brasilia for routine vaccination. The reactogenicity was of the type and frequency expected for the vaccines and no severe adverse event was associated to either vaccine. Seroconversion and seropositivity 30 days or more after vaccination against yellow fever was similar across groups defined by YFV substrain. Subjects injected YFV and MMR simultaneously had lower seroconversion rates--90% for rubella, 70% for yellow fever and 61% for mumps--compared with those vaccinated 30 days apart--97% for rubella, 87% for yellow fever and 71% for mumps. Seroconversion rates for measles were higher than 98% in both comparison groups. Geometric mean titers for rubella and for yellow fever were approximately three times higher among those who got the vaccines 30 days apart. For measles and mumps antibodies GMTs were similar across groups. MMR's interference in immune response of YFV and YFV's interference in immune response of rubella and mumps components of MMR had never been reported before but are consistent with previous observations from other live vaccines. These results may affect the recommendations regarding primary vaccination with yellow fever vaccine and MMR.
一项随机试验评估了在分别接种、间隔 30 天或更长时间接种以及同时接种（麻疹-腮腺炎-风疹联合疫苗[MMR]后）黄热病疫苗（YFV）的情况下，YFV 的免疫原性和反应原性。志愿者还被随机分配接种来自 17DD 和世界卫生组织 17D-213 亚株的 YFV。该研究组包括 1769 名 12 个月大的健康儿童，他们因常规免疫接种被带到巴西利亚的医疗保健中心。反应原性为疫苗预期的类型和频率，两种疫苗均未出现严重不良事件。接种 YFV 30 天或更长时间后，针对黄热病的血清转化率和血清阳性率在 YFV 亚株定义的各组之间相似。与间隔 30 天接种的组相比，同时接种 YFV 和 MMR 的组的风疹血清转化率较低（90%对 70%对 61%），而麻疹（97%对 87%对 71%）和腮腺炎（97%对 87%对 71%）的血清转化率较高。两组的麻疹血清转化率均高于 98%。风疹和黄热病的几何平均滴度（GMT）在间隔 30 天接种疫苗的组中约高 3 倍。麻疹和腮腺炎抗体 GMT 在各组之间相似。MMR 对 YFV 免疫应答的干扰以及 YFV 对 MMR 中风疹和腮腺炎成分免疫应答的干扰以前从未报道过，但与以前来自其他活疫苗的观察结果一致。这些结果可能会影响有关黄热病疫苗和 MMR 基础免疫接种的建议。
