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联合型流感嗜血杆菌 B 型-脑膜炎奈瑟菌 C 群疫苗与其他常规推荐疫苗同时接种时,对早产儿具有免疫原性且耐受性良好。

Combined Haemophilus Influenzae type B-Neisseria meningitidis serogroup C vaccine is immunogenic and well tolerated in preterm infants when coadministered with other routinely recommended vaccines.

机构信息

Hospital La Paz, Serv. Neonatología, Madrid, Spain.

出版信息

Pediatr Infect Dis J. 2011 Nov;30(11):e216-24. doi: 10.1097/INF.0b013e3182293a82.

Abstract

BACKGROUND

Preterm infants are at greater risk of morbidity from vaccine-preventable diseases. Therefore, their responses to vaccination are of particular interest.

METHODS

In this open, controlled, Spanish multicenter study, we assessed immunogenicity and safety following primary vaccination of 163 preterm infants (n = 56, <31 weeks' gestation; n = 107, 31-36 weeks' gestation) and 150 full-term infants (>36 weeks' gestation), with Haemophilus Influenzae type B (Hib)-MenC-TT, DTaP(diphtheria-tetanus-acellular pertussis vaccine)-HepB-IPV, and PCV7 at 2 to 4-6 months of age followed by booster vaccination at 16 to 18 months of age. Serum bactericidal activity (rabbit complement) against MenC, and antibodies to Hib and hepatitis b (anti-HBs) were determined. Local/general symptoms were assessed after each vaccination via diary cards. Serious adverse events were recorded throughout the study.

RESULTS

There were no statistically significant differences between preterm and full-term infants in either Hib or MenC seroprotection rates or geometric mean concentrations at 1 month postdose 3, before or 1 month postbooster. Postdose 3, >99% of participants had seroprotective anti-HBs antibody concentrations. Anti-HBs geometric mean concentrations was significantly lower in the <31-week group compared with other groups and this difference persisted until 16 to 18 months of age. Hib-MenC-TT vaccine was well tolerated at all ages. There was one death caused by meningococcal serogroup-B sepsis (full term). No serious adverse events were assessed by the investigator as being vaccine related.

CONCLUSIONS

Hib-MenC-TT vaccine had a similar immunogenicity and safety profile in preterm and full-term infants. These results demonstrate that preterm infants can be safely vaccinated with Hib-MenC-TT at the recommended chronologic age without impacting the responses to the Hib and MenC antigens.

摘要

背景

早产儿患疫苗可预防疾病的发病率更高。因此,他们的疫苗接种反应尤其受到关注。

方法

在这项开放性、对照性、西班牙多中心研究中,我们评估了 163 名早产儿(<31 周胎龄,n=56;31-36 周胎龄,n=107)和 150 名足月儿(>36 周胎龄)在接受 Hib-MenC-TT、DTaP(白喉-破伤风-无细胞百日咳疫苗)-HepB-IPV 和 PCV7 初免后,于 2 至 4-6 月龄进行接种,16 至 18 月龄进行加强免疫后的免疫原性和安全性。通过兔补体测定血清杀菌活性(SRBC)针对 MenC,以及针对 Hib 和乙型肝炎(抗-HBs)的抗体。通过日记卡记录每次接种后的局部/全身症状。在整个研究过程中记录严重不良事件。

结果

在 1 个月时,第 3 剂后,Hib 或 MenC 血清保护率或几何平均浓度在早产儿和足月儿之间没有统计学差异;或加强免疫前或加强免疫后 1 个月。第 3 剂后,>99%的参与者有血清保护性抗-HBs 抗体浓度。与其他组相比,<31 周龄组的抗-HBs 几何平均浓度显著较低,这种差异持续到 16 至 18 月龄。Hib-MenC-TT 疫苗在所有年龄组均具有良好的耐受性。有 1 例因脑膜炎奈瑟菌 B 组脓毒症(足月)而死亡。研究者未评估任何严重不良事件与疫苗相关。

结论

Hib-MenC-TT 疫苗在早产儿和足月儿中的免疫原性和安全性相似。这些结果表明,早产儿可以按照推荐的时间间隔安全接种 Hib-MenC-TT,而不会影响 Hib 和 MenC 抗原的反应。

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