儿童接种两剂与三剂当前甲型肝炎疫苗的保护持续时间比较。
Duration of protection against hepatitis A for the current two-dose vaccine compared to a three-dose vaccine schedule in children.
机构信息
Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 4055 Tudor Centre Drive, Anchorage, AK 99508, USA.
出版信息
Vaccine. 2013 Apr 19;31(17):2152-5. doi: 10.1016/j.vaccine.2013.02.048. Epub 2013 Mar 5.
BACKGROUND
Hepatitis A is mostly a self-limiting disease but causes substantial economic burden. Consequently, United States Advisory Committee for Immunization Practices recommends inactivated hepatitis A vaccination for all children beginning at age 1 year and for high risk adults. The hepatitis A vaccine is highly effective but the duration of protection is unknown.
METHODS
We examined the proportion of children with protective hepatitis A antibody levels (anti-HAV ≥20 mIU/mL) as well as the geometric mean concentration (GMC) of anti-HAV in a cross sectional convenience sample of individuals aged 12-24 years, who had been vaccinated with a two-dose schedule in childhood, with the initial dose at least 5 years ago. We compared a subset of data from persons vaccinated with two-doses (720 EL.U.) at age 3-6 years with a demographically similar prospective cohort that received a three-dose (360 EL.U.) schedule and have been followed for 17 years.
RESULTS
No significant differences were observed when comparing GMC between the two cohorts at 10 (P=0.467), 12 (P=0.496), and 14 (P=0.175) years post-immunization. For the three-dose cohort, protective antibody levels remain for 17 years and have leveled-off over the past 7 years.
CONCLUSION
The two- and three-dose schedules provide similar protection >14 years after vaccination, indicating a booster dose is not needed at this time. Plateauing anti-HAV GMC levels suggest protective antibody levels may persist long-term.
背景
甲型肝炎大多是自限性疾病，但会造成巨大的经济负担。因此，美国免疫实践咨询委员会建议对所有 1 岁及以上儿童和高危成年人使用甲型肝炎灭活疫苗。甲型肝炎疫苗的有效性很高，但保护期未知。
方法
我们检查了横断面便利样本中儿童的保护性甲型肝炎抗体水平（抗-HAV ≥20 mIU/mL）的比例以及抗-HAV 的几何平均浓度（GMC），这些儿童在童年时期接受了两剂疫苗接种，初始剂量至少在 5 年前。我们比较了两剂（720 EL.U.）在 3-6 岁接种的人群与具有相似人口统计学特征的前瞻性队列的部分数据，该队列接受了三剂（360 EL.U.）方案，并随访了 17 年。
结果
在免疫后 10 年（P=0.467）、12 年（P=0.496）和 14 年（P=0.175）时，两组之间的 GMC 没有观察到显著差异。对于三剂组，保护性抗体水平在 17 年内保持不变，并在过去 7 年内趋于平稳。
结论
两剂和三剂方案在接种后 >14 年提供相似的保护作用，表明此时不需要加强剂量。抗-HAV GMC 水平趋于平稳表明保护性抗体水平可能长期存在。
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