Leuridan E, Maertens K, Wautier M, Hutse V, Theeten H
Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium,
Eur J Pediatr. 2015 Jul;174(7):925-32. doi: 10.1007/s00431-014-2481-5. Epub 2015 Jan 13.
The second dose of an MMR vaccine is a catch up for persons who did not receive the first dose or for primary vaccine failures. Catch up doses can be scheduled according to convenience into the program of the country. The second MMR dose is often administered at the age of 5 years, before school entry. Some countries chose to implement the second dose at the age of 10-13 years, as is the case for Belgium. The here presented long-term follow-up of a cohort of children, set up originally to analyze maternal antibodies against vaccine preventable diseases, offers a unique opportunity to evaluate ad interim the current long-interval MMR vaccination schedule in Belgium. After 1 MMR dose at 12 months of age, rubella immunity is almost intact at 5 years of age (94.5 % is seropositive), measles seropositivity scores 86.8 %, and mumps 32 %, measured with ELISA. A seroneutralization (SN) test for mumps antibodies reveals much higher seropositivity rates (88 %). Using a regression model on the log (IgG) titer for all antigens, no influence was found from any of the studied variables, except for girls who had a significantly higher rubella IgG titer (p=0.002) compared to boys.
The data show considerable susceptibility to mumps and measles in 5-year-old children, confirming a previously conducted seroprevalence study (2006). Both advantages and disadvantages of shortening or enlarging the vaccine schedule are discussed.
麻腮风疫苗的第二剂是针对未接种第一剂或初次疫苗接种失败的人群的补种剂次。补种剂次可根据各国的便利情况安排到国家计划中。麻腮风疫苗的第二剂通常在5岁入学前接种。一些国家选择在10至13岁时接种第二剂,比利时就是这种情况。这里介绍的一组儿童的长期随访最初是为了分析母体针对疫苗可预防疾病的抗体而设立的,这为临时评估比利时目前的长间隔麻腮风疫苗接种计划提供了一个独特的机会。在12月龄接种一剂麻腮风疫苗后,5岁时风疹免疫力几乎完好(94.5%呈血清阳性),麻疹血清阳性率为86.8%,腮腺炎为32%(采用酶联免疫吸附测定法测定)。腮腺炎抗体的血清中和(SN)试验显示血清阳性率高得多(88%)。对所有抗原的对数(IgG)滴度使用回归模型,除了女孩的风疹IgG滴度显著高于男孩(p=0.002)外,未发现任何研究变量有影响。
数据显示5岁儿童对腮腺炎和麻疹有相当高的易感性,证实了之前进行的血清流行率研究(2006年)。讨论了缩短或延长疫苗接种计划的利弊。