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越南孕期百日咳疫苗接种:一项随机对照试验的结果 孕期百日咳疫苗接种

Pertussis vaccination during pregnancy in Vietnam: Results of a randomized controlled trial Pertussis vaccination during pregnancy.

作者信息

Hoang Ha Thi Thu, Leuridan Elke, Maertens Kirsten, Nguyen Trung Dac, Hens Niel, Vu Ngoc Ha, Caboré Raissa Nadège, Duong Hong Thi, Huygen Kris, Van Damme Pierre, Dang Anh Duc

机构信息

National Institute of Hygiene and Epidemiology, Yersin Street 1, Hanoi 10000, Vietnam.

Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Universiteitsplein 1, Wilrijk, 2610 Antwerpen, Belgium.

出版信息

Vaccine. 2016 Jan 2;34(1):151-9. doi: 10.1016/j.vaccine.2015.10.098. Epub 2015 Oct 31.

Abstract

A pertussis vaccination during pregnancy has recently been adopted in several countries to indirectly protect young infants. This study assessed the effect of adding a pertussis component to the tetanus vaccination, in the pregnancy immunization program in Vietnam. A randomized controlled trial was performed. Pregnant women received either a Tdap (tetanus, diphtheria acellular pertussis) vaccine or a tetanus only vaccine between 19 and 35 weeks' gestational age. Immunoglobulin G (IgG) against tetanus (TT), diphtheria (DT), pertussis toxin (PT), filamentous hemaglutinin (FHA) and pertactin (Prn) were measured using commercial ELISA tests, at baseline, 1 month after maternal vaccination, at delivery, and in infants from cord blood and before and after the primary series (EPI: month 2-3-4) of a pertussis containing vaccine. Significantly higher geometric mean concentrations (GMC) were observed for all 3 measured pertussis antigens in the offspring of the Tdap group, up to 2 months of age. One month after completion of the primary infant vaccination schedule, anti-Prn GMC, but not anti-PT and anti-FHA GMCs, was significantly (p=0.006) higher in the control group. Maternal antibodies induced by vaccination during pregnancy close the susceptibility gap for pertussis in young infants. Limited interference with the infant vaccine responses was observed. Whether this interference effect disappears with the administration of a fourth vaccine dose is further studied.

摘要

最近,几个国家采用了孕期接种百日咳疫苗的方法来间接保护幼儿。本研究评估了在越南的孕期免疫规划中,在破伤风疫苗中添加百日咳成分的效果。进行了一项随机对照试验。孕妇在孕19至35周期间接种了吸附无细胞百白破疫苗(Tdap)或仅接种破伤风疫苗。使用商业酶联免疫吸附测定(ELISA)试验,在基线、孕妇接种疫苗后1个月、分娩时以及在婴儿的脐带血中以及在接种含百日咳疫苗的基础免疫程序(扩大免疫规划:第2 - 3 - 4个月)前后,测量了针对破伤风(TT)、白喉(DT)、百日咳毒素(PT)、丝状血凝素(FHA)和百日咳杆菌黏附素(Prn)的免疫球蛋白G(IgG)。在Tdap组后代中,直至2月龄时,所有3种检测的百日咳抗原的几何平均浓度(GMC)均显著更高。在婴儿完成基础免疫接种程序1个月后,对照组的抗Prn GMC显著(p = 0.

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