Goujon Catherine, Gougeon Marie-Lise, Tondeur Laura, Poirier Béatrice, Seffer Valérie, Desprès Philippe, Consigny Paul-Henri, Vray Muriel
Institut Pasteur, Centre médical, Paris, France.
Institut Pasteur, Unité de Recherche et d'Expertise Immunité anti-virale, Biothérapie et Vaccins, Paris, France.
Vaccine. 2017 Oct 27;35(45):6166-6171. doi: 10.1016/j.vaccine.2017.09.047. Epub 2017 Sep 25.
For administration of multiple live attenuated vaccines, the Advisory Committee on Immunization Practices recommends either simultaneous immunization or period of at least 28days between vaccines, due to a possible reduction in the immune response to either vaccine. The main objective of this study was to compare the immune response to measles (alone or combined with mumps and rubella) and yellow fever vaccines among infants aged 6-24months living in a yellow fever non-endemic country who had receivedmeasles and yellow fever vaccines before travelling to a yellow fever endemic area.
A retrospective, multicenter case-control study was carried out in 7 travel clinics in the Paris area from February 1st 2011 to march 31, 2015. Cases were defined as infants immunized with the yellow fever vaccine and with the measles vaccine, either alone or in combination with mumps and rubella vaccine, with a period of 1-27days between each immunization. For each case, two controls were matched based on sex and age: a first control group (control 1) was defined as infants having received the measles vaccine and the yellow fever vaccine simultaneously; a second control group (control 2) was defined as infants who had a period of more than 27days between receiving the measles vaccine and yellow fever vaccine. The primary endpoint of the study was the percentage of infants with protective immunity against yellow fever, measured by the titer of neutralizing antibodies in a venous blood sample.
One hundred and thirty-one infants were included in the study (62 cases, 50 infants in control 1 and 19 infants in control 2). Of these, 127 (96%) were shown to have a protective titer of yellow fever antibodies. All 4 infants without a protective titer of yellow fever antibodies were part of control group 1.
The measles vaccine, alone or combined with mumps and rubella vaccines, appears to have no influence on humoral immune response to the yellow fever vaccine when administered between 1 and 27days. The absence of protective antibodies against yellow fever was observed only among infants who received both vaccines simultaneously.
These results may support a revision of current vaccination recommendations concerning the administration of these two live attenuated vaccines either on the same day or at least 28days apart. Our findings show no statistically significant difference if the interval between both vaccines is more than 24 h, but the immune response seems to be reduced when the two vaccines are given at the same time.
对于多种减毒活疫苗的接种，免疫实践咨询委员会建议同时接种或两种疫苗之间间隔至少28天，因为这可能会降低对任一种疫苗的免疫反应。本研究的主要目的是比较生活在黄热病非流行国家的6至24个月大婴儿在前往黄热病流行地区之前接种麻疹疫苗（单独或与腮腺炎和风疹联合）和黄热病疫苗后的免疫反应。
2011年2月1日至2015年3月31日在巴黎地区的7家旅行诊所进行了一项回顾性多中心病例对照研究。病例定义为接种了黄热病疫苗和麻疹疫苗（单独或与腮腺炎和风疹疫苗联合）且每次接种间隔为1至27天的婴儿。对于每个病例，根据性别和年龄匹配两个对照组：第一个对照组（对照1）定义为同时接种了麻疹疫苗和黄热病疫苗的婴儿；第二个对照组（对照2）定义为接种麻疹疫苗和黄热病疫苗之间间隔超过27天的婴儿。该研究的主要终点是通过静脉血样中中和抗体滴度测量的对黄热病具有保护性免疫的婴儿百分比。
131名婴儿纳入研究（62例病例，对照1组50名婴儿，对照2组19名婴儿）。其中，127名（96%）显示具有黄热病抗体的保护性滴度。所有4名没有黄热病抗体保护性滴度的婴儿均属于对照1组。
麻疹疫苗单独或与腮腺炎和风疹疫苗联合使用时，在1至27天内接种似乎对黄热病疫苗的体液免疫反应没有影响。仅在同时接种两种疫苗的婴儿中观察到缺乏针对黄热病的保护性抗体。
这些结果可能支持修订关于这两种减毒活疫苗在同一天或至少间隔28天接种的现行疫苗接种建议。我们的研究结果表明，如果两种疫苗之间的间隔超过24小时，没有统计学上的显著差异，但同时接种两种疫苗时免疫反应似乎会降低。
