Mathias R G, Meekison W G, Arcand T A, Schechter M T
Department of Health Care and Epidemiology, University of British Columbia, Vancouver.
Am J Public Health. 1989 Apr;79(4):475-8. doi: 10.2105/ajph.79.4.475.
An outbreak of measles in 1985-86 in a community where measles vaccine trials had been carried out from 1974-76 allowed the assessment of the role of secondary vaccine failures in previously immunized children. A total of 188 children from the vaccine trial were followed. Of these, 175 seroconverted initially while 13 (6 per cent) required re-immunization (primary failure). A total of 13 cases of measles, eight of which were laboratory and/or physician-confirmed, were reported in this cohort. Of these, nine cases occurred in the 175 subjects who had hemagglutination inhibition test (HI) and neutralizing antibody responses following the initial immunization. These nine cases represent secondary vaccine failures. An additional four cases occurred in the 13 subjects with primary vaccine failure. We conclude that secondary vaccine failures occur and that while primary failures account for most cases, secondary vaccine failures contribute to the occurrence of measles cases in an epidemic. A booster dose of measles vaccine may be necessary to reduce susceptibility to a sufficiently low level to allow the goal of measles elimination to be achieved.
1985 - 1986年，在一个自1974 - 1976年开展过麻疹疫苗试验的社区爆发了麻疹疫情，这使得人们能够评估既往免疫儿童中继发疫苗失败的作用。对疫苗试验中的188名儿童进行了随访。其中，175名儿童最初血清转化，13名（6%）需要再次免疫（初次失败）。该队列中共报告了13例麻疹病例，其中8例经实验室和/或医生确诊。在这13例中，9例发生在初次免疫后有血凝抑制试验（HI）和中和抗体反应的175名受试者中。这9例代表继发疫苗失败。另外4例发生在13名初次疫苗失败的受试者中。我们得出结论，继发疫苗失败确实存在，虽然初次失败占大多数病例，但继发疫苗失败在麻疹流行中导致了麻疹病例的发生。可能需要一剂麻疹疫苗加强针，以将易感性降低到足够低的水平，从而实现消除麻疹的目标。
