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[比较不同剂型脊髓灰质炎灭活疫苗(sIPV)序贯接种口服脊髓灰质炎减毒活疫苗(bOPV,Ⅰ+Ⅲ)的免疫原性和安全性]

[Comparing the immunogenicity and safety of sequential inoculation of sIPV followed by bOPV (Ⅰ+Ⅲ) in different dosage forms].

作者信息

Ye H, Huang T, Ying Z F, Li G L, Che Y C, Zhao Z M, Wang J F, Yang X L, Shi L, Jiang R J, Liu X C, Mo Z J, Li C G, Yang J S

机构信息

Institute of Medical Biology, Chinese Academy of Medical Sciences, Pekin Union Medical College, Kunming 650118, China.

Guangxi Center for Disease Prevention and Control, Division of Vaccine Clinical Trial, Nanning 530028, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2018 Jan 6;52(1):43-49. doi: 10.3760/cma.j.issn.0253-9624.2018.01.009.

Abstract

To compare the safety and immunogenicity of two different sequential schedules of inactivated poliomyelitis vaccine made from Sabin strain (sIPV) followed by typeⅠ+Ⅲ bivalent oral poliovirus vaccine (bOPV) in Drug Candy (DC) form or liquid dosage form). This randomized, blinded, single center, parallel-group controlled trial was done from September 2015 to June 2016 in Liuzhou, Guangxi province. Healthy infants aged ≥2 months were eligible for enrollment and divided into 1sIPV+2bOPV or 2sIPV+1bOPV sequential schedules. According to the bOPV dosage form each sequential schedules, the subjects again were divided into drug candy(DC) form or liquid dosage form group, being 1sIPV+bOPV (DC)/1sIPV+2bOPV(liquid)/2sIPV+1bOPV(DC)/2sIPV+1bOPV(liquid). According to 0, 28, 56 d immunization schedule, Each group were given 3 doses. We recorded adverse events during the clinical trial (399 participants who receive at least one dose). 28 days post-Dose 3, we receive a total of 350 blood samples (excluding the quitters or subjects against trial plan), using cell culture trace against polio virus neutralization test Ⅰ, Ⅱ, Ⅲ neutralizing antibody (GMT), calculating the antibody positive rate.PolioⅠ,Ⅱand Ⅲ antibody titers were assessed by virus-neutralizing antibody assay and the seroconversion (4-fold increase in titer) from pre-Dose 1 to 28 days post-Dose 3 was calculated (total 350 samples) . During the vaccination, the incidence of AEs in 1sIPV+2bOPV(DC), 1sIPV+2bOPV (liquid), 2sIPV+1bOPV(DC), 2sIPV+1bOPV (liquid) group were 79%, 76%, 80% and 74% (χ(2)=1.23, 0.747) , respectively. The severe AEs in groups were 6%, 5%, 6% and 4% (χ(2)=0.57, 0.903) , respectively, and none was considered to be vaccination related. 28 days after 3(rd) vaccination, the seroconversion rates in 1sIPV+2bOPV (DC), 1sIPV+2bOPV (liquid), 2sIPV+1bOPV (DC), 2sIPV+1bOPV (liquid) group, were 99%, 100%, 99% and 99% (χ(2)=0.94, 0.815) , respectively, for type Ⅰ poliovirus; and 47%, 57%, 80%, 79% (χ(2)=31.56, 0.001) , respectively, for type Ⅱ; and were 100%, 99%, 100%, 99% (χ(2)=2.02, 0.568) , respectively, for type Ⅲ. In each group, the GMT of antibody against poliovirus typeⅠ were 4 539.68, 6 243.43, 6 819.53 and 7 916.29 (25.87, 0.001) , respectively; Type Ⅱ were 12.98, 10.54, 63.75 and 84.21 (8.68, 0.034) , respectively; Type Ⅲ were 1 172.55, 1 416.03, 2 648.89 and 3 250.75 (14.50, 0.002) , respectively. On the same sequential schedules, there was no significant difference between the dosage forms, all of them showed good safety and immunogenicity. In the same dosage forms with different sequential schedules, the seroconversion rate was higher in 2 dose sIPV group than the 1 dose sIPV group, especially at the neutralizing antibody GMT level against polio type Ⅱ and Ⅲ after vaccination.

摘要

比较两种不同序贯接种程序的萨宾株灭活脊髓灰质炎疫苗(sIPV)后续接种Ⅰ+Ⅲ型二价口服脊髓灰质炎疫苗(bOPV,药物糖丸剂型或液体剂型)的安全性和免疫原性。这项随机、双盲、单中心、平行组对照试验于2015年9月至2016年6月在广西柳州开展。≥2月龄的健康婴儿符合入组条件,被分为1剂sIPV+2剂bOPV或2剂sIPV+1剂bOPV序贯接种程序。根据每种序贯接种程序中bOPV的剂型,受试者再分为药物糖丸(DC)剂型组或液体剂型组,即1sIPV+bOPV(DC)/1sIPV+2bOPV(液体)/2sIPV+1bOPV(DC)/2sIPV+1bOPV(液体)。按照0、28、56天免疫程序,每组均接种3剂。我们记录了临床试验期间的不良事件(399名至少接种1剂的参与者)。第3剂接种后28天,我们共采集了350份血样(不包括退出者或违反试验方案的受试者),采用细胞培养微量中和试验检测脊髓灰质炎病毒Ⅰ、Ⅱ、Ⅲ型中和抗体(GMT),计算抗体阳性率。脊髓灰质炎Ⅰ、Ⅱ、Ⅲ型抗体滴度通过病毒中和抗体测定进行评估,并计算从第1剂接种前到第3剂接种后28天的血清转化率(共350份样本)。接种期间,1sIPV+2bOPV(DC)、1sIPV+2bOPV(液体)、2sIPV+1bOPV(DC)、2sIPV+1bOPV(液体)组的不良事件发生率分别为79%、76%、80%和74%(χ²=1.23,P=0.747)。各组严重不良事件发生率分别为6%、5%、6%和4%(χ²=0.57,P=0.903),且均不认为与疫苗接种相关。第3剂接种后28天,1sIPV+2bOPV(DC)、1sIPV+2bOPV(液体)、2sIPV+1bOPV(DC)、2sIPV+1bOPV(液体)组Ⅰ型脊髓灰质炎病毒的血清转化率分别为99%、100%、99%和99%(χ²=0.94,P=0.815);Ⅱ型分别为47%、57%、80%和79%(χ²=31.56,P=0.001);Ⅲ型分别为100%、99%、100%和99%(χ²=2.02,P=0.568)。在相同序贯接种程序中,不同剂型之间无显著差异,均显示出良好的安全性和免疫原性。在相同剂型但不同序贯接种程序中,2剂sIPV组的血清转化率高于1剂sIPV组,尤其是接种后脊髓灰质炎Ⅱ型和Ⅲ型中和抗体GMT水平。

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