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评价 9 月龄马里婴儿接种五价轮状病毒疫苗加强针与麻疹、黄热病和脑膜炎 A 联合疫苗的效果。

Evaluation of a Booster Dose of Pentavalent Rotavirus Vaccine Coadministered With Measles, Yellow Fever, and Meningitis A Vaccines in 9-Month-Old Malian Infants.

机构信息

Centre pour le Développement des Vaccins-Mali, Bamako.

Center for Vaccine Development, University of Maryland School of Medicine, Baltimore.

出版信息

J Infect Dis. 2018 Jul 13;218(4):606-613. doi: 10.1093/infdis/jiy215.

Abstract

BACKGROUND

Rotavirus vaccines given to infants are safe and efficacious. A booster dose of rotavirus vaccine could extend protection into the second year of life in low-resource countries.

METHODS

We conducted an open-label, individual-randomized trial in Bamako, Mali. We assigned 600 infants aged 9-11 months to receive measles vaccine (MV), yellow fever vaccine (YFV), and meningococcal A conjugate vaccine (MenAV) with or without pentavalent rotavirus vaccine (PRV). We assessed the noninferiority (defined as a difference of ≤10%) of seroconversion and seroresponse rates to MV, YFV, and MenAV. We compared the seroresponse to PRV.

RESULTS

Seroconversion to MV occurred in 255 of 261 PRV recipients (97.7%) and 246 of 252 control infants (97.6%; difference, 0.1% [95% confidence interval {CI}, -4.0%-4.2%]). Seroresponse to YFV occurred in 48.1% of PRV recipients (141 of 293), compared with 52.2% of controls (153 of 293; difference, -4.1% [95% CI, -12.2%-4.0%]). A 4-fold rise in meningococcus A bactericidal titer was observed in 273 of 292 PRV recipients (93.5%) and 276 of 293 controls (94.2%; difference, -0.7% [95% CI, -5.2%-3.8%]). Rises in geometric mean concentrations of immunoglobulin A and immunoglobulin G antibodies to rotavirus were higher among PRV recipients (118 [95% CI, 91-154] and 364 [95% CI, 294-450], respectively), compared with controls (68 [95% CI, 50-92] and 153 [95% CI, 114-207], respectively).

CONCLUSIONS

PRV did not interfere with MV and MenAV; this study could not rule out interference with YFV. PRV increased serum rotavirus antibody levels.

CLINICAL TRIALS REGISTRATION

NCT02286895.

摘要

背景

给予婴儿的轮状病毒疫苗是安全有效的。在资源匮乏的国家,给予婴儿轮状病毒疫苗加强针可以将保护作用延长至第二年。

方法

我们在马里巴马科进行了一项开放性、个体随机试验。我们将 600 名 9-11 月龄的婴儿分为两组,分别接种麻疹疫苗(MV)、黄热病疫苗(YFV)和脑膜炎球菌 A 结合疫苗(MenAV),并联合或不联合五价轮状病毒疫苗(PRV)。我们评估了 MV、YFV 和 MenAV 血清转化率和血清应答率的非劣效性(定义为差异≤10%)。我们比较了 PRV 的血清应答。

结果

在 261 名 PRV 接种者中有 255 名(97.7%)和 252 名对照婴儿(97.6%;差异,0.1%[95%置信区间{CI},-4.0%-4.2%])发生 MV 血清转化。48.1%的 PRV 接种者(293 名中的 141 名)发生了 YFV 血清应答,而对照组中为 52.2%(293 名中的 153 名;差异,-4.1%[95%CI,-12.2%-4.0%])。292 名 PRV 接种者中有 273 名(93.5%)和 293 名对照者(94.2%)的脑膜炎球菌 A 杀菌抗体滴度升高了 4 倍(差异,-0.7%[95%CI,-5.2%-3.8%])。PRV 接种者的轮状病毒免疫球蛋白 A 和免疫球蛋白 G 抗体的几何平均浓度升高分别为 118[95%CI,91-154]和 364[95%CI,294-450],而对照组分别为 68[95%CI,50-92]和 153[95%CI,114-207]。

结论

PRV 不干扰 MV 和 MenAV;本研究不能排除对 YFV 的干扰。PRV 增加了血清轮状病毒抗体水平。

临床试验注册

NCT02286895。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7f0/6047426/665dd7bcf70f/jiy21501.jpg

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