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健康婴儿和幼儿接种六价-五价-六价联合疫苗系列后再加强接种五价疫苗的效果评估。

Evaluation of a Hexavalent-Pentavalent-Hexavalent Infant Primary Vaccination Series Followed by a Pentavalent Booster Vaccine in Healthy Infants and Toddlers.

机构信息

From the Hospital Clínico Universitario de Santiago de Compostela, A Choupana, Santiago de Compostela, Spain.

Vaccine Research Department, FISABIO-Public Health, Av da Cataluña, Valencia, Spain.

出版信息

Pediatr Infect Dis J. 2019 Mar;38(3):317-322. doi: 10.1097/INF.0000000000002231.

Abstract

BACKGROUND

This study assessed a pediatric mixed hexavalent diphtheria (D)-tetanus (T)-acellular pertussis (aP)-inactivated poliovirus (IPV)-hepatitis B (HB)-Haemophilus influenzae b [polyribosylribitol phosphate (PRP-T)]-pentavalent (DTaP-IPV//PRP-T)-hexavalent primary series schedule followed by a pentavalent booster.

METHODS

Healthy infants (N = 265) who had received a prior HB vaccination received a fully liquid, hexavalent vaccine (DTaP-IPV-HB-PRP-T) at 2 and 6 months of age and a reconstituted pentavalent vaccine (DTaP-IPV//PRP-T) at 4 months of age. Coadministered vaccines were pneumococcal vaccine at 2 and 4 months (and optionally at 6 months of age), rotavirus vaccine at 2, 4, 6 months and meningococcal serogroup C vaccine at 2 months. At 18 months, participants received DTaP-IPV//PRP-T and pneumococcal vaccine boosters. Immunogenicity was assessed using validated assays and safety by parental reports.

RESULTS

For the hexavalent and pentavalent vaccines, the primary series and booster immune responses in terms of seroprotection and vaccine response rates were high for all antigens (generally > 99% and > 95% for the primary series and booster, respectively) and prebooster antibody persistence was good for all antigens (in particular, 92.4% of participants had prebooster anti-HB antibody ≥ 10 mIU/mL). The incidence of solicited reactions was lower after the booster vaccination (56.9%-73.1%) than the primary series (76.6%-97.4%); there were few vaccine-related unsolicited adverse events (1.9% and 1.5% for the primary series and booster, respectively), none led to participant discontinuation and none was serious.

CONCLUSIONS

This study provides data that allow recommending authorities to consider the use of a sequential hexavalent-pentavalent-hexavalent primary vaccination series followed by a pentavalent booster in coadministration with other common childhood vaccines.

摘要

背景

本研究评估了一种儿科混合六价白喉(D)-破伤风(T)-无细胞百日咳(aP)-灭活脊髓灰质炎(IPV)-乙型肝炎(HB)-流感嗜血杆菌 b [多聚核糖醇磷酸(PRP-T)]-五价(DTaP-IPV//PRP-T)-六价基础系列方案,随后进行五价加强免疫。

方法

已接受过乙型肝炎疫苗接种的健康婴儿(N=265)于 2 月龄和 6 月龄时接种全液体六价疫苗(DTaP-IPV-HB-PRP-T),4 月龄时接种重组五价疫苗(DTaP-IPV//PRP-T)。同时接种疫苗有 2 月龄和 4 月龄的肺炎球菌疫苗(6 月龄时可选)、2 月龄、4 月龄、6 月龄的轮状病毒疫苗和 2 月龄的脑膜炎球菌 C 群疫苗。18 月龄时,参与者接受 DTaP-IPV//PRP-T 和肺炎球菌疫苗加强免疫。采用验证后的检测方法评估免疫原性,通过家长报告评估安全性。

结果

对于六价和五价疫苗,从血清保护率和疫苗反应率来看,所有抗原的基础系列和加强免疫应答都很高(一般为基础系列和加强免疫的 99%以上和 95%以上),所有抗原的前加强免疫抗体持久性良好(特别是,92.4%的参与者前加强免疫乙型肝炎抗体≥10 mIU/mL)。与基础系列疫苗相比,加强免疫后的不良反应发生率较低(56.9%-73.1%);疫苗相关不良事件很少(基础系列和加强免疫分别为 1.9%和 1.5%),没有导致参与者停药,也没有严重不良事件。

结论

本研究提供的数据允许推荐机构考虑使用序贯六价-五价-六价基础系列疫苗,随后与其他常见儿童疫苗同时接种五价疫苗加强免疫。

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