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初免和加强接种六价白喉、破伤风、无细胞百日咳、乙型肝炎、灭活脊髓灰质炎和流感嗜血杆菌 b 型疫苗后的免疫原性和安全性:美国的一项随机试验。

Immunogenicity and safety following primary and booster vaccination with a hexavalent diphtheria, tetanus, acellular pertussis, hepatitis B, inactivated poliovirus and Haemophilus influenzae type b vaccine: a randomized trial in the United States.

机构信息

a Kaiser Permanente Vaccine Study Center , Oakland , CA , USA.

b GSK , Philadelphia , PA , USA.

出版信息

Hum Vaccin Immunother. 2019;15(4):809-821. doi: 10.1080/21645515.2018.1549449. Epub 2019 Jan 4.


DOI:10.1080/21645515.2018.1549449
PMID:30444673
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6605854/
Abstract

Combined hexavalent diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated poliomyelitis and Haemophilus influenzae type b vaccine (DTaP-HBV-IPV/Hib) can further reduce the number of injections in pediatric immunization schedules of countries currently using pentavalent DTaP combination vaccines. This open-label, randomized, multicenter study (NCT02096263) conducted in the United States evaluated the immunogenicity and safety of DTaP-HBV-IPV/Hib vaccine compared with concomitant administration of DTaP-HBV-IPV and Hib or DTaP-IPV/Hib and HBV vaccines. We randomized (1:1:1) infants to receive 3-dose priming with DTaP-HBV-IPV/Hib boosted with DTaP+ Hib, DTaP-HBV-IPV+ Hib boosted with DTaP+ Hib, or DTaP-IPV/Hib+ HBV boosted with DTaP-IPV/Hib, at 2, 4, 6, and 15-18 months of age. We enrolled and vaccinated 585 participants, 486 received a booster, and 476 completed the study. Of these, 466 participants were included in the primary and 408 in the booster according-to-protocol cohorts for immunogenicity. We demonstrated non-inferiority of DTaP-HBV-IPV/Hib vaccine to DTaP-HBV-IPV+ Hib co-administered vaccines in terms of geometric mean concentrations for pertussis antibodies post-primary vaccination. Post-primary vaccination, seroprotection/seropositivity rates for all vaccine antigens were similarly high between DTaP-HBV-IPV/Hib (≥ 94.8%), DTaP-HBV-IPV+ Hib (≥ 98.1%) or DTaP-IPV/Hib+ HBV (≥ 97.8%) groups. We observed robust immune responses post-booster, indicating effective priming by the 3 regimens. Reactogenicity was similar in the 3 groups. Twenty-eight serious adverse events were reported during the study; 3 were considered related to vaccination and resolved by the end of the study. These results confirm that DTaP-HBV-IPV/Hib could be a valuable additional source of pediatric DTaP, IPV, HBV, and Hib-containing vaccine in countries that currently use multivalent vaccines.

摘要

六联无细胞百白破-破伤风-乙型肝炎联合疫苗(DTaP-HBV-IPV/Hib)可进一步减少目前使用五联 DTaP 联合疫苗的国家儿童免疫计划中的注射次数。这项在美国进行的开放性、随机、多中心研究(NCT02096263)评估了 DTaP-HBV-IPV/Hib 疫苗与同时使用 DTaP-HBV-IPV 和 Hib 或 DTaP-IPV/Hib 和 HBV 疫苗相比的免疫原性和安全性。我们将婴儿随机(1:1:1)分为三组,分别接受 3 剂 DTaP-HBV-IPV/Hib 初免,随后分别用 DTaP+ Hib、DTaP-HBV-IPV+ Hib 或 DTaP-IPV/Hib+ HBV 疫苗加强,于 2、4、6 和 15-18 月龄时接种。我们共招募和接种了 585 名参与者,486 名接受了加强针,476 名完成了研究。其中,466 名参与者被纳入主要免疫原性按方案分析队列,408 名参与者被纳入加强免疫原性按方案分析队列。我们证明了 DTaP-HBV-IPV/Hib 疫苗与同时使用 DTaP-HBV-IPV 和 Hib 疫苗相比,在初免后百日咳抗体的几何平均浓度方面具有非劣效性。初免后,所有疫苗抗原的血清保护/阳性率在 DTaP-HBV-IPV/Hib(≥94.8%)、DTaP-HBV-IPV+ Hib(≥98.1%)或 DTaP-IPV/Hib+ HBV(≥97.8%)组之间相似。我们观察到加强针后具有强大的免疫反应,表明 3 种方案均能有效进行初免。3 组的不良反应发生率相似。研究期间报告了 28 例严重不良事件,其中 3 例被认为与接种有关,在研究结束时已解决。这些结果证实,DTaP-HBV-IPV/Hib 可能是目前使用多价疫苗的国家儿童 DTaP、IPV、HBV 和 Hib 疫苗的另一种有价值的来源。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e8a/6605854/929ef55496d7/khvi-15-04-1549449-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e8a/6605854/f188d8bd6011/khvi-15-04-1549449-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e8a/6605854/bd6369274437/khvi-15-04-1549449-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e8a/6605854/a5e457f6d8a7/khvi-15-04-1549449-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e8a/6605854/3986435daa2f/khvi-15-04-1549449-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e8a/6605854/929ef55496d7/khvi-15-04-1549449-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e8a/6605854/f188d8bd6011/khvi-15-04-1549449-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e8a/6605854/bd6369274437/khvi-15-04-1549449-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e8a/6605854/a5e457f6d8a7/khvi-15-04-1549449-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e8a/6605854/3986435daa2f/khvi-15-04-1549449-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e8a/6605854/929ef55496d7/khvi-15-04-1549449-g005.jpg

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