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黄热病疫苗在 9 至 11 月龄马里和加纳儿童中的抗体应答。

Antibody responses to yellow fever vaccine in 9 to 11-month-old Malian and Ghanaian children.

机构信息

a The Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine , Fajara , The Gambia.

b CIHLMU Center for International Health, Medical Center of the University of Munich (LMU) , Munich , Germany.

出版信息

Expert Rev Vaccines. 2019 Aug;18(8):867-875. doi: 10.1080/14760584.2019.1640118. Epub 2019 Jul 17.

Abstract

: The World Health Organization recommends use of a single yellow fever (YF) vaccine dose for life and fractional doses in outbreaks when there are limited vaccine stocks. In endemic regions, this vaccine is given as part of routine infant immunization programs around 9 months of age. There is a need to better understand immune responses when vaccinating infants particularly in contexts where the child may be malnourished. : Data from 393 Malian and Ghanaian infants who concomitantly received measles and YF vaccines at 9 to 11 months of age were retrospectively analyzed. Response to YF vaccine was examined for association with nutritional status at time of vaccination, sex, age, pre-vaccination titers and season of vaccination. : Neutralizing antibodies following vaccination were unaffected by season of vaccination, sex, pre-vaccination titers or nutritional status, though there was a trend to higher titers in males and children with higher height for age z-scores. Seroconversion rates differed significantly between countries (63.5 in Ghana vs. 91.0% in Mali). : Longitudinal, prospective studies are needed to optimize the use of YF vaccine in infants in endemic settings. There may be a need for booster vaccinations and to compare various vaccine preparations to optimize the use of available vaccines.

摘要

世界卫生组织建议使用单剂黄热病(YF)疫苗终生接种,并在疫苗库存有限时,在爆发疫情时使用小剂量疫苗。在流行地区,该疫苗作为常规婴儿免疫计划的一部分,在 9 个月大时接种。需要更好地了解婴儿接种疫苗时的免疫反应,特别是在儿童可能营养不良的情况下。

对同时在 9 至 11 个月大时接种麻疹和 YF 疫苗的 393 名马里和加纳婴儿的回顾性数据进行了分析。考察了 YF 疫苗接种时的营养状况、性别、年龄、接种前滴度和接种季节与疫苗反应的关系。

接种后的中和抗体不受接种季节、性别、接种前滴度或营养状况的影响,但男性和身高年龄 Z 分数较高的儿童的滴度有升高的趋势。血清转化率在不同国家之间有显著差异(加纳为 63.5%,马里为 91.0%)。

需要进行纵向、前瞻性研究,以优化在流行地区婴儿中使用 YF 疫苗。可能需要加强接种,并比较各种疫苗制剂,以优化现有疫苗的使用。

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