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在一项四期研究中,评估 6-71 月龄儿童中使用 EV71 灭活疫苗的有效性和安全性。

Effectiveness and Safety of an Inactivated Enterovirus 71 Vaccine in Children Aged 6-71 Months in a Phase IV Study.

机构信息

Hubei Provincial Center for Disease Control and Prevention, Wuhan, China.

Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, China.

出版信息

Clin Infect Dis. 2020 Dec 3;71(9):2421-2427. doi: 10.1093/cid/ciz1114.

Abstract

BACKGROUND

Evaluation of a licensed inactivated enterovirus type 71 (EV71) vaccine is needed in a phase IV study with a large population to identify its effectiveness and safety for further application.

METHODS

An open-label, controlled trial involving a large population of 155 995 children aged 6-71 months was performed; 40 724 were enrolled in the vaccine group and received 2 doses of inactivated EV71 vaccine at an interval of 1 month, and the remaining children were used as the control group. The EV71-infected cases with hand, foot, and mouth disease were monitored in the vaccine and control groups during a follow-up period of 14 months since the 28th day postinoculation through the local database of the Notifiable Infectious Diseases Network. The effectiveness of the vaccine was estimated by comparing the incidence density in the vaccine group versus that in the control group based upon EV71-infected patients identified via laboratory testing. In parallel, the active and passive surveillance for safety of the vaccine was conducted by home or telephone visits and by using the Adverse Event Following Immunization (AEFI) system, respectively.

RESULTS

An overall level of 89.7% (95% confidence interval, 24.0-98.6%) vaccine effectiveness against EV71 infection and a 4.58% rate of reported adverse events were observed. Passive surveillance demonstrated a 0.31% rate of reported common minor reactions.

CONCLUSIONS

The clinical protection and safety of the EV71 vaccine were demonstrated in the immunization of a large population.

CLINICAL TRIALS REGISTRATION

NCT03001986.

摘要

背景

需要在一项涉及大量人群的四期研究中评估已上市的肠道病毒 71 型(EV71)灭活疫苗,以确定其有效性和安全性,从而进一步应用。

方法

进行了一项开放性、对照试验,涉及 155995 名 6-71 月龄儿童的大人群;40724 名儿童纳入疫苗组,接受 2 剂 EV71 灭活疫苗,间隔 1 个月,其余儿童作为对照组。在接种后第 28 天至 14 个月的随访期间,通过传染病网络直报系统的本地数据库监测疫苗组和对照组中手足口病的 EV71 感染病例。通过比较实验室确诊的 EV71 感染患者在疫苗组和对照组中的发病率密度,评估疫苗的有效性。同时,通过家庭或电话访问和使用疑似预防接种异常反应(AEFI)系统分别进行疫苗安全性的主动和被动监测。

结果

观察到针对 EV71 感染的疫苗总有效率为 89.7%(95%置信区间,24.0-98.6%),报告的不良事件发生率为 4.58%。被动监测显示报告的常见轻微反应发生率为 0.31%。

结论

在大规模人群免疫中,EV71 疫苗表现出临床保护和安全性。

临床试验注册

NCT03001986。

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