Ruan H S, Gao Y J, Fei Y, Cao Q, Chen W J, Chen J, Zhang H, Wang X W, He M X, Zhou F
Department of Hematology and Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.
Department of Immunology and Prevention, Center for Disease Control and Prevention of Shanghai Pudong, Shanghai 200129, China.
Zhonghua Er Ke Za Zhi. 2021 Apr 2;59(4):305-310. doi: 10.3760/cma.j.cn112140-20200729-00761.
To preliminarily establish the multidisciplinary cooperative vaccination management model for pediatric patients with hematological and oncological diseases, and to explore its feasibility. In this prospective study a total of 150 children with hematological and oncological diseases visited immunization clinic of Shanghai Children's Medical Center from March 2017 to August 2018 were enrolled in this study. After establishing the multidisciplinary team, designing vaccination plan, staff training, implementation and quality control, a multidisciplinary immunization clinic was set up and the vaccination plan were implemented. The implementation rate of vaccination immunization, the HBsAb level and serum hepatitis B surface antibody (HBsAb) level before and after treatment, the HBsAb level and serum immunoglobulin G antibody (IgG) levels of measles, mumps, rubella (MMR) before and 6 months after immunization, the vaccine-related adverse reactions were assessed prospectively. Chi-square test or Fisher exact test was used to compare the differences of antibody level. A total of 124 cases had been vaccinated as planned, with a coverage rate of 82.7%. Among these cases, the difference of HBsAb positive rate before and after treatment was significant (62.9% (78/124) .13.7% (17/124), χ²= 63.489, 0.01). In 64 cases that completed three doses of hepatitis B immunization, there was a significant difference in HBsAb positive rate before and 6 months after immunization (6.3% (4/64) . 98.4% (63/64), 0.01). In 40 cases that completed MMR immunization, the IgG antibody positive rate for measles (22.5% (9/40) . 82.5% (33/40), χ²31.746,0.01), mumps (22.5% (9/40) .82.5% (33/40), χ²28.872,0.01), rubella (25.0% (10/40) .62.5% (25/40), χ²11.429, 0.01) before and 6 months after immunization were significantly different. Of the 421 doses of immunization, 25 (5.9%) doses reported controlled systemic or local adverse event. The immunization of pediatric patients with hematological and oncological diseases is of great importance. The newly-developed multidisciplinary cooperation immunization model for Chinese children with hematological and oncological diseases is feasible, and the immunization protocol is safe and has a certain effect.
初步建立血液肿瘤患儿多学科协作疫苗接种管理模式,并探讨其可行性。在这项前瞻性研究中,选取了2017年3月至2018年8月期间到上海儿童医学中心免疫门诊就诊的150例血液肿瘤患儿纳入研究。组建多学科团队、设计疫苗接种计划、进行人员培训、实施及质量控制后,设立了多学科免疫门诊并实施疫苗接种计划。前瞻性评估疫苗接种实施率、治疗前后乙肝表面抗体(HBsAb)水平及血清学乙肝表面抗体水平、免疫接种前及接种后6个月麻疹、腮腺炎、风疹(MMR)的HBsAb水平及血清免疫球蛋白G抗体(IgG)水平、疫苗相关不良反应。采用卡方检验或Fisher确切检验比较抗体水平差异。共有124例按计划接种,接种率为82.7%。其中,治疗前后HBsAb阳性率差异有统计学意义(62.9%(78/124)对13.7%(17/124),χ² = 63.489,P < 0.01)。在完成3剂乙肝疫苗接种的64例中,接种前及接种后6个月HBsAb阳性率差异有统计学意义(6.3%(4/64)对98.4%(63/64),P < 0.01)。在完成MMR免疫接种的40例中,接种前及接种后6个月麻疹IgG抗体阳性率(22.5%(9/40)对82.5%(33/40),χ² = 31.746,P < 0.01)、腮腺炎IgG抗体阳性率(22.5%(9/40)对82.5%(33/40),χ² = 28.872,P < 0.01)、风疹IgG抗体阳性率(25.0%(10/40)对62.5%(25/40),χ² = 11.429,P < 0.01)差异均有统计学意义。在421剂次免疫接种中,25剂次(5.9%)报告有可控的全身或局部不良事件。血液肿瘤患儿的免疫接种非常重要。新建立的中国血液肿瘤患儿多学科协作免疫模式是可行的,免疫方案安全且有一定效果。