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3-7 岁儿童接种两剂含腮腺炎成分疫苗后腮腺炎特异性抗体持久性:中国江苏省前瞻性队列研究。

Mumps-specific antibody persistence in children aged 3-7 years immunized with two doses of mumps-containing vaccines: A prospective cohort study in Jiangsu Province, China.

机构信息

Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China.

Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China.

出版信息

Hum Vaccin Immunother. 2023 Dec 31;19(1):2166758. doi: 10.1080/21645515.2023.2166758. Epub 2023 Jan 18.

Abstract

Mumps reemergence has been reported in developed countries with high levels of two-dose mumps-containing vaccine (MuCV) coverage. The effectiveness of the two-dose MuCV may be compromised by limitations in the persistence of immunity. This prospective cohort study evaluated the persistence of immunity of a two-dose MuCV in children aged 3-7 years from 2015 to 2020. Persistence of antibody to mumps, determined as the geometric mean antibody concentration (GMC), and seropositivity were analyzed for both repeated measurements from three follow-ups and on each cross-section, respectively. A total of 105 eligible subjects were recruited. Their overall seropositivity rate was relatively high and stable (92.4%-84.8%), while the overall GMC decreased from 547.6 U/ml to 333.3 U/ml. Analysis of waning immunity in 91 participants showed a significant and consistent downward trend for GMC, which differed significantly in boys and girls. The overall seropositivity rate decreased slightly from 2015 (95.6%) to 2016 (92.3%) but both were significantly higher than in 2018 (84.6%). The rates in girls remained stable, while those in boys declined to 75% in 2018. The seropositivity rate of the cross-section level decreased from 95.4% to 86.4% in 4 years. Although two-dose MuCV may result in a high level of immunity, antibody concentrations decay over 2 years after the second dose. Children with waning immunity after receiving two doses, especially boys, require further surveillance at 4 years and later to avoid future mumps epidemics. NCT02901990.

摘要

流行性腮腺炎在发达国家再次出现,这些国家的两剂含腮腺炎疫苗(MuCV)覆盖率很高。两剂 MuCV 的有效性可能因免疫持久性的限制而受到影响。本前瞻性队列研究评估了 2015 年至 2020 年间,3-7 岁儿童接种两剂 MuCV 后的免疫持久性。通过对 3 次随访的重复测量和每次横断面的分析,分别评估了抗腮腺炎抗体的持久性(以几何平均抗体浓度[GMC]表示)和血清阳性率。共招募了 105 名合格受试者。他们的总体血清阳性率相对较高且稳定(92.4%-84.8%),而总体 GMC 从 547.6 U/ml 降至 333.3 U/ml。对 91 名免疫衰减参与者的分析显示,GMC 呈显著且一致的下降趋势,男孩和女孩之间的 GMC 差异有统计学意义。2015 年(95.6%)和 2016 年(92.3%)的总体血清阳性率略有下降,但均明显高于 2018 年(84.6%)。女孩的比例保持稳定,而男孩的比例在 2018 年下降至 75%。4 年来,横断面水平的血清阳性率从 95.4%下降至 86.4%。虽然两剂 MuCV 可能会产生高水平的免疫力,但在第二剂接种后 2 年内,抗体浓度会下降。接受两剂疫苗后免疫力下降的儿童,尤其是男孩,需要在 4 岁及以后进行进一步监测,以避免未来的流行性腮腺炎流行。NCT02901990。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41f5/9980565/c877ac4100fe/KHVI_A_2166758_F0001_B.jpg

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