Halsey N A, Boulos R, Mode F, Andre J, Bowman L, Yaeger R G, Toureau S, Rohde J, Boulos C
N Engl J Med. 1985 Aug 29;313(9):544-9. doi: 10.1056/NEJM198508293130904.
To study the factors affecting the serologic response to measles vaccination, we evaluated 595 Haitian infants from 6 through 12 months of age, and their mothers, at the beginning of an immunization program. Thirty-four per cent of the infants had preexisting serologic evidence of measles infections by 11 months of age. Among infants more than nine months of age, those who had had measles had a significantly lower nutritional status than those who had not (P less than 0.01). After vaccination, seroconversion rates increased from 45 per cent at 6 months to 100 per cent at 12 months. The lowest rate of vaccine failure compatible with acceptably low rates of natural infections could be achieved by vaccination after eight months of age. Infants born to mothers with low levels of antibody to measles (hemagglutination-inhibition antibody titers less than 1:40) were significantly more likely to have had natural measles (P less than 0.01) or to have seroconversion after vaccination (P less than 0.001) at 6 to 10 months of age than were infants born to mothers with higher of age than were infants born to mothers with higher titers. Malnutrition and acute infections did not affect seroconversion rates. These data support the World Health Organization recommendation to administer measles vaccine in under-developed countries as soon after nine months of age as possible, regardless of nutritional status or the presence of minor illnesses.
为研究影响麻疹疫苗血清学反应的因素，我们在一项免疫计划开始时，对595名6至12个月大的海地婴儿及其母亲进行了评估。到11个月大时，34%的婴儿已有麻疹感染的血清学证据。在9个月以上的婴儿中，患过麻疹的婴儿营养状况明显低于未患过麻疹的婴儿（P<0.01）。接种疫苗后，血清转化率从6个月时的45%升至12个月时的100%。在8个月龄后接种疫苗，可实现与可接受的低自然感染率相符的最低疫苗失败率。母亲麻疹抗体水平低（血凝抑制抗体滴度低于1:40）的婴儿，在6至10个月龄时比母亲抗体滴度高的婴儿更易患自然麻疹（P<0.01）或接种疫苗后血清转化（P<0.001）。营养不良和急性感染不影响血清转化率。这些数据支持世界卫生组织的建议，即在欠发达国家，无论营养状况或是否患有轻症疾病，应在婴儿9个月龄后尽快接种麻疹疫苗。
