Mark A, Björkstén B, Granström M
Department of Paediatrics, University of Göteborg, Ostra Hospital, Sweden.
Vaccine. 1995 May;13(7):669-73. doi: 10.1016/0264-410x(94)00017-h.
Immunoglobulin E responses to diphtheria and tetanus toxoids were investigated in pre- and postbooster samples of 104 children given, at 10 years of age, a DT booster with either an adsorbed (n = 51) or a non-adsorbed, fluid vaccine (n = 53). Vaccination with adsorbed DT is part of a national immunisation programme and represents the first regular booster given to these children, primarily immunised with three doses of adsorbed DT at age 3-6 months. The vaccines, with a content of 30 Lf of diphtheria toxoid and 7.5 Lf of tetanus toxoid per millilitre, were given for booster in a dose of 0.25 ml as a deep subcutaneous injection. In the prebooster samples, 3 and 14% had measurable IgE to diphtheria and tetanus, respectively. These rates rose to 94 and 92% in the postbooster samples, respectively. The median (range) of IgE to tetanus among recipients of the adsorbed vaccine was 0.59 PRU ml-1 (< 0.1-17.5), as compared to 0.27 (< 0.1-8.22) in the recipients of the fluid vaccine (p = 0.027). The median IgE response to diphtheria toxoid in the whole group was 1.8 (< 0.1-17.5), with no significant difference between the two vaccines (p = 0.76). There was no correlation between the IgE and IgG responses (r < 0.07, p > 0.5) but the two IgE responses as well as the ratios of IgG/IgE showed strong correlations (r > 0.7, p < 0.001). The study thus revealed unexpectedly high rates of IgE responses to diphtheria and tetanus toxoids in a regular DT booster vaccination programme, which were associated to high rates of local side effects.(ABSTRACT TRUNCATED AT 250 WORDS)
对104名10岁儿童进行了白喉和破伤风类毒素的免疫球蛋白E反应研究,这些儿童在10岁时接受了吸附型(n = 51)或非吸附型液体疫苗(n = 53)的白喉破伤风联合疫苗加强免疫。接种吸附型白喉破伤风联合疫苗是国家免疫规划的一部分,也是这些儿童首次常规加强免疫,他们主要在3 - 6个月龄时接种了三剂吸附型白喉破伤风联合疫苗。疫苗每毫升含30Lf白喉类毒素和7.5Lf破伤风类毒素,以0.25ml的剂量进行深部皮下注射作为加强免疫。在加强免疫前的样本中,分别有3%和14%的儿童对白喉和破伤风有可测量的免疫球蛋白E。在加强免疫后的样本中,这些比例分别升至94%和92%。吸附型疫苗接种者中破伤风免疫球蛋白E的中位数(范围)为0.59 PRU/ml(<0.1 - 17.5),而液体疫苗接种者为0.27(<0.1 - 8.22)(p = 0.027)。整个组对白喉类毒素的免疫球蛋白E反应中位数为1.8(<0.1 - 17.5),两种疫苗之间无显著差异(p = 0.76)。免疫球蛋白E和免疫球蛋白G反应之间无相关性(r < 0.07,p > 0.5),但两种免疫球蛋白E反应以及免疫球蛋白G/免疫球蛋白E的比值显示出强相关性(r > 0.7,p < 0.001)。该研究因此揭示,在常规的白喉破伤风联合疫苗加强免疫计划中,对白喉和破伤风类毒素的免疫球蛋白E反应率出乎意料地高,且与高比例的局部副作用相关。(摘要截短至250字)