Lieberman J M, Greenberg D P, Wong V K, Partridge S, Chang S J, Chiu C Y, Ward J I
Division of Pediatric Infectious Diseases, University of California, Los Angeles.
J Pediatr. 1995 Feb;126(2):198-205. doi: 10.1016/s0022-3476(95)70545-7.
We randomly assigned 150 newborn infants to receive diphtheria and tetanus toxoids (DT) or Hib oligosaccharide conjugate (HbOC) at birth to determine whether exposure to the Haemophilus influenzae type b (Hib) conjugate vaccines' carrier proteins would enhance immune responses to subsequent administrations of HbOC or PRP-tetanus toxoid conjugate (PRP-T) at 2, 4, and 6 months of age. Their antibody responses were compared with those of 100 children immunized with HbOC or PRP-T beginning at 2 months of age. No serious adverse reactions were associated with neonatal vaccination. Administration of HbOC at birth did not lead to earlier or higher antibody levels. Newborn immunization with DT did not prime children for enhanced antibody responses. Moreover, Hib antibody levels were lower in DT-primed children than in children immunized beginning at 2 months of age. Diphtheria antibody levels, but not tetanus antibody levels, were also lower in children immunized with DT at birth. We conclude that neonatal immunization with Hib conjugate vaccines is not a means to provide earlier protection against invasive Hib disease. Newborn DT administration does not enhance subsequent antibody responses to Hib conjugate vaccines, and may lead to suppression of Hib and diphtheria antibody responses.
我们随机将150名新生儿分为两组，一组在出生时接种白喉破伤风类毒素（DT），另一组接种b型流感嗜血杆菌寡糖结合疫苗（HbOC），以确定接触b型流感嗜血杆菌（Hib）结合疫苗的载体蛋白是否会增强在2、4和6月龄时后续接种HbOC或破伤风类毒素结合疫苗（PRP-T）后的免疫反应。将他们的抗体反应与100名从2月龄开始接种HbOC或PRP-T的儿童的抗体反应进行比较。新生儿接种疫苗未出现严重不良反应。出生时接种HbOC并未导致抗体水平提前升高或升高幅度更大。出生时接种DT的新生儿未对增强抗体反应产生预激发作用。此外，接种DT的儿童的Hib抗体水平低于从2月龄开始接种疫苗的儿童。出生时接种DT的儿童的白喉抗体水平较低，但破伤风抗体水平未见降低。我们得出结论，新生儿接种Hib结合疫苗并非提供针对侵袭性Hib疾病早期保护的手段。新生儿接种DT不会增强随后对Hib结合疫苗的抗体反应，反而可能导致Hib和白喉抗体反应受到抑制。
