Fishbein D B, Yenne K M, Dreesen D W, Teplis C F, Mehta N, Briggs D J
Viral and Rickettsial Zoonoses Branch, Centers for Disease Control, Atlanta, GA 30333.
Vaccine. 1993 Nov;11(14):1390-4. doi: 10.1016/0264-410x(93)90167-v.
To determine the incidence of and risk factors for adverse reactions following the boosters, we conducted a nationwide prospective study of persons receiving pre-exposure booster vaccination with human diploid cell rabies vaccine (HDCV). Persons who had previously received three pre-exposure doses of HDCV and whose rabies neutralizing antibody titres were < or = 1:5 were enrolled in the study if they stated that they intended to receive a booster. Of the 98 persons enrolled in the study, 40 (41%) were in risk groups for whom boosters are not recommended. Three (3%) of 98 developed generalized urticaria or wheezing within 1 day of receiving boosters and three others (3%) developed urticaria 6 to 14 days after the booster. No differences were found between individuals with reactions (either type) and those with no adverse reaction according to age, gender, occupation, history of previous allergies, or time since or route of primary vaccination. Reactions were somewhat more common among persons who received primary vaccinations by the intramuscular route (i.m.) and booster vaccinations by the intradermal route (i.d.) (3/15, 20%) or primary vaccinations i.d. and booster vaccinations i.m. (2/10, 20%), and somewhat less common among persons who received both these vaccinations i.d. (1/52, 2%) or i.m. (0/7). The number of persons who develop allergic reactions may be minimized by administering vaccinations only when vaccination is strictly indicated. The influence of the route of primary and booster vaccinations on the development of reactions deserves further study.
为了确定加强免疫后不良反应的发生率及危险因素，我们对接受人二倍体细胞狂犬病疫苗（HDCV）暴露前加强免疫的人群开展了一项全国性前瞻性研究。之前已接种3剂次HDCV暴露前疫苗且狂犬病中和抗体滴度≤1:5的人群，若表示打算接受加强免疫，则纳入本研究。在纳入研究的98人中，40人（41%）属于不建议进行加强免疫的风险组。98人中有3人（3%）在接受加强免疫后1天内出现全身性荨麻疹或喘息，另有3人（3%）在加强免疫后6至14天出现荨麻疹。根据年龄、性别、职业、既往过敏史或初次接种后的时间及接种途径，有反应者（任何一种类型）与无不良反应者之间未发现差异。在接受肌内注射（i.m.）进行初次接种和皮内注射（i.d.）进行加强免疫的人群中（3/15，20%），或初次接种采用皮内注射、加强免疫采用肌内注射的人群中（2/10，20%），反应更为常见，而在初次接种和加强免疫均采用皮内注射的人群中（1/52，2%）或均采用肌内注射的人群中（0/7），反应则相对较少见。仅在严格有接种指征时进行接种，可将发生过敏反应的人数降至最低。初次接种和加强免疫的途径对反应发生的影响值得进一步研究。
