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全球直接面向患者(DTP)药品生产能力与水平。现状报告:1995年1月

Global DTP manufacturing capacity and capability. Status report: January 1995.

作者信息

Milstien J B, Gellin B G, Kane M, di Fabio J L, Homma A

机构信息

Global Programme for Vaccines and Immunization, World Health Organization, Geneva, Switzerland.

出版信息

Vaccine. 1996 Mar;14(4):313-20. doi: 10.1016/0264-410x(95)00181-y.

Abstract

A recently completed survey of 63 manufacturers of diphtheria-tetanus-pertussis (DTP) vaccine and its components in 42 countries shows that there is potentially a large excess installed capacity for DTP production. However, many manufacturers are not producing to capacity, and demand and supply for this vaccine are not matched in individual countries. About half of all countries producing DTP vaccine and its components do not have fully functional national control systems, and some countries are performing none of the critical functions for an effective control of quality. Thus, potential for export of excess capacity is limited. The data collected indicate much homogeneity in the preparation of diphtheria and tetanus toxoids. Nearly all manufacturers use the same seeds and similar purification methods, but there is variability in whether purification is done before or after conversion of toxin to toxoid. About 10% of all manufacturers do not meet WHO-defined standards of purity for these toxoids. There is much more heterogeneity in the pertussis seed strains and the methods of purification used. The formulation of DTP vaccine differs considerably among producers. Potency testing is not being done by the WHO-recommended method by about 50% of manufacturers on lots of diphtheria and tetanus toxoids for release. Testing of irreversibility of conversion of toxin to toxoid, a WHO-specified safety test, is also not being done on each lot of diphtheria toxoid by 15% of manufacturers surveyed nor on each lot of tetanus toxoid vaccine by 30% of manufacturers surveyed. Access to technology to develop new DTP-based combination vaccines will be delayed if these manufacturers cannot ensure consistent high quality vaccine for their target populations. The results and conclusions suggest areas for future activities to strengthen the supply and quality of DTP and DTP-based combination vaccines.

摘要

最近对42个国家的63家白喉-破伤风-百日咳(DTP)疫苗及其成分生产商进行的一项调查显示,DTP生产的潜在产能过剩情况严重。然而,许多生产商并未满负荷生产,而且在个别国家,该疫苗的供需并不匹配。在所有生产DTP疫苗及其成分的国家中,约有一半没有功能齐全的国家控制系统,一些国家甚至没有执行有效质量控制所需的任何关键职能。因此,产能过剩的出口潜力有限。收集到的数据表明,白喉和破伤风类毒素的制备方法具有很大的同质性。几乎所有生产商都使用相同的种子和类似的纯化方法,但在毒素转化为类毒素之前还是之后进行纯化存在差异。约10%的生产商不符合世卫组织规定的这些类毒素纯度标准。百日咳种子菌株和所用纯化方法的异质性要大得多。不同生产商生产的DTP疫苗配方差异很大。约50%的生产商在放行白喉和破伤风类毒素批次时未采用世卫组织推荐的效力测试方法。在接受调查的生产商中,15%的生产商未对每批白喉类毒素进行毒素转化为类毒素不可逆性的测试(这是世卫组织规定的一项安全性测试),30%的生产商未对每批破伤风类毒素疫苗进行此项测试。如果这些生产商不能确保为目标人群提供质量始终如一的高质量疫苗,开发新型基于DTP的联合疫苗的技术获取将被推迟。这些结果和结论表明了未来加强DTP及基于DTP的联合疫苗供应和质量的活动领域。

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