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[白喉、破伤风、百日咳杆菌和乙型肝炎四联疫苗:西班牙的经验]

[Quadrivalent vaccine against diphtheria, tetanus, B. pertussis and hepatitis B: experience in Spain].

作者信息

González López A, Arístegui Fernández J, Díez-Delgado J, Dal-Ré Saavedra R

机构信息

Departmento Médico, SmithKline Beecham Pharmaceuticals, Madrid, España.

出版信息

An Esp Pediatr. 1998 Feb;48(2):132-7.

PMID:9577019
Abstract

OBJECTIVE

The objective of this study was to perform a pooled analysis of the immunogenicity and reactivity results obtained in 2 trials carried out in Spain with a combined DTP-HB vaccine.

PATIENTS AND METHODS

Vaccine was administered according to one of two existing vaccination schedules: 2-4-6 and 3-5-7 months of age. Blood samples for antibody determination were obtained 3-6 weeks after the third dose. Anti-diphtheria, anti-tetanus and anti- B. pertussis antibodies were measured by ELISA and anti-HB by radioimmunoassay. Local and general signs and symptoms were recorded by the parents on diary cards for a 4-day follow-up period after each vaccination.

RESULTS

A total of 231 infants received three doses of DTP-HB vaccine. All of these doses were accompanied by the corresponding diary card (693 data points for the evaluation of reactogenicity). Two-hundred and nineteen subjects ere included in the analysis of immunogenicity. After the full vaccination course, all subjects had sero-protective titers against diphtheria, tetanus and hepatitis B and were sero-positive of B. pertussis. Geometric mean titers of anti-HB antibodies was 1986 mIU/ml. Pain at the injection site (64%) and unusual crying (71.5%) were the most frequently reported local and general symptoms, respectively. Fever (rectal temperature > or = 38 degrees C) was reported after 46% of the doses, but was considered as severe (> 39.5 degrees C) only in 5 cases.

CONCLUSIONS

These results show that this combined DTP-HB vaccine induced a strong immune response to all vaccine components. The safety profile of this DTP-HB is similar to that of classical DTP vaccines.

摘要

目的

本研究的目的是对在西班牙进行的两项关于联合白喉-破伤风-百日咳-乙肝疫苗试验中获得的免疫原性和反应性结果进行汇总分析。

患者和方法

疫苗按照两种现有接种程序之一进行接种:2、4、6月龄和3、5、7月龄。在第三剂接种后3至6周采集用于抗体测定的血样。通过酶联免疫吸附测定法检测抗白喉、抗破伤风和抗百日咳博德特氏菌抗体,通过放射免疫测定法检测抗乙肝抗体。每次接种后,家长在日记卡上记录4天随访期内的局部和全身体征及症状。

结果

共有231名婴儿接种了三剂白喉-破伤风-百日咳-乙肝疫苗。所有这些剂量都附有相应的日记卡(用于评估反应原性的693个数据点)。219名受试者纳入免疫原性分析。在全程接种疫苗后,所有受试者对白喉、破伤风和乙肝均具有血清保护滴度,并且百日咳博德特氏菌血清学阳性。抗乙肝抗体的几何平均滴度为1986 mIU/ml。注射部位疼痛(64%)和异常哭闹(71.5%)分别是最常报告的局部和全身症状。46%的剂量接种后报告有发热(直肠温度≥38℃),但仅5例被认为是严重发热(>39.5℃)。

结论

这些结果表明,这种联合白喉-破伤风-百日咳-乙肝疫苗对所有疫苗成分均诱导了强烈的免疫反应。这种白喉-破伤风-百日咳-乙肝疫苗的安全性与经典白喉-破伤风-百日咳疫苗相似。

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