| 龚健,李翠云,董柏青,黄景枝,权怡,陆万专,罗成慧,毛伟成,廖和壮,方锦嵩,崔萱林,谢贵林,吴兴华,蓝荣伟.A+C群脑膜炎球菌多糖疫苗在C群流脑暴发中应急接种效果的研究[J].中华流行病学杂志,2008,29(6):552-555 |
| A+C群脑膜炎球菌多糖疫苗在C群流脑暴发中应急接种效果的研究 |
| Effectiveness of an immunization campaign with group A and C meningococcal polysaccharide vaccine in controlling an outbreak of group C meningococcal disease |
| 收稿日期:2008-01-31 出版日期:2014-09-18 |
| DOI：10.3321/j.issn:0254-6450.2008.06.009 |
| 中文关键词: 流行性脑脊髓膜炎|疫苗|应急接种|保护效果 |
| 英文关键词: Meningococcal meningitis|Vaccine|Vaccination campaign|Efficacy |
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| 中文摘要: |
| 目的 报告A+C群脑膜炎球菌多糖疫苗(A+C群MPV)在C群流行性脑脊髓膜炎(流脑)暴发疫情中应急接种的安全性、免疫原性和保护效果．方法 在2002年广西来宾市发生C群流脑局部暴发接种A群MPV人群中约6周后应急接种A+C群MPV，观察接种对象局部和全身反应．选择疫点人群71人和非疫点人群43人于应急接种前和接种后1个月采血，用ELISA检测脑膜炎球菌C群和A群多糖抗体IgG．随访接种人群流脑发病情况至免疫后5年．结果 A+C群MPV应急接种率为97%，接种后未观察到严重不良反应．疫点人群、非疫点人群、应急接种前C群抗体阴性者和阳性者的C群流脑抗体阳性率为97.67%～100%，几何平均浓度(GMC)为30.81～37.44 μg/ml，各组人群抗体水平差异无统计学意义．流脑罹患率在及时接种学校(218.58/10万)比不及时接种学校(705.72/10万)减少69.02%．接种人群随访15 760人年未发现流脑临床确诊病例．结论 国产A+C群MPV应急接种可成功扑灭C群流脑暴发疫情，与A群MPV仅间隔6周接种仍然安全，对易感人群可诱导产生高水平的特异性抗体，对已有抗体者可显著提高抗体水平，保护效果至少持续5年． |
| 英文摘要: |
| Objective To assess the safety, immunogenicity and efficacy of group A and C meningococcal polysaccharide vaccine (A/C MPV) in response to an outbreak of group C meningococcal disease. Methods A vaccination campaign with A/C MPV was prompted 6 weeks after the use of group A MPV in Laibin city, Guangxi, where an outbreak of group C meningococcal meningitis occurred in 2002.Vaccinees were observed for local and systemic reactions after the vaccination and followed up for the meningococcal disease for 5 years. Blood samples were collected from 71 people in the epidemic and 43 in the non-epidemic areas before and 1 month after the vaccination and examined by ELISA to detect IgG antibodies to group A and C polysaccharides. Results The vaccination coverage was 97%. No significant adverse reactions were observed. The positive rates of group C antibodies after vaccination was between 97.67% and 100% among the populations in the epidemic and non-epidemic areas, as well as among those negative and positive for group C antibodies prior to the vaccination.The geometric mean anti-C concentrations ranged 30.81 μg/ml to 37.44 μg/ml, showing no significant difference between groups. The incidence rate of meningococcal disease in students with timely immunization (218.58/100 000) dropped by 69.02% , when compared to that in those with delayed immunization (705.72/100 000). No clinical cases were identified during the follow-up period of 15 760 person-years. Conclusion The vaccination campaign with the Chinese group A/C MPV seemed successful in controlling the group C meningococcal outbreak.The vaccine was shown to be safe even administered after the group A vaccine only 6 weeks apart. It could induce high levels of antibodies in vulnerable population and significantly increase antibody levels in seropositive individuals, thus providing a protection of at least 5 years. |
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