文章摘要
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
基金项目:
作者单位
龚健 广西壮族自治区疾病预防控制中心, 南宁 530028 
李翠云 广西壮族自治区疾病预防控制中心, 南宁 530028 
董柏青 广西壮族自治区疾病预防控制中心, 南宁 530028 
黄景枝 广西壮族自治区来宾市疾病预防控制中心 
权怡 广西壮族自治区疾病预防控制中心, 南宁 530028 
陆万专 广西壮族自治区来宾市疾病预防控制中心 
罗成慧 海南省卫生学校 
毛伟成 广西壮族自治区来宾市疾病预防控制中心 
廖和壮 广西壮族自治区疾病预防控制中心, 南宁 530028 
方锦嵩 广西壮族自治区疾病预防控制中心, 南宁 530028 
崔萱林 兰州生物制品研究所 
谢贵林 兰州生物制品研究所 
吴兴华 广西壮族自治区疾病预防控制中心, 南宁 530028 
蓝荣伟 广西壮族自治区来宾市疾病预防控制中心 
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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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