| 庄防成,毛子安,姜立民,吴洁,陈悦青,姜器,陈念良,柴少爱,毛江森.甲型肝炎减毒活疫苗(H2株)一针接种后免疫保护效果的15年观察[J].Chinese journal of Epidemiology,2010,31(12):1332-1335 |
| 甲型肝炎减毒活疫苗(H2株)一针接种后免疫保护效果的15年观察 |
| Long．term immunogencity and effectiveness of live attenuated hepatitis A vaccine(H2-strain) a study on the result of 15 years'follow up |
| Received:March 18, 2010 |
| DOI：10.3760/emaj.issn.0254-6450.2010.12.002 |
| KeyWord: 甲型肝炎疫苗 免疫持久性 流行病学效果 |
| English Key Word: Hepatitis A vaccine Long-term immunogencity Epidemiological effectivness |
| FundProject:九五”国家科技攻关课题(030101) |
| Author Name | Affiliation | E-mail | | Zhuang Fangcheng | Institute of Viral Disease,Zhejiang Academy of Medical Sciences,Hangzhou 310013 China | fczhuang@163.com | | Mao Zian | Institute of Viral Disease,Zhejiang Academy of Medical Sciences,Hangzhou 310013 China | | | Jiang Limin | Institute of Viral Disease,Zhejiang Academy of Medical Sciences,Hangzhou 310013 China | | | Wu Jie | Institute of Viral Disease,Zhejiang Academy of Medical Sciences,Hangzhou 310013 China | | | Chen Yueqing | Institute of Viral Disease,Zhejiang Academy of Medical Sciences,Hangzhou 310013 China | | | Jiang Qi | Jiaojiang Center for Disease Control and Prevention.Taizhou city. Zhejiang Province | | | Chen Nianliang | Institute of Viral Disease,Zhejiang Academy of Medical Sciences,Hangzhou 310013 China | | | Chai Shaoai | Institute of Viral Disease,Zhejiang Academy of Medical Sciences,Hangzhou 310013 China | | | Mao Jiangsen | Institute of Viral Disease,Zhejiang Academy of Medical Sciences,Hangzhou 310013 China | |
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| Abstract: |
| 目的评估甲型肝炎(甲肝)减毒活疫苗(H2株)一针接种后的15年血清学和流行病学保护效果.方法在浙江省台州市椒江区选择220名免前抗甲肝抗体阴性儿童(年龄1—3岁作为血清免疫学追踪观察对象,分别于接种H2株疫苗后的2个月、12个月、6年、lO年和15年观察抗甲肝抗体阳性率和几何平均滴度(GMT).分析该观察区l—15岁儿童组疫苗接种率和甲肝发病率之间的关系及整个人群15年流行病学效果观察.血清学检测方法采用ELISA法(用WHO标准品校正)和ABBOTT(美国)AxSYM mEIA法.结果在血清学追踪观察人群中疫苗接种后2个月和接种后15年,抗体阳转率分别为98.6%和81.3%,抗体阳转率下降缓慢;15年后抗一的GMT为128 mIU/ml,显著高于WHO专家建议的20 mIU/ml保护水平.随着疫苗接种率的逐年提高,l—15岁年龄组儿童的甲肝发病率明显下降,二者之间有非常明显的相关性(Kendall.相关性检验,t=一0.931,P<0.01).疫苗接种者连续15年累计观察236 413人年,未发生一例甲肝;而未接种者累计观察27 206人年,发生甲肝4例,疫苗保护率为100%;儿童大规模免疫接种为整个人群建立了良好免疫屏障,甲肝发病率下降幅度达96.7%.结论甲肝减毒活疫苗(H2株)一针接种后的血清学和流行病学保护效果持久,可达15年. |
| English Abstract: |
| Objective To evaluate the long-term immunogencity and effectiveness of live attenuated hepatitis A(HA)vaccine(H2 strain)after one dose injection，through a 15 years'follow up observation．Methods A total of 220 children with negative anti—HAV antibody(aged l一3 y) were involved and followed up in Jiaojiang district，Taizhou city，Zhejiang province．Indicators would include seroconversion and geometric meantiter(GMT)levels after inoculation the vaccine with single dose at 2 m，12 m，6 years，10 years and 15 years．Epidemiological observation was carried out within the l 5 years tO evaluate the relationship between vaccine coverage，the incidence of HA and the overall effectiveness．In the studied population，serum was tested by ELlSA(calibrated by WHO international reference)and ABBOTT Axsym HAVAB.Results Seroconversion rates were found to be 98．6％and 8 1．3％after 2 months and 15 years of inoculation and slowly decreased．GMT level was 128 mIU/ml after 15 years．significantly higher than the required protective level of 20 mIU/ml， recommended bv WHO experts．Effectiveness through the l 5-year follow up program showed a significant correlation between vaccine coverage and incidence of HA in 1-15 years aged group (Kendall．Rank test．T=一0．931．P<0．01)．There was no HA case seen among the observed accumulated 236 413 person．year Vaccines．compared to 4 HA cases discovered in the 27 206 personyear of the non．vaccinees．The overall protective rate reached 100％．Through a mass vaccination program on children．the whole population established all incidence-defence to enable the incidence of HA decreased bv 96．7％．Conclusion The long-term immunogencity and effectiveness of live attenuatedhepatitisAvaccine(H2 strain)afteronedoseinjection couldlast aslong as 15 years． |
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