关键词： 脊髓灰质炎   灭活疫苗   减毒疫苗   序贯免疫   剂型  

摘要： 目的比较Sabin株脊髓灰质炎灭活疫苗(Sabin strain-based inactivated poliovirus vaccine,sIPV)与不同剂型Ⅰ型Ⅲ型脊髓灰质炎减毒活疫苗(bivalent typesⅠand Ⅲoral poliovirus vaccine,bOPV)序贯接种的抗体滴度。方法选择柳州400名2月龄婴儿,按1∶1∶1∶1随机分为sIPV+2bOPV糖丸、sIPV+2bOPV液体、2sIPV+bOPV糖丸、2sIPV+bOPV液体4组,按0 d、28d、56 d免疫程序接种疫苗。检测免前、免后28 d脊灰中和抗体滴度。结果序贯程序相同时,1剂sIPV糖丸组与液体组免后Ⅰ型抗体滴度分布差异有统计学意义(Z=-2. 589,P=0. 010),Ⅱ型(Z=-0. 331,P=0. 741)和Ⅲ型(Z=-1. 556,P=0. 120)差异均无统计学意义(均有P> 0. 05); 2剂sIPV糖丸组与液体组免后Ⅰ型(Z=-1. 249,P=0. 212)、Ⅱ型(Z=-1. 658,P=0. 097)和Ⅲ型(Z=-1. 436,P=0. 151)抗体滴度分布差异均无统计学意义(均有P> 0. 05)。剂型相同时,2剂sIPV组与1剂sIPV组各型抗体滴度分布差异均有统计学意义(均有P <0. 05)(1剂sIPV液体组与2剂sIPV液体组:Ⅰ型:Z=-2. 766,P=0. 006;Ⅱ型:Z=-9. 137,P <0. 001;Ⅲ型:Z=-5. 529,P <0. 001。1剂sIPV糖丸组与2剂sIPV糖丸组:Ⅰ型:Z=-3. 748,P <0. 001;Ⅱ型:Z=-7. 660,P <0. 001;Ⅲ型:Z=-6. 030,P <0. 001)。结论 bOPV糖丸和液体剂型免疫效果相似,各地接种部门应结合疫苗效果、接种对象特征和人口密度,选择适宜剂型接种;如sIPV供应充足,建议优先选择2剂sIPV序贯程序完成脊灰基础免疫接种。

关键词： Polio eradication   Binding inhibition ELISA   IgY   Neutralization test  

摘要： The first application results of enzyme immunoassay system (ELISA) - binding inhibition ELISA (BI ELISA) for the detection of antibodies to polioviruses of three types based on the use of specific antibodies from chicken yolk (IgY) are presented. This variant of ELISA is a "surrogate" neutralization test (NT). When comparing the results of the detection of antibodies in 90 sera of children who were vaccinated with oral and inactivated poliovirus vaccines, good correlation (r = 0.67, 0.61, 0.76 for types 1, 2, 3 respectively) between the BI ELISA and the NT results was shown. The presented variant of ELISA is the further stage of the development of "IgY-technology" for laboratory diagnostics of viral infections, namely poliovirus infection, which can be used for seroepidemiological studies as an analogue of the NT which requires the use of life poliovirus with the required standard of biosafety containment facilities.

关键词： Polio   Sabin-derived inactivated poliovirus vaccine   Routine immunization   Vaccination coverage   Seroprevalence  

摘要： In Japan, the oral poliovirus vaccine (OPV) was changed to 2 types of inactivated poliovirus vaccine (IPV), the standalone conventional IPV (cIPV) and the Sabin-derived IPV combined with diphtheria-tetanus-acellular pertussis vaccine (DTaP-sIPV), for routine immunization in 2012. We evaluated polio vaccination coverage and the seroprevalence of poliovirus antibodies using data from the National Epidemiological Surveillance of Vaccine-Preventable Diseases (NESVPD) from 2011 to 2015. Several years before the introduction of IPV in 2012, OPV administration for children was refused by some parents because of concerns about the risk of vaccine-associated paralytic poliomyelitis. Consequently, in children aged <1 years who were surveyed in 2011-2012, polio vaccination coverage (45.0-48.8%) and seropositivity rates for poliovirus (type 1: 51.7-65.9%, type 2: 48.3-53.7%, and type 3: 15.0-29.3%) were decreased compared to those surveyed in 2009. However, after IPV introduction, the vaccination coverage (95.5-100%) and seropositivity rates (type 1: 93.2-96.6%, type 2: 93.1-100%, and type 3: 88.6-93.9%) increased among children aged <1 years in 2013-2015. In particular, seropositivity rates and geometric mean titers (GMTs) for poliovirus type 3 in <5-year-old children who received 4 doses of IPV (98.5% and 247.4, respectively) were significantly higher than in those who received 2 doses of OPV (72.5% and 22.9, respectively). Furthermore, in <5-year-old children who received 4 doses of either DTaP-sIPV or cIPV, the seropositivity rates and the GMTs for all 3 types of poliovirus were similarly high (96.5-100% and 170.3-368.8, respectively). Our findings from the NESVPD demonstrate that both the vaccination coverage and seropositivity rates for polio remained high in children after IPV introduction. (C) 2019 Elsevier Ltd. All rights reserved.

关键词： Immunization   Coverage   Timeliness   Immunization   Coverage   Timeliness  

摘要： Objective: To systematically review literature on uptake and timeliness of diphtheria-tetanus-pertussis, measles-mumps-rubella, and/or polio-containing vaccines in infants who were born preterm, with a low birth weight, and/or with chronic health conditions that were diagnosed within the first 6 months of life. Methods: Using a standardized search strategy developed by a medical librarian, records were extracted from MEDLINE, Embase, Database of Abstracts of Reviews of Effects, and CINAHL up to May 8, 2018. Results: Out of the 1997 records that were screened, we identified 21 studies that met inclusion criteria. Eleven studies assessed vaccine coverage and/or timeliness in preterm infants, 6 in low birth weight infants, and 7 in children with chronic health conditions. Estimates of coverage in these populations were highly variable, ranging from 40% to 100% across the vaccines and population groups. Conclusions: There is a lack of studies reporting coverage and timeliness of routine immunizations in special populations of children. Policy implications: Our review suggests a need for improved surveillance of immunization status in special populations of infants, as well as a need for standardization of reporting practices. (C) 2019 The Authors. Published by Elsevier Ltd.

关键词： Afghanistan   Poliovirus   Serosurvey   Eradication   Immunity  

摘要： Background: Afghanistan remains among the three countries with endemic wild poliovirus transmission, and high population immunity levels are required to interrupt transmission and prevent outbreaks. Surveillance and vaccination of children in Afghanistan have been challenging due to security issues limiting accessibility in certain areas. Methods: A serosurvey was conducted in 2013 within accessible enumeration areas (EAs) among children aged <5 years using samples collected for a national micronutrient assessment survey to assess poliovirus immunity in Afghanistan. Of 21194 total EAs in Afghanistan, 107 were inaccessible and therefore were excluded from the sampling frame. Results: Population immunity was high overall but varied for the poliovirus serotypes, and was lowest for type 3 (95% [95% CI: 93%, 96%]) compared to type 1 (99% [95% CI:97%, 99%]) and type 2 (98% [95% CI:96%, 99%]). The proportion of the population immune to all three types was 93% (95% CI: 91%, 95%), and the proportion seronegative for all three types was 0.5% (95% CI: 0.2%, 1.7%). Conclusion: Except for regional differences in immunity to type 3 virus, there were no other apparent differences in seroprevalence by region or by any of the demographic or nutritional characteristics assessed in this study. The study was not powered to provide provincial level seroprevalence estimates, but Paktika Province, in the South region, had the largest proportion of seronegative specimens for type 1 (4 seronegative of 17 serum specimens compared to 14 seronegative of 673 for the remainder of the areas). Among accessible children in Afghanistan, seroprevalence of antibodies to poliovirus was high, with most seroprevalence reported at 95% or greater. Despite high seroprevalence in areas assessed in this study, the continued detection of poliovirus cases in the South and East regions indicate that overall regional vaccination coverage and performance is not sufficient to stop polio transmission. Published by E

摘要： Widespread use of live attenuated (Sabin) oral poliovirus vaccine (OPV) has resulted in marked progress toward global poliomyelitis eradication (1). However, in underimmunized populations, extensive person-to-person transmission of Sabin poliovirus can result in genetic reversion to neurovirulence and paralytic vaccine-derived poliovirus (VDPV) disease (1). This report updates (as of February 26, 2019) previous reports on circulating VDPV type 2 (cVDPV2) outbreaks during 2017-2018 in the Democratic Republic of the Congo (DRC) and in Somalia, which experienced a concurrent cVDPV type 3 (cVDPV3) outbreak* (2,3). In DRC, 42 cases have been reported in four cVDPV2 outbreaks; paralysis onset in the most recent case was October 7, 2018 (2). Challenges to interrupting transmission have included delays in outbreak-response supplementary immunization activities (SIAs) and difficulty reaching children in all areas. In Somalia, cVDPV2 and cVDPV3 were detected in sewage before the detection of paralytic cases (3). Twelve type 2 and type 3 cVDPV cases have been confirmed; the most recent paralysis onset dates were September 2 (cVDPV2) and September 7, 2018 (cVDPV3). The primary challenge to interrupting transmission is the residence of >300,000 children in areas that are inaccessible for vaccination activities. For both countries, longer periods of surveillance are needed before interruption of cVDPV transmission can be inferred.

关键词： 卡介苗   预防接种   脊髓灰质炎减毒活疫苗   儿童  

摘要： 目的:研究儿童预防接种副反应的原因及其应对策略,供临床借鉴。方法:以2017年4月至2018年3月龙川县疾病预防控制中心各乡镇卫生院接诊的预防接种儿童11000名为研究对象,并按照疫苗操作的规程要求和免疫程序对所选儿童进行接种,充分了解儿童接种副反应的发生情况,并经分析后找到副反应产生的原因,同时提出相应的解决对策。结果:本研究11000名接种儿童中有8例在接种后发生副反应,当中有3例在接种脊髓灰质炎减毒活疫苗(OPV)后发生副反应,有4例在接种百白破混合制剂(DPT)后发生副反应,有1例在接种卡介苗(BCG)后发生副反应。对于月龄为6～12个月的儿童,其在预防接种后最容易发生副反应。接种副反应最常发生在5～9月份,有5例(62.5%),1～4月份有2例(25.0%),11月份有1例(12.5%)。一般性反应有4例(50.0%),在通过常规的反应处理后,症状自行消失;加重反应有3例(37.5%),异常反应有1例(12.5%)。结论:儿童接种疫苗后有可能会发生副反应,特别是对于年龄小于2岁的儿童来说,其发生疫苗接种副反应的概率更高。故临床应积极采取有效的措施对预防接种儿童进行干预,以尽可能的减少其副反应发生的风险,提高疫苗接种效果。

关键词： 脊髓灰质炎   Sabin   IPV病毒   纯化   凝胶层析   离子层析   柱效  

摘要： 目的:建立Sabin株脊髓灰质炎灭活疫苗(Vero细胞)病毒浓缩液(s IPV)纯化层析柱柱效。方法:连续对3个批次Sabin s IPV病毒的纯化工艺的凝胶层析柱和离子层析柱的柱效进行检测并分析其柱效值,检测两种层析获得的病毒纯化液的D抗原、总蛋白含量、比活性及纯度。结果:通过对连续3个批次的s IPV病毒纯化工艺的监测,建立凝胶层析柱的柱效不低于3 605 N/m,离子层析柱的柱效不低于2 222 N/m,凝胶柱效值>离子柱的柱效值,连续3批检测D抗原和总蛋白含量稳定,比活性为78～86 DU/μg,纯度为100%。结论:建立的层析柱柱效获得的病毒纯化液质量稳定。

关键词： 脊髓灰质炎疫苗   疑似预防接种异常反应   安全性  

摘要： 目的分析二价脊髓灰质炎减毒活疫苗(bivalent oral live attenuated poliomyelitis vaccine,bOPV)、三价脊髓灰质炎减毒活疫苗(trivalent oral live attenuated poliomyelitis vaccine,t OPV)及脊髓灰质炎灭活疫苗(inactivated polio-virus vaccine,IPV)疑似预防接种异常反应(Adverse Events Following Immunization,AEFI)发生情况,评价bOPV安全性。方法收集大连市2009～2017年所有疫苗(包括第一类和第二类疫苗)的AEFI报告病例数和疫苗接种剂次,采用描述性流行病学方法进行统计分析。结果 bOPV发生AEFI 19例(男性8例,女性11例,男女发病比例为0. 73∶1),报告发生率为6. 88/10万,低于全部疫苗的平均报告发生率,高于t OPV,差异均有统计学意义(P <0. 05),与IPV-Salk相比,差异无统计学意义(P> 0. 05);11例发生在接种1 d内,7例发生在接种1 d后,1例发生在接种15 d后,其中一般反应18例,异常反应1例,发生严重异常反应的报告发生率为0. 36/10万,与全部疫苗和t OPV发生严重异常反应的报告发生率相比,差异无统计学意义(P> 0. 05)。结论 b OPV的AEFI发生率高于t OPV,低于全部疫苗,疫苗有较高的安全性。