5～60岁人群伤寒Vi多糖疫苗和A群脑膜炎球菌多糖疫苗大规模接种结果分析

为考核国产伤寒Vi多糖疫苗在现场试验的效果 ,以A群脑膜炎球菌多糖疫苗为对照 ,对广西壮族自治区河池市城市和农村的 5～ 6 0岁居民进行了一次大规模接种。结果显示 :应接种对象 1180 71人 ,实际接种 92 4 76人 ,接种率为 78 32 % ,其中伤寒Vi多糖疫苗为 76 87% ,A群脑膜炎球菌多糖疫苗为 79 6 9% ;接种率最高的组群接种率为 92 4 8% ,最低为 6 5 2 0 %。按城乡划分 ,城区的接种率为 77 2 9% ,农村的接种率为 80 5 8% ,组群接种率的高低分布无明显的地理性差异。 5～ 9岁接种率最高为 89 6 5 % ,2 0～ 2 9岁接种率最低为 6 9 0 7% ;男女接种率分别为79 0 7%和 82 11%。有 6 6人被观察到或报告出现不良反应 ,不良反应发生率为 71 37/ 10万。表明两种疫苗的安全性好。在大规模疫苗接种中 ,充分发挥当地干部的宣传组织作用 ,并把接种的有关信息提前通知当地居民 ,对于提高接种率十分重要。补漏接种能使接种率低的组群得到显著的提高。在大规模疫苗接种中必须严格遵守安全注射操作程序 ,避免发生不安全注射事故。两种疫苗的平均接种率、年龄别接种率、性别接种率、组群接种率的地理分布均达到了较好均衡性 ,是可比的 ,为今后考核疫苗效果提供了良好的现场背景     

大规模疫苗接种一般副反应调查

对中国兰州生物制品研究所制备的伤寒Vi疫苗进行接种副反应调查，并以A群流脑疫苗作为对照，对92467名接种者的副反应调查结果表明，伤寒Vi疫苗组副反应发生率为59．01／10万，流脑疫苗组发生率为82．60／10万，2个疫苗接种组一般副反应发生率无显著性差异。伤寒Vi疫苗组共出现16种症状38人次，主要症状为发热占21.05％、皮疹占18．92％、头晕占18．92％；流脑疫苗组出现25种症状91人次，排前3位的是发热占18．68％、头晕9.89％、冷汗7．69％。认为伤寒Vi疫苗副反应轻微，安全性好，是一种群众愿意接受，特别是欠发达地区值得推广的疫苗。     

A+C群脑膜炎球菌多糖疫苗安全性评估

目的 评估A＋C群脑膜炎球菌多糖疫苗的安全性。方法 以A＋C群脑膜炎球菌多糖疫苗为观察组，伤寒Vi多糖疫苗为对照组，按整群随机分层配对的原则，将研究现场分为108个组群，观察组和对照组各分配54个组。对两组同时建立接种反应监测系统，按统一表格和方法对两组的接种反应进行监测、记录，并进行流行病学调查。结果 两组共接种34543人，其中A＋C群脑膜炎球菌多糖疫苗接种18167人，伤寒Vi疫苗接种16376人。A＋C群脑膜炎球菌多糖疫苗速发接种反应率为0．44‰，一般接种反应率为0．38％o；伤寒Vi疫苗速发接种反应率为0．79％，一般接种反应率为0．73％o；跟踪随访接种反应对象共1239人，其中接种A＋C群脑膜炎球菌多糖疫苗的771人，接种伤寒Vi疫苗的468人。接种后第1天，A＋C群脑膜炎球菌多糖疫苗组的局部反应发生率要明显高于伤寒Vi疫苗（X^2。=13．98，P=0．0002）；接种后第2—3天局部反应和全身反应的发生率，两组差异无统计学意义；两组各自接种人群和未接种人群发热发生率的差异无统计学意义，两组已接种人群的发热发生率差异也无统计学意义；两组均未发现严重反应。结论 A＋C群脑膜炎球菌多糖疫苗与伤寒Vi疫苗均可在不同年龄组人群开展大规模接种，局部及全身接种反应轻微，接种反应率低，有良好的安全性。     

河北省肾综合征出血热高发乡镇疫苗接种效果评价

目的评价肾综合征出血热（HFRS）双价疫苗防病效果。方法选择HFRS高发乡镇为疫苗接种试点，接种对象为16～60岁人群，要求以接种的自然村为单位，疫苗接种率达到70％以上。采用间接免疫荧光法对人群免疫前后IgG抗体水平检测，了解抗体阳转情况。在其他因素不变的情况下，观察疫苗干预前后对HFRS的防病效果。结果（1）接种率：16～60岁人群应接种29088人，2针疫苗实际接种22821人，接种率78．46％，其中滦南县接种人群的接种率最高为90．37％，抚宁县最低为73．39％，滦县、卢龙和青龙县分别为80．29％、74．19％和75．57％。（2）IgG抗体阳性率：免疫前平均为3．33％，免疫后平均为80．63％。同一人群免疫前后抗体配对检测，免疫前平均为2．62％，免疫后平均为80．63％。（3）发病率：接种HFRS疫苗后高发乡镇HFRS发病数为9例，发病率为18．79／10万；干预前发病数为80例，发病率为166．56／10万。结论高发病乡镇疫苗接种覆盖率达70％以上时，防病效果显著，值得在全省其他乡镇推广。     

海南农垦区18岁以下人群乙肝疫苗免疫效果调查分析

目的 调查乙肝疫苗接种率与HBsAg携带率的关系及海南垦区乙肝疫苗接种的免疫效果，为制定海南垦区乙肝疫苗免疫策略提供依据。方法 采用回顾性调查的方法调查垦区1－18岁人群乙肝疫苗接种史，用ELISA法检测HBsAg和抗－HBs。结果 调查1－18岁人群6669人，乙肝疫苗接种率为41．2％，HBsAg携带为9．2％。其中全程接种HBsAg携带率为2．4％，未接种（或未全程接种）HBsAg携带率为14．0％。差别有显性；全程接种HBsAg感染保护率为82．9％。抽查843人的抗－HBsAg，阳性率为62．8％，其中全程接种抗－HBs阳性率为85．7％，未接种（或未全程接种）抗－HBs阳性率为36．9％。结论 HBsAg携带率高低与乙肝疫苗接种率高低存在密切的相关关系。海南垦区1－18岁人群乙肝疫苗接种率尚不高，目前仍处于高HBsAg携带率水平。     

2001～2004年屏南县部分1～2岁儿童乙型肝炎疫苗接种情况分析

[目的]了解屏南县儿童乙肝疫苗接种情况及影响因素，以便更好地开展新生儿乙肝疫苗的接种工作。[方法]采取按容量比例概率抽样（PPS）方法，2001-2004年分别在屏南县抽取部分1～2岁幼儿进行调查。[结果]2001-2004年合计调查860名幼儿，乙肝疫苗首针及时接种率、全程及时接种率、全程接种率分别为61．74％、59．42％、90．70％，均呈逐年上升趋势（P〈0．01）；居住在村庄的幼儿首针及时接种率、全程及时接种率明显低于居住在乡驻地与县城者（P〈0．01）。[结论]儿童乙肝疫苗接种指标均呈逐年上升趋势，但仍低于同期福建省平均水平。     

成人及儿童大规模预防接种活动结果评价

目的 对在广西壮族自治区河池市进行的成人及儿童伤寒Vi疫苗及A群流脑疫苗大规模预防接种活动的组织实施、安全注射、冷链管理、宣传发动以及接种率的结果进行描述和分析。方法 按有对照的组群随机抽样原则，把接种地区分为107个组群，其中53个组群随机接种伤寒Vi疫苗，54个组群随机接种A群流脑疫苗。对接种的覆盖率、计划安排、促进策略，所涉及的人力资源、后勤供应、设备，使用的和浪费的疫苗剂量、冷链及接种的安全性(安全注射及副反应)等方面进行评估。结果 接种活动耗时5周，分为4个阶段：预试验、分组群接种、补种及扫尾，接种覆盖率为78．30％；15岁以下儿童为89．30％，成人为76．60％；分30个接种组，平均每组用去疫苗3082人份；接种组人员每组由1名医生、1名接种员、1名登记员及若干名社区领导组成。疫苗总浪费率为11．10％，其中A群流脑疫苗较高。冷链运转良好，接种未发生重大的安全问题。结论 在广西壮族自治区的中小城市对成人及儿童进行大规模预防接种的后勤工作证明是可行的和安全的。未来的接种活动采用类似形式是可行的，但要强调安全注射、社区参与的重要性及具体的补漏扫尾接种策略。     

珠海市1～30岁健康人群风疹抗体水平监测和风疹疫苗免疫的血清学效果

为给我省将风疹疫苗接种纳入计划免疫管理提供科学依据，１９９６年以珠海市为试点，在该市三个区选择９４４名１～３０岁健康人群，用微量血球凝集抑制（ＨＩ）试验检测风疹ＨＩ抗体，总阳性率为６８．２％，几何平均滴度倒数（ＧＭＲＴ）为３６．１，其中＜１６岁儿童的风疹抗体阳性率和ＧＭＲＴ均明显低于≥１６岁人群。从９４４人中随机抽取１６９人接种风疹疫苗，观察免疫后的血清效果，免疫成功率为４７．３％，其中免前抗体阴性者，免后阳转率为９６．５％，免前抗体≤１：６４者，免疫成功率为９５．６％，免后比免前ＧＭ－ＲＴ增长９．３倍。同时对珠海市１～７岁儿童普遍接种风疹功苗，接种率为６１．２％，其中１岁儿童接种率７１．１％。疫苗接后未发现严重副反应，显示风疹疫苗有良好的免疫原性，安全可靠，建议逐步将风疹疫苗接种纳入计划免疫管理。     

2002年青岛市市区居民被动物致伤及狂犬病疫苗接种状况调查

[目的]了解青岛市市区居民动物致伤及狂犬病疫苗接种状况。[方法]对2002年在青岛市预防接种服务中心就诊的动物致伤并全程接种狂犬病疫苗者进行调查。接种国产狂犬病疫苗者全程接种后半个月检测血清狂犬病抗体。[结果]全年动物致伤7076例，占市区总人口的456．02／10万，无狂犬病病人发生。7～8月为致伤高峰；致伤者男女持平，青壮年居多。伤人动物86．59％是犬，其次是猫；80％的动物未进行免疫接种。上肢伤占64．78％。患者92．25％在24h内就医，狂犬病疫苗接种率为99．11％，85％的患者能得到及时清洗伤口。全程接种国产精制狂犬病疫苗后半个月，抗体阳性率为99．12％。[结论]青岛市市区居民动物致伤者较多，受伤者狂犬病疫苗接种率很高。     

2008-2012年黎平县常住儿童免疫规划疫苗接种率分析

目的了解黎平县2008-2012年常住儿童免疫规划疫苗接种情况,为制定科学的免疫规划策略提供依据。方法对全县25个乡（镇）的行政村按好、中、差三个层次各抽查1个行政村随机抽取5～7名的适龄儿童。调查其免疫规划疫苗基础免疫和加强免疫的接种情况。结果2008～2012年黎平县常住儿童2325名,建卡率为99．61％,建证率为99．40％,卡、证、机信息符合率为77．73％。基础免疫疫苗接种合格率除A群流脑疫苗（MenA）、乙脑疫苗（JEV）分别为82．28％和77．98％外,卡介苗（BCG）、乙肝疫苗（HepB）、脊灰疫苗（OPV）全程、百白破混合疫苗（DPT）全程、含麻疹成分混合疫苗（MV、MR）接种合格率分别达到98．45％、93．85％、95．10％、92．30％、94．06％。加强免疫疫苗DPT、JEV、麻腮风混合疫苗（MMR）接种合格率分别达83．01％、69．03％、81．12％。HepB、MV（MR）及时接种合格率分别为78．71％、79．23％。结论黎平县免疫规划疫苗基础疫苗接种合格率较高,加强免疫疫苗接种合格率和卡、证、机信息符合率离国家目标要求还有一定的差距,有待进一步加强。     

Telephone survey assessment of household patterns of influenza vaccination, Twin Cities seven county metro area, 2008-2009

Major national surveys do not collect the influenza vaccination status of all household members, thus limiting current understanding of household influenza vaccination patterns. In an early 2009 telephone survey of 800 households in the metropolitan Minneapolis-St Paul area, household respondents reported the age, gender, and 2008-2009 seasonal influenza vaccination status of all household members. After poststratification to adjust for nonresponse, the full household influenza vaccination rate for multiperson households is 35.2%, partial household influenza vaccination rate is 39.9% and the rate of complete household nonvaccination is 24.9%. Full household influenza vaccination is more common in households with an elderly resident, intermediate in households with a child under 5 years of age, and less common in the remaining households. No household members are vaccinated in approximately 10% of multiperson households with either an elderly adult or young child; the corresponding rate in other households is 32.8%. An estimated 51.4% of households with children over 1 year of age have all children vaccinated against influenza; 43.5% of households with children had no children vaccinated against influenza. Households with younger children are more likely to have all children vaccinated and less likely to have no children vaccinated. We believe this is the first study to describe the prevalence of household influenza vaccination patterns. Continued efforts to monitor and increase household vaccination may be a valuable strategy to protect individuals and communities from influenza.     

Simultaneous influenza and pneumocococcal vaccination in elderly individuals

The study was performed to evaluate the effects of influenza and pneumococcal vaccines administered alone or in combination. 124 elderly subjects living in community were vaccinated either with influenza split vaccine or with pneumococcal 23-valent or with both vaccines at the same time in different sites. Sera were tested for hemoagglutination inhibiting antibodies for influenza and for antibodies against 23-valent vaccine for streptococcus pneumoniae. No side effects were observed in the vaccinated population. Serological results indicated that influenza vaccine increased significantly antibody levels. No difference was observed between the group which received influenza vaccine alone and that which received influenza and pneumococcal vaccines associated, considering either G.M.T or the percentages of protected individuals or the percentages of subjects who seroconverted. When pneumococcal vaccine was administered at the same time with influenza vaccine, there was a not statistically significant reduction in both mean antibody concentration and mean fold increase. It is concluded that the simultaneous administration of influenza and pneumococcal vaccines to elderly individuals, including subjects at risk, is safe, effective and economically advantageous.     

2010-2012年嘉兴市加强免疫接种数据分析

目的：通过对2010-2012年嘉兴市常规免疫年报中加强免疫接种数据的分析,明确加强免疫的薄弱针次,分析查找薄弱环节和原因,提出对策措施,提升免疫规划工作整体水平。方法：利用嘉兴市常规免疫接种年报数据库,对其中的加强免疫接种情况进行描述性流行病学分析。结果：嘉兴市加强免疫接种次数总体呈上升趋势,但每年以百白破第4针为基准比较,发现4周岁的脊灰加强、6周岁的A＋C流脑第2针和白破接种次数均明显减少,而且流动儿童比本地儿童下降更明显。结论：在做好基础免疫工作的同时,更要加强适龄儿童特别是流动儿童的免疫规划长效管理工作,重视加强免疫接种的全面开展。     

Factors associated with influenza vaccine receipt in community dwelling adults and their children

Background

Factors associated with influenza vaccine receipt are well studied in healthcare personnel, pregnant women, and the elderly. There has been substantially less research in community dwelling adults and children, and none among entire households. Many studies determine vaccination status by self-report or behavioral intention, outcomes susceptible to misclassification. Given that vaccine is recommended for everyone over six months, re-evaluating these factors is warranted.

Methods

The Household Influenza Vaccine Effectiveness (HIVE) study is a prospective cohort of households with children. In 2010–2011, 549 adults representing 312 households completed surveys evaluating knowledge, attitudes, and practices regarding influenza vaccination for themselves and their children. Using the health belief model (HBM) as a framework, we examined factors associated with documented seasonal influenza vaccine receipt using log-binomial regression models.

Results

In multivariate models, cues to action such as doctor recommendation, (RR 1.62, 95% CI: 1.25–2.10), perceived benefits (RR 1.25, 95% CI: 1.04–1.50), and perceived susceptibility (RR 1.21, 95% CI: 1.03–1.42) were significantly associated with increased likelihood of vaccine receipt among adults while high perceived barriers were associated with decreased likelihood (RR 0.38, 95% CI: 0.25–0.59). Similarly, parents reporting higher barriers were less likely (RR 0.58, 95% CI: 0.42–0.79) and those perceiving greater benefits (RR 4.16, 95% CI: 2.28–7.59) and severity (RR 1.13, 95% CI: 1.00–1.27 were more likely to vaccinate their children. The observed effects of perceptions of susceptibility, severity, and benefits were more pronounced at low cues to action for children, as were the effects of perceptions of barriers and severity among adults.

Conclusion

Perceived benefits and barriers are most strongly associated with vaccine receipt. However, the effects of various factors were most pronounced in the absence of cues to action, which may be an important component of targeted interventions.     

Risk of lymphoma and leukaemia after bacille Calmette-Guérin and smallpox vaccination: A Danish case-cohort study

Vaccines may have non-specific effects as suggested mainly in mortality studies from low-income countries. The objective was to examine the effects of BCG and smallpox vaccinations on subsequent risk of lymphoma and leukaemia in a Danish population experiencing rapid out-phasing of these vaccines. In a background cohort (N = 47,622) from the Copenhagen School Health Records Register, cases of leukaemia (N = 20) and lymphoma (N = 51) were identified through the Danish Cancer Registry. The vaccination status of the cases was compared with the vaccination status of a 5% random sample (N = 2073) of the background cohort and analysed in a case-cohort design. BCG vaccination reduced the risk of lymphomas (HR = 0.49 (95% CI: 0.26–0.93)), whereas smallpox vaccination did not (HR = 1.32 (0.56–3.08)). With the small number of leukaemia cases, the analysis of leukaemia had limited power (BCG vaccination HR = 0.81 (0.31–2.16); smallpox vaccination HR=1.32 (0.49–3.53)). The present study with very reliable vaccine history information indicates a beneficial effect of BCG vaccination on the risk of lymphomas.     

Predictors of tetanus,diphtheria, acellular pertussis and influenza vaccination during pregnancy among full-term deliveries in a medically underserved population

ObjectiveTo evaluate predictors of vaccination among women who received tetanus, diphtheria, and acellular pertussis vaccination (Tdap), influenza vaccination, and Tdap and influenza vaccinations.Study DesignIn a retrospective cohort study of all full-term (≥37 weeks gestation) deliveries between July 1, 2016 and June 30, 2018 at a single, safety-net institution, we used multinomial logistic regression models to compare predictors of vaccination among women who received Tdap only, influenza only, and both Tdap and influenza vaccines.ResultsAmong 3132 full-term deliveries, women were primarily non-Hispanic black (67.5%), between the ages of 21–34 (65.3%), and multiparous (76.0%). The rates of only influenza or Tdap vaccination were 10.3% and 21.6%, respectively; 43.3% of women received both vaccines, and 24.9% of women did not receive either vaccine. In the adjusted models, Hispanic ethnicity was positively associated with receipt of all types of vaccination and non-Spanish language interpreter use was positively associated with receipt of Tdap vaccination and Tdap and influenza vaccination. A parity of greater than three and inadequate and unknown prenatal care adequacy were negative predictors of all types of vaccination. Pre-existing hypertension was negatively associated with Tdap vaccination, and HIV-positive status was negatively associated with influenza vaccination and Tdap and influenza vaccination.ConclusionCompared to the national rate of both Tdap and influenza vaccination (32.8%), a higher proportion of women received both vaccines in our study population. Vaccine uptake may be affected by race/ethnicity, use of interpreter services, parity, pre-existing comorbidities, and prenatal care adequacy. The lower rate of influenza vaccination compared to Tdap vaccination suggests that other factors, such as vaccine hesitancy and mistrust, may be differentially impacting influenza vaccination uptake in our predominantly minority population. Future provider and public health approaches to vaccine promotion should incorporate culturally appropriate strategies that address vaccine-related beliefs and misconceptions.     

Enhancing DNA vaccination by sequential injection of lymph nodes with plasmid vectors and peptides

DNA vaccines or peptides are capable of inducing specific immunity; however, their translation to the clinic has generally been problematic, primarily due to the reduced magnitude of immune response and poor pharmacokinetics. Herein, we demonstrate that a novel immunization strategy, encompassing sequential exposure of the lymph node milieu to plasmid and peptide in a heterologous prime-boost fashion, results in considerable MHC class I-restricted immunity in mice. Plasmid-primed antigen expression was essential for the generation of a population of central memory T cells, expressing CD62L and low in PD-1, with substantial capability to expand and differentiate to peripheral memory and effector cells, following subsequent exposure to peptide. These vaccine-induced T cells dominated the T cell repertoire, were able to produce large amounts of chemokines and pro-inflammatory cytokines, and recognized tumor cells effectively. In addition to outlining a feasible and effective method to transform plasmid DNA vaccination into a potentially viable immunotherapeutic approach for cancer, this study sheds light on the mechanism of heterologous prime-boost and the considerable heterogeneity of MHC class I-restricted T cell responses.     

A fully liquid DTaP-IPV-Hep B-PRP-T hexavalent vaccine for primary and booster vaccination of healthy Mexican children

Objectives

To evaluate an investigational, fully liquid hexavalent diphtheria-tetanus-acellular pertussis-inactivated poliovirus-hepatitis B-Haemophilus influenzae type b (DTaP-IPV-Hep B-PRP-T: Hexaxim™) vaccine for primary and booster vaccination of healthy children in Mexico.

Methods

Infants (N = 1189) were randomized to receive one of three lots of the DTaP-IPV-Hep B-PRP-T vaccine or a licensed hexavalent control vaccine (Infanrix™ hexa) for primary vaccination at 2, 4 and 6 months. All participants who completed the primary series and agreed to participate in the booster part of the study received a dose of the investigational vaccine at 15–18 months of age. Validated serological assays and parental reports were used to assess immunogenicity and safety, respectively.

Results

Post-primary vaccination, ≥95.8% of participants in both the DTaP-IPV-Hep B-PRP-T and control groups were seroprotected (SP) against diphtheria, tetanus, poliovirus, hepatitis B and PRP, or had seroconverted (SC) to the pertussis toxin (PT) and filamentous hemagglutinin (FHA) pertussis antigens. The SP/SC rates induced by the three DTaP-IPV-Hep B-PRP-T lots were equivalent. No differences in SP/SC rates were observed between the pooled lots of investigational vaccine and the control vaccine. Antibody persistence at 15–18 months was comparable between groups, with strong increases in all antibody concentrations post-DTaP-IPV-Hep B-PRP-T booster. Both vaccines were well tolerated for primary vaccination, as was the booster dose of DTaP-IPV-Hep B-PRP-T.

Conclusion

These study findings confirm the suitability of the combined, fully liquid DTaP-IPV-Hep B-PRP-T vaccine for inclusion in routine childhood vaccination schedules.