国产水痘减毒活疫苗接种的血清学免疫效果及成本效益分析

[目的 ]　观察不同代次、不同剂量的国产水痘减毒活疫苗的安全性和免疫效果 ,分析不同年龄组儿童水痘疫苗接种的经济效益。　 [方法 ]　随机分组 ,接种不同代次、不同剂量的国产水痘疫苗 ,对每组儿童进行人体反应性及免疫原性观察 ,用酶联免疫吸附法 (ELISA)测定水痘抗体 ,采用成本效益分析方法计算各年龄组效益费用比 (BCR)。　 [结果 ]　各组水痘疫苗免后副反应率及抗体水平差异均无显著性。免后 1～ 3月 ,抗体阳转率达到 96 %以上 ,几何平均滴度(GMT)达到 76 0以上。以后抗体逐渐下降 ,接种后 2年抗体阳转率为 81.40 %,GMT为 36 7.2 0。水痘疫苗接种后成本效益比值 ,2岁以下年龄组BCR值小于 1,3～ 7岁年龄组BCR值均大于 1,其中 6～ 7岁组经济效益最高。　 [结论 ]　不同代次、不同剂量的国产水痘疫苗副反应率较低 ,免疫效果好。 3～ 7岁组儿童接种水痘疫苗能获得正效益 ,应作为水痘疫苗免疫接种的首选对象。     

人群水痘—带状疱疹病毒流行率及发病状况分析

为了解本辖区现阶段健康人群水痘 -带状疱疹病毒 (VZV)流行情况 ,采用酶联免疫吸附实验 (ELISA)分别对本地以及外来人员共 40 7名 1～ 50岁健康人群VZV的血清流行病学情况进行检测 ,同时根据 2 0 0 2始纳入国家传染病管理信息系统报告的天河区水痘发病状况进行统计分析。结果显示 :人群中血清抗VZV -IgG阳性率平均为 61 7% ,年龄别流行率 1～ 2岁、3～ 6岁、7～ 1 2岁、1 3～ 1 9岁、2 0～ 2 9岁、30～ 39岁、40～ 50岁组分别为 1 4 1 %、2 4 3 %、62 0 %、85 7%、95 2 %、92 9%、1 0 0 % ,说明血清年龄别流行率以1～ 6岁组最低 ,以后随年龄增长而上升。同时对天河区 2 0 0 2～ 2 0 0 3年收到报告的 1 883例水痘病例分析表明 ,1 0岁以下儿童的发病占总病例的 79 1 % ,与所检测的人群VZV流行率相一致 ,表明婴儿、幼儿、学前班儿童、小学低年级学生为高度易感人群 ,是水痘疫苗的主要免疫对象     

上海市宝山区2～7岁儿童的水痘抗体水平

目的观察水痘疫苗的免疫效果和免疫持久性,为水痘疫情的控制提供免疫预防的参考依据。方法对上海市宝山区已种和未种水痘疫苗的2～7岁儿童共455名采集手指末梢血后进行抗体水平测定并进行比较;对已种疫苗儿童进行不同制品、接种年限的比较。结果未种疫苗儿童体内抗体水平随年龄增加逐渐上升;已种儿童体内抗体水平明显高于未种儿童2岁～和4岁～组,组间差异有统计学意义(t值分别为14.439和3.050,均P0.01)。接种国产、进口疫苗的儿童抗体水平差异无统计学意义;随接种年限的延长,儿童体内抗体水平逐渐降低,差异有统计学意义(F=4.529,P0.05),阳性率从接种后1年的78.10%下降到接种后3年的66.06%和接种后5年的65.12%,而接种后3和5年的抗体水平之间,差异无统计学意义(χ2=5.061,P0.05)。结论接种水痘疫苗后可获得较好的免疫保护;国产和进口疫苗效果相当;接种疫苗3年后抗体水平明显下降,建议在首剂接种3年后加强1剂,以提高疫苗的保护效果。     

人群中水痘-带状疱疹病毒流行率及其疫苗免疫效果

为了解健康人群水痘－带状疱疹病毒（VZV）流行情况及国产Oka株水痘减毒活疫苗（水痘疫苗）的免疫效果，采用酶联免疫吸附试验（ELISA）监测了384名0～50岁健康人群VZV的血清流行病学情况，同时对国产水痘疫苗在2～6岁无水痘感染史及疫苗接种史的健康儿童中进行了免疫原性和人体反应性观察。结果显示人群中血清抗VZV－IgG阳性率平均为64.32％，年龄别流行率在0～2岁、3～6岁、7～12岁、13～19岁和40～50岁组分别为13.24％、29.58％、75.71％、88.57％和100.00％。说明血清年龄别流行率以0～2岁组最低，以后随年龄增长而很快上升。国产水痘疫苗接种后全身和局部反应轻微，血清抗体阳转率为94.1％，几何平均滴度为18.400。证明了该疫苗有良好的有效性和安全性，可用作水痘－带状疱疹病毒自动免疫预防。     

上海市卢湾区0～7岁儿童水痘发病情况及疫苗保护效果观察

随着计划免疫工作的深入开展 ,水痘已被列为下一个要控制的疾病。为了解我区 0～ 7岁儿童水痘发病情况及国产水痘疫苗的保护效果 ,我们于 2 0 0 1年 4月在卢湾区两个街道进行了水痘发病情况的调查和疫苗保护效果的观察。1　对象与方法1.1　对象在卢湾区打浦和淮海两个街道 ,各随机选择 10个里委 ,抽到的里委全部挨户询问填写 0～ 7岁儿童 (本区户口 )水痘发病史及主要临床症状等 ,共完成 2 5 32份 ;并对淮海街道 6个幼儿园的 3～ 6岁未接种过水痘疫苗及无水痘感染史的健康儿童10 5 6名 ,以儿童的出生日期分组 ,一组接种国产水痘疫苗 5 0 6名…     

国产冻干水痘减毒活疫苗的安全性和免疫原性研究

目的 评价国产水痘减毒活疫苗的安全性和免疫原性.方法 选择1～12岁的健康儿童以随机方式接种国产和进口冻干水痘减毒活疫苗,依据<预防接种手册>观察安全性,用膜抗原荧光抗体(FAMA)法测定血清中的抗水痘病毒抗体阳性率和抗体水平.结果 国产疫苗和进口对照疫苗局部反应率分别为5.3%和6.0%,全身反应为13.0%和8.0%,差异均无统计学意义;试验疫苗和对照疫苗免疫后水痘抗体阳性率分别为98.3%和99.4%;抗体GMT为1:146.34和1:153.58,均无组间差异.结论 试验疫苗与进口对照疫苗具有同样良好的安全性和免疫原性.     

越城区水痘疫苗免疫接种效果情况调查分析

目的掌握浙江省绍兴市越城区水痘疫情特征,评价疫苗免疫效果,为有效控制水痘疫情提供依据。方法对2010年和2011年发病资料进行描述分析,同时对越城区属的水痘病例中1～11岁的859例病例进行疫苗接种史回顾性调查。结果水痘平均发病率172.05/10万,0～9岁组占72.92%。发病前有无免疫史的差异有统计学意义(χ2=454.67,P<0.001),疫苗的总体保护率为75.37%;接种国产疫苗和进口疫苗的发病率差异有统计学意义(χ2=5.62,P=0.018),国产疫苗相对于进口疫苗保护效果的OR值为1.53(95%CI:1.07～2.18)。结论提高接种率是控制水痘发病的有效手段,且进口疫苗免疫效果优于国产疫苗,当前应扩大疫苗接种年龄范围。     

昆明市官渡区2019年1-14岁健康儿童水痘-带状疱疹病毒抗体水平北大核心

目的分析昆明市官渡区2019年健康儿童水痘-带状疱疹病毒(Varicella-zoster virus,VZV)抗体水平。方法采用多阶段随机抽样方法在官渡区9个街道选择1-14岁儿童采集血清标本,使用酶联免疫吸附试验检测VZV IgG抗体,分析抗体阳性率和中位数浓度(Median concentration,MC)。结果官渡区1-14岁健康儿童VZV抗体阳性率为71.1%(207/291),抗体MC为168.5mIU/mL。城区、城乡结合区儿童VZV抗体阳性率分别为81.1%、61.5%(χ^2=13.65,P=0.000),1-2岁、3-4岁、5-6岁、7-14岁儿童分别为60.0%、77.8%、73.6%、73.6%(χ^2=6.51,P=0.089),0剂次、1剂次、2剂次水痘疫苗(VarV)免疫史儿童分别为18.8%、72.0%、89.3%(χ^2=56.31,P=0.000)。儿童1剂次VarV免疫史后0-2年、3-5年、≥6年VZV抗体阳性率分别为75.2%、71.1%、60.7%(χ^2=1.42,P=0.383)。结论官渡区1-14岁健康儿童VZV抗体水平高,但随着VarV免疫后时间推移而下降;建议提高适龄儿童特别是城乡结合区儿童2剂次VarV接种率。     

不同批号国产流行性腮腺炎减毒活疫苗免疫效果观察

为考核流行性腮腺炎 (腮腺炎 )疫苗的免疫效果 ,用 6批国产腮腺炎疫苗和进口的麻疹、腮腺炎、风疹 (MMR)联合疫苗在奉化市接种 30 7名 1～ 3岁儿童 ,用酶联免疫吸附试验 (ELISA)测定免疫前后腮腺炎IgG抗体。结果显示 :免疫后 6周各组免疫前抗体阴性的易感儿童IgG抗体阳转率为 83 33%～ 94 2 9% ;各组免疫前抗体阳性的儿童免疫成功率为 4 5 4 5 %～ 90 0 0 % ;各批疫苗均有良好的免疫应答 ,各组之间差异无显著的统计学意义。国产腮腺炎疫苗对易感儿童和腮腺炎IgG抗体阳性的对象均有满意的免疫作用     

儿童水痘血清流行率调查及其疫苗免疫效果

为了解儿童水痘流行情况及水痘减毒活疫苗的免疫效果 ,采用全抗原ELISA方法对 315名3～ 7岁儿童水痘的血清流行情况进行了调查 ,血清抗VZV -IgG阳性率为 4 1.6% ,且不同幼儿园中水痘流行情况有所不同 ,表现出明显的群体差异。同时对Oka株水痘减毒活疫苗在该人群的免疫效果进行了调查 ,结果表明该疫苗接种后无明显副反应 ,血清阳转率为 85.1%。证明了减毒活疫苗有良好的安全性和有效性。     

广东省农村地区水痘-带状疱疹病毒感染状况及抗体水平调查

目的:了解农村地区健康儿童水痘-带状疱疹病毒(VZV)的自然免疫状况。方法:采集2~13岁儿童血清标本共计418份,应用酶联免疫吸附试验(ELISA)检测水痘-带状疱疹病毒IgG抗体。结果:418份血清标本中,水痘-带状疱疹病毒抗体阳性194人,抗体阳性率为46.41%,抗体含量均值为366 m IU/m l。各年龄组抗体阳性率差异有统计学意义(P<0.01),其中2岁年龄组的阳性率(12.86%)最低,10~13岁年龄组的阳性率(90.00%)最高。结论:建议农村地区6岁以下儿童应在经济条件许可的情况下接种水痘疫苗。     

国产冻干水痘减毒活疫苗的安全性及免疫原性观察

目的观察国产冻干水痘减毒活疫苗（Varicella Attenuated Live Vaccine,Freeze-dried;VarV）的安全性及免疫原性。方法对未感染水痘-带状疱疹病毒、1～13岁健康儿童,接种国产VarV进行安全性观察,应用膜免疫荧光抗体方法检测水痘抗体。结果观察对象接种后30min和4h、24h、48h、72h的不良反应发生率,分别为2.29%、3.69%、3.82%、1.78%、0.25%,6周后无不良反应报告。总发热反应率为3.82%,注射部位红肿反应发生率为3.69%,局部硬结发生率为0.64%。VarV免疫后,免疫成功率为98.3%,免疫前、后抗体几何平均滴度增长明显。结论国产VarV临床反应轻微,安全性和免疫原性良好。     

Seroprevalence of varicella-zoster virus in the German population

The present study was conducted to generate data on the epidemiology of varicella-zoster virus (VZV) infections in Germany as a basis for health economic evaluations of varicella vaccination strategies. The survey was designed as a cross-sectional, age-stratified study of the VZV seroprevalence in the German population. The status of immunity of 4602 individuals a aged 0 to >70 years was investigated by means of an indirect enzyme immunoassay and the fluorescent antibody to membrane assay. After waning of maternal antibodies over the period of 6-9 months seropositivity rates remained low by the end of the 1st year of life. By the age of 4-5 years 62.5% (95% CI; 56.0-68.5) of the pre-school children had already been infected with VZV and at the age of 10-11 years 94.2% (95% CI; 91.0-96.0) of children were positive for anti-VZV antibodies. Among the age-group of >40 years old, only few individuals were susceptible for VZV. The median antibody levels to VZV did not significantly decline with increasing age. In comparison with figures of previous studies the age-specific seroprevalence data presented here do not provide evidence for an upward shift in the age distribution of varicella in Germany. Since the majority of VZV infections occurs during the early childhood, the best option to reduce the circulation of wild-type VZV in the population would be the immunization of young children.     

水痘疫苗在学校水痘暴发疫情中保护效果的病例对照研究

目的 评价接种1剂水痘疫苗在学校水痘暴发疫情中的保护效果(vaccine effectiveness, VE)。方法 采用1:2配对病例对照研究,收集中山市2013—2021年水痘暴发疫情调查资料,将病例数≥5例的班的所有病例（共942例）作为病例组,按1:2的比例选取同班、同年龄（±1岁）、同性别的1 884名健康儿童作为对照组,调查其水痘疫苗接种史,采用条件logistic回归分析水痘疫苗保护效果。结果 共调查3～14岁儿童2 826名,儿童接种1剂水痘疫苗的保护效果为58%（95%CI:50%～66%）,3～5岁、6～14岁儿童接种1剂水痘疫苗保护效果分别为75%（95%CI:62%～83%）和51%（95%CI:40%～61%）。儿童接种1剂后≤2年、3～5年、6～8年、≥9年的保护效果分别为78%（95%CI:66%～86%）、66%（95%CI:57%～74%）、51%（95%CI:36%～62%）、23%（95%CI:-11%～46%）。儿童接种1剂水痘疫苗的保护效果随接种后时间的延长而降低（趋势χ²=13.071,P<0.001）。结论 儿童接种1剂水痘疫苗有助于防控水痘暴发疫情,但其保护效果随接种后时间的延长而降低,难以阻断水痘传播。建议儿童及时接种2剂水痘疫苗,以预防学校水痘暴发疫情。     

Seroepidemiology of varicella zoster virus infection in Vojvodina,Serbia

The present cross-sectional serosurvey constitutes the first effort to describe the varicella zoster virus (VZV) seroepidemiology in Serbia. An age-stratified serum bank of 3570 residual samples collected between 2015 and 2016 in each of the seven districts of the Vojvodina Province was tested for IgG anti-VZV antibodies with an enzyme immunoassay. Results were standardised into common units according to the European Sero-Epidemiology Network (ESEN2) methodology. Univariable and multivariable analyses were used to examine the relationships between standardised anti-VZV positivity or logarithmically transformed antibody titres and demographic features of study subjects. Seropositivity (85% overall) increased with age, in parallel with geometric mean titres. By the time of school entry, 68% of children were immune. The slower subsequent acquisition of immunity leaves epidemiologically relevant proportions of adolescents (7%), young adults (6%) and especially females of reproductive age (6%) prone to more severe forms of varicella. In the ongoing pre-vaccine era, natural infection provides a high level of collective immunity, with the highest VZV transmission in children of preschool age. The detected gaps in VZV immunity of the Serbian population support the adoption of the official recommendations for varicella immunisation of non-immune adolescents and young adults, including non-pregnant women of childbearing age.Key words: Antibodies to varicella zoster virus (anti-VZV), chickenpox, ESEN2, Europe, seroprevalence, standardisation, vaccines and immunisation     

Varicella seroepidemiology in United States air force recruits: A retrospective cohort study comparing immunogenicity of varicella vaccination and natural infection

Background/ObjectivesInfection with varicella zoster virus (VZV) produces lifelong immunity, but duration of post-vaccination immunity has not been established. The purpose of this study is to determine if a difference exists in the long-term seropositivity of anti-VZV antibodies in a cohort of young adults who were vaccinated against varicella as compared to a similar cohort with a history of chickenpox disease, and to determine which variables best predict waning seropositivity following varicella vaccination.MethodsThis retrospective cohort study captures immunization and serology data from approximately 10,000 recruits who entered basic military training between January 1, 2008, and December 31, 2015, and who have childhood immunization records in the Air Force Aeromedical Services Information Management System. Varicella vaccine immunogenicity was determined relative to the immunogenicity of chickenpox disease, as measured by multiplex flow immunoassay. Among vaccine recipients, waning seroimmunity was modeled and adjusted for several important covariates.ResultsBasic military trainees who received varicella vaccine in childhood were 24% less likely to be seropositive to VZV than trainees who were exempt from vaccine due to a history of chickenpox disease. There was no significant difference in seropositivity between male and female trainees. The odds of a vaccinated trainee being seropositive to VZV decreased by 8% with each year elapsed since vaccination. Seroprevalence declined below estimated herd immunity thresholds in vaccinated trainees born after 1994, and in the cohort as a whole for trainees born after 1995.ConclusionDespite prior vaccination, seroimmunity in a large cohort of young adults unexposed to wild-type VZV failed to meet the estimated threshold for herd immunity. If vaccination in accordance with the current US VZV vaccination schedule is inadequate to maintain herd immunity, young adults not previously exposed to wild-type VZV may be at increased risk for varicella outbreaks.     

一起水痘爆发的病毒分离鉴定及血清学分析

目的对上海市闸北区2007年一起水痘爆发进行病原学鉴定和血清学分析。方法对采集的双份血清用酶联免疫吸附试验进行水痘-带状疱疹病毒（Varicella-zoster Virus,VZV）IgM和IgG抗体检测,采用疫苗生产用的VZV敏感细胞--人胚肺成纤维细胞（MRC-5）,对采集的疱疹液进行病毒分离以及标准血清中和鉴定,并通过特异性的引物对病毒分离株进行聚合酶链反应（Polymerase Chain Reaction,PCR）扩增。结果采集到的5例病人的双份血清中,急性期血清IgM阳性2份,IgG阳性1份,灰区2份;恢复期血清IgG均为阳性,其中4份标本IgG抗体滴度≥4倍升高。从采集的5份疱疹液标本中均分离到致细胞病变的病毒,经VZV标准血清中和鉴定,证实为VZV。PCR扩增产物电泳结果显示,在目的条带处均有单一的特异性条带。结论该次爆发是由VZV引起的,水痘减毒活疫苗（Varicella Virus Attenuated Live Vaccine,VarV）的作用已被证实,但该次水痘爆发中,47.4%的患者在出生后3年内曾接种过国产或者进口VarV,应深入研究VarV的免疫策略。     

Cellular immune response of a varicella vaccine following simultaneous DTaP and VZV vaccination

BACKGROUND: Chickenpox and zoster are an important cause of morbidity among children and adults. The ability of a new, thermostable vaccine to induce varicella-zoster-virus (VZV)-specific humoral and cell mediated immunity when given simultaneously with diphtheria-tetanus-acellular pertussis vaccine (DTaP) as a booster dose in the second year of life was investigated. METHODS: A new, temperature stable varicella vaccine (OKA-strain, SB-Biologicals, Rixensart, Belgium) was given simultaneously with a booster dose of DTaP vaccine. VZV-specific humoral and cell-mediated immunity was studied in the first 27 out of 232 vaccinated children at 16-28 months of age, from blood samples drawn just before and six weeks after vaccination. VZV-specific antibody response, T-cell proliferation, cytokine production and expression of activation markers (CD25, HLADR) on T-cells were analyzed. RESULTS: Vaccination resulted in a significant rise of VZV-specific serum IgG titers and in a strong VZV-specific T-cell response in all vaccinated infants. Analysis of the expression of activation marker revealed activation of both CD4+-T-helper- and CD8+-T-cells. CONCLUSIONS: The varicella vaccine given simultaneously with DTaP produced strong B- and T-cell responses alike. This is the first report to show that CMI to VZV is conferred to young children by vaccination with a temperature stable VZV vaccine.