水痘减毒活疫苗接种后的效果观察

[目的]了解预防接种水痘减毒活疫苗后的反应及预防控制水痘的效果观察。[方法]对1999～2006年，我预防保健科对1岁以上健康儿童，预防接种上海生物研究所生产的水痘减毒活疫苗1768人，接种葛兰素史克生产的威克蒙水痘减毒活疫苗427人，共计儿童2195人进行跟踪随访观察。[结果]接种水痘减毒活疫苗后局部反应轻微，全身反应头痛、发热发生率〈2．5％。1例预防接种d　2发热1　d、烦躁1周、出现丘疹样皮疹，1个月痊愈，1例接种d　2，出现荨麻疹1周后痊愈。36例接种1．5～5年后感染水痘，不典型，症状轻，出水痘数量少。1例感染水痘后，发热、全身症状重，水泡疹遍及全身。预防接种水痘后保护率为98．3％。[结论]接种水痘减毒活疫苗是预防水痘最经济、有效的方法,可有效控制水痘的传染与流行。     

水痘减毒活疫苗Oka株的分子生物学特性免疫原性及安全性

水痘是由水痘-带状疱疹病毒(VZV)引起的一种高传染性的呼吸道疾病。目前预防接种是控制感染唯一的有效手段。现在使用的是Oka株水痘减毒活疫苗,疫苗Oka株独特的分子生物学活性可能与减毒作用相关。健康和免疫系统受损的个体,在接种Oka株水痘减毒活疫苗后都能产生特异性的体液和细胞介导的免疫应答,并能预防水痘的发生。30余年的临床应用表明该疫苗是安全有效的。     

江苏省适龄儿童二类疫苗接种情况调查分析

目的了解江苏省2~3岁儿童二类疫苗的接种情况。方法通过江苏省儿童预防接种信息系统,对全省2~3岁儿童随机抽样调查二类疫苗接种率。结果共调查43 200名儿童,32 704名接种过二类疫苗,二类疫苗接种率为75.70%。水痘减毒活疫苗、b型流行性感冒(流感)嗜血杆菌结合疫苗、口服轮状病毒减毒活疫苗、流感疫苗、23价肺炎球菌多糖疫苗、7价肺炎球菌结合疫苗6种儿童常用二类疫苗的接种率分别为61.91%、52.59%、25.99%、23.70%、19.43%和3.17%。多剂次免疫程序的二类疫苗全程接种率较低。结论需进一步规范儿童二类疫苗的预防接种服务管理。     

水痘减毒活疫苗接种后的效果分析

目的对水痘减毒活疫苗接种后的临床治疗效果进行分析。方法选取2003年2月—2004年2月来该院接受水痘疫苗接种的儿童208例,对着208例患儿接种水痘减毒活体疫苗,作为观察组,另选取未接种水痘疫苗的儿童188例,作为对照组,比较两组儿童在2004—2011年感染水痘的情况,并将感染结果使用SPSS13.0统计学软件进行t检验,α=0.05。结果观察组儿童中3例出现水痘,对照组儿童中38例出现水痘,t检验结果为P<0.05,差异具有统计学意义。结论适龄儿童接种水痘减毒活疫苗可有效地降低日后水痘的发病率。     

接种麻疹风疹联合减毒活疫苗gl起过敏性紫癜1例

2009年2月,诸城市对7～14岁儿童开展了麻疹疫苗查漏补种活动,对未完成3剂次麻疹疫苗者接种1剂次麻疹减毒活疫苗,家长也可自愿选择接种麻疹风疹联合减毒活疫苗。1名儿童在接种麻疹风疹联合减毒活疫苗后第3天,双下肢出现紫癜。诸城市疾病预防控制中心接到城区预防接种门诊的报告后,     

两种国产冻干水痘减毒活疫苗免疫原性及疫苗安全性比较

接种水痘疫苗是预防水痘的有效措施之一。为了解不同厂家生产的水痘疫苗免疫原性及疫苗安全性的异同,2002年6月我们在嘉善县和秀洲区对两种国产冻干水痘减毒活疫苗免疫成功率及疫苗安全性进行了调查。选择嘉善县和秀洲区2～6岁儿童,随机分成2组,分别接种卫生部上海生物制品所生产(上海产)水痘减毒活疫苗(批号:20020300)和卫生部长春生物制品所生产(长春产)水痘减毒活疫苗(批号:200107099、200202002、200106073),疫苗均在有效期内使用,分别于皮下接种1剂0.5ml。免疫前及免疫后6周分     

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.     

北京市西城区某小学突破性水痘暴发疫情调查

了解某学校一起突破性水痘暴发情况,为探讨水痘减毒活疫苗保护效率和控制疫情提供参考.方法 收集暴发疫情全部病例,对疫苗接种史和患病史进行回顾,计算罹患率并分析疫苗有效率.结果 全部184名学生中,累计发生水痘11例(突破病例10例),无并发症及死亡,总体罹患率6.3%,水痘疫苗总覆盖率95.4%;1剂次和2剂次水痘减毒活疫苗接种者罹患率分别为9.0%和0,差异有统计学意义(x2=8.927,P=0.012);免疫史≥3年儿童出现突破病例是<3年儿童的7.62倍(95%CI=0.943~61.617).结论 水痘减毒活疫苗高覆盖率可降低发病率并防止重症水痘,但接种时间≥3年后保护性降低,可能出现突破性病例.应提高2剂次接种率,并适当扩大应急接种范围.     

国产冻干水痘减毒活疫苗免疫效果观察

目的：观察国产冻干水痘减毒活疫苗的免疫效果。方法：在广西桂林市漳阳县和吉林省和龙市选择1—6岁健康易感儿童接种国产冻干水痘减毒活疫苗，进行安全性、免疫原性观察；同时，选择与疫苗接种密切接触的非接种进行疫苗株传播性观察。结果：410名观察对象接种水痘疫苗后无明显副反应。检测有效血清271份，血清抗体阳转率为98．89％，GMT为1:36.83％。该疫苗株接种不存在传播性。结论：接种国产冻干水痘减毒活疫苗安全、有效。     

2006-2012年海阳市入托入学儿童免疫规划疫苗预防接种证查验情况调查

目的为全面掌握儿童免疫规划疫苗预防接种工作的现状,进一步探讨今后开展儿童免疫规划疫苗预防接种工作的有效方法。方法对海阳全市2006-2012年入托人学儿童免疫规划疫苗预防接种情况证进行统计分析查验工作进行分析。结果入托儿童常规免疫接种水平较高,为99．42％,部分疫苗卡介苗（BCG）、脊髓灰质炎减毒活疫苗（OPV）、百白破混合制剂（DTP）、麻疹疫苗（MV）、流行性乙型脑炎减毒活疫苗（JE）、A群流脑疫苗（MenA）、乙型肝炎疫苗（HepB）七种免疫规划疫苗接种合格基础合格率均较高,达到99％以上。其中,入托儿童免疫规划疫苗合格接种率为99．22％,常住儿童免疫规划疫苗合格接种合格率为64％65％以上。结论全市入托入学儿童免疫规划疫苗预防接种证查验接种合格率为68．7460％,提示流动儿童是做好免疫规划管理工作的重点应常抓不懈。     

Decline in annual incidence of varicella--selected states, 1990-2001

Varicella (chickenpox) is a common, highly infectious, and vaccine-preventable disease. Before the introduction of the live attenuated varicella vaccine in 1995, approximately 4 million cases of varicella occurred annually in the United States, resulting in approximately 11,000 hospitalizations and 100 deaths. In 1996, the Advisory Committee on Immunization Practices (ACIP) recommended routine vaccination of all children at age 12-18 months, catch-up vaccination of all susceptible children before age 13 years, and vaccination of susceptible persons with close contact to persons at high risk for serious complications. In 1999, ACIP updated these recommendations to include vaccination requirements for child care and school entry and for postexposure; ACIP also strengthened recommendations for vaccination of susceptible adults and indicated that varicella vaccine should be considered for outbreak control. Changes in the national annual reported incidence of varicella disease during 1972-1997 have been reported previously. This report summarizes trends in the annual reported incidence of varicella disease in selected states during 1990-2001. The findings underscore the continued need to improve varicella surveillance to monitor the impact of the varicella vaccination program and assess any changes in varicella transmission and disease.     

Development of varicella vaccine in Japan and future prospects

In Japan, Dr. Michiaki Takahashi (1928–2013) successfully developed the first live attenuated varicella vaccine in the world. The virus used for this vaccine was varicella-zoster virus isolated from the vesicular fluid of a child with typical varicella and it was named the Oka strain after the family name of the child. In 1974, a patient with nephrosis developed varicella in the Pediatric Ward, and uninfected pediatric patients received varicella vaccine immediately. As a result, there were no cases of varicella in the other children and all of the vaccinated children acquired immunity to the disease. These results were published in the Lancet, demonstrating the safety and efficacy of varicella Oka strain vaccine for the first time. When clinical studies were conducted at the start of vaccine development, most of the subjects were pediatric patients with a high risk of contracting severe varicella. Therefore, the development process was different from that for other vaccines, since clinical studies are generally performed in healthy individuals.This vaccine was approved in Japan in 1986, and voluntary single-dose vaccination for children aged 1 year or older was started in 1987. However, the vaccination coverage rate remained low and the number of patients with varicella did not decrease significantly. Due to its voluntary status, the cost of vaccination was borne by the child's family and this was considered to be a reason for the low coverage rate. Moreover, although the vaccine achieved a good antibody response, the number of cases of breakthrough varicella (BV) was relatively high and showed an increasing trend that was also a concern. In order to increase the coverage rate and reduce BV, the Japanese government changed the varicella vaccination policy from voluntary to routine vaccination in October 2014. At the same time, a two-dose schedule was introduced that involved administration of the vaccine twice at an interval of at least 3 months up to the age of 3 years.At present, cases of varicella are only monitored at the pediatric sentinel clinics in Japan. Therefore, we need to establish a system to survey all patients, in order to demonstrate the efficacy of varicella vaccine based on detailed surveillance data. We also need to investigate the optimum timing of the second dose of the vaccine and the necessity for further booster vaccination. A combined live vaccine containing varicella vaccine has not yet been approved in Japan. Because of the greater convenience of combined vaccines, development and introduction of such a vaccine in the future would be desirable. Routine varicella vaccination is also expected to eventually reduce the occurrence of herpes zoster, although there are no supporting epidemiological data. The prevalence of herpes zoster has attracted attention, but it is necessary to develop a surveillance system for this disease. In March 2016, use of varicella vaccine to prevent herpes zoster in adults aged 50 years or older was approved in Japan, and the results of this policy change need to be assessed.     

Recombinant varicella vaccines induce neutralizing antibodies and cellular immune responses to SIV and reduce viral loads in immunized rhesus macaques

The development of an effective AIDS vaccine remains one of the highest priorities in HIV research. The live, attenuated varicella-zoster virus (VZV) Oka vaccine, safe and effective for prevention of chickenpox and zoster, also has potential as a recombinant vaccine against other pathogens, including human immunodeficiency virus (HIV). The simian varicella model, utilizing simian varicella virus (SVV), offers an approach to evaluate recombinant varicella vaccine candidates. Recombinant SVV (rSVV) vaccine viruses expressing simian immunodeficiency virus (SIV) env and gag antigens were constructed. The hypothesis tested was that a live, attenuated rSVV-SIV vaccine will induce immune responses against SIV in the rhesus macaques and provide protection against SIV challenge. The results demonstrated that rSVV-SIV vaccination induced low levels of neutralizing antibodies and cellular immune responses to SIV in immunized rhesus macaques and significantly reduced viral loads following intravenous challenge with pathogenic SIVmac251-CX-1.     

一种无明胶冻干水痘减毒活疫苗的安全性观察分析

目的 对东莞市一种无明胶冻干水痘减毒活疫苗接种后不良反应的发生情况进行分析,为免疫策略的制定提供依据. 方法 于接种后30 min、6h、24 h、48 h、72 h、4～10 d对受种者进行随访,通过电话或自动报告监测不良反应发生情况;所有受种者接种后情况均登记在《冻干水痘减毒活疫苗接种安全观察登记表》,使用Excel2003和SPSS13.0进行分析. 结果 2011年7月26日-2012年9月30日,东莞市无明胶冻干水痘减毒活疫苗接种后不良反应发生率为4.46/万,病例在不同性别及不同年龄组间的不良反应发生情况差异无统计学意义.大多数（76.19％）为异常反应,多为（86.36％）24 h内出现症状,以皮疹为主要表现. 结论 东莞市无明胶冻干水痘减毒活疫苗接种后产生的不良反应以轻症为主,接种安全性较高.     

国产冻干水痘减毒活疫苗的接种反应及免疫效果观察

目的分析国产冻干水痘减毒活疫苗的接种反应,探讨其免疫效果。方法将2008-2010年间来我院接种水痘疫苗的728例儿童随机分为观察组和对照组,每组各364例,观察组儿童接种国产冻干水痘减毒活疫苗,对照组儿童接种麻疹腮腺炎减毒活疫苗,比较两组研究对象的接种反应及免疫效果。结果观察组儿童接种前后抗体阳转率为97.8%(356/364),对照组儿童接种前后抗体阳转率为95.3%(347/364),抗体阳转率组间差异无统计学意义(P>0.05)。两组儿童接免疫种后的GMT水平较接种前有显著改善,差异有统计学意义(P<0.05),观察组儿童接种后的GMT水平优于对照组,差异有统计学意义(P<0.05)。观察组儿童接种应发生率为0.330%,对照组儿童为0.302%,接种反应发生率组间差异无统计学意义(P>0.05)。结论接种国产冻干水痘减毒活疫苗免疫效果确切,且接种不良反应发生率低,是一种安全有效的接种方法,值得临床进一步推广使用。     

Humoral and cellular response after varicella vaccination in VZV IgG seronegative kidney transplant candidates

BackgroundIn immunocompromised patients, primary infection with VZV may have a disastrous clinical course. Vaccination of VZV-seronegative patients on the waiting list for renal transplantation may prevent severe disease. However, the immunologic response of end-stage renal disease patients to peptide vaccines is far from optimal. Our question was whether end-stage renal disease patients with undetectable VZV-IgG levels were able to mount an adequate humoral and cellular response to a live attenuated varicella vaccine.MethodsKidney transplant candidates with undetectable VZV levels were vaccinated twice with a live attenuated varicella vaccine at an interval of 6 weeks. VZV IgG levels were analysed till 2 years after vaccination. The VZV-specific T-cell reactivity was determined prior to vaccination and after transplantation.ResultsSeventy-seven percent (40/52) of the vaccinees reached positive VZV-IgG levels after vaccination (responders). Eighty-two percent (9/11) showed an increase in VZV-specific CD4⁺ memory T-cells (both central and effector memory cells). The percentage VZV-specific CD8⁺ memory T-cells did not increase. None of the non-responders suffered from primary VZV after transplantation. No severe vaccine-related adverse events were reported, only spontaneously resolving local skin irritation.ConclusionThe live attenuated varicella vaccine evokes positive VZV IgG-levels and VZV-specific memory T-cells in VZV-seronegative potential kidney transplant candidates.     

Responses of varicella zoster virus (VZV)-specific immunity in seropositive adults after inhalation of inactivated or live attenuated varicella vaccine

To examine boostering of varicella zoster virus (VZV)-specific immunity in seropositive adults after nasal inhalation of heat-inactivated or live attenuated varicella vaccine, we determined specific cellular immunity, IgG antibody in sera and secretory IgA antibody in saliva before and after the inhalation. The mean titers in specific IgG antibody and skin test findings significantly increased following inhalation of both vaccines. However, the ratio of a two-fold or more increase in the levels of IgG antibody or skin test did not show significant difference after inhalation of the inactivated vaccine in comparison with those in the control. After inhalation of the live vaccine, the ratio showed significant difference but transmission of the live vaccine virus to others was suspected. No significant increase in VZV-secretory IgA antibody levels in saliva was noted following inhalation. The results of this study suggested that nasal inhalation of the live vaccine could increase specific immunity in adults. This method would be similar to the natural infection and simpler than subcutaneous injection.     

Use of statistical models for evaluating antibody response as a correlate of protection against varicella

In vaccine clinical trials, humoral antibody responses are often used to measure the effect of a vaccine because they correlate with a vaccine's protective efficacy against the target disease. While the concept of a correlate of protection usually refers to establishing a protective level of antibody titre, identifying a clear-cut value is often impossible because vaccine efficacy is not related solely to the antibody titre. We propose examining the relationship between disease protection and the whole distribution of antibody responses rather than a single cut-off level. In particular, we use failure-time models to estimate the relationship between long-term disease breakthroughs and primary antibody responses after vaccination. We apply these models to show that the varicella antibody response measured by glycoprotein enzyme-linked immunosorbent assay 6 weeks after vaccination strongly correlate with protection against varicella (chickenpox); we used 7-year follow-up data from children who received one dose of a live attenuated varicella (Oka/Merck) vaccine. In addition, we explore the potential use of these models to predict long-term disease breakthrough rates and to estimate the predicted vaccine efficacy of a similar varicella vaccine made with a modified manufacturing process.     

Modeling the impact of combined vaccination programs against varicella and herpes zoster in Norway

BackgroundAdoption of varicella immunization in Europe is limited due to a predicted increase in the incidence of herpes zoster (HZ) resulting from a removal of exogenous boosting by varicella vaccination. Most available assessments of immunization strategies only considered universal varicella vaccination (alone or in combination with HZ by the live vaccine). The development of a new subunit recombinant zoster vaccine may provide new perspectives of HZ control.MethodsWe used a mathematical model for VZV in Norway based on the progressive immunity formulation of exogenous boosting. We evaluated a complete range of alternative immunization options against varicella and HZ including both universal and targeted varicella vaccination, either alone or with zoster immunization, and zoster immunization alone. We considered all values of the boosting intensity consistent with the Norwegian HZ incidence and compared the performance of the currently available live vaccine vs. a new recombinant vaccine.ResultsUniversal varicella vaccination alone resulted in a marked increase in the incidence of HZ under all scenarios considered. Even under the most favorable hypotheses on the magnitude of the boosting intensity, this increase could be mitigated only by a parallel HZ immunization with a recombinant vaccine, assuming a long duration of protection. Targeted varicella immunization of adolescents resulted in a modest increase in the HZ incidence which could be counterbalanced by both the live and, especially, the recombinant vaccine.ConclusionsGiven current knowledge on HZ pathogenesis and exogenous boosting, targeted varicella vaccination of adolescents was the only strategy that was not predicted to impact the epidemiology of HZ, and therefore it may represent a suitable alternative to universal vaccination. These results are aimed to support vaccine policy decisions in Norway and other countries with a similar VZV epidemiology.     

Protective effect of vaccination against chickenpox

In a group of student volunteers vaccinated at the age of 13-17 years with vaccine produced by SmithKline Beecham Biologicals which contains the live attenuated strain of the Oka virus of varicella zoster the period of the protective effect of vaccination was assessed. In the course of 310,000 man-days of detailed investigation the authors revealed in 55 vaccinated subjects close exposure to a patient with varicella, and six of the vaccinated subjects contracted the disease after exposure. In the course of the subsequent three years no further case of varicella was recorded. Subjects vaccinated only by a single dose of the vaccine with low post-vaccination levels of specific antibodies contracted the disease.