流行性乙型脑炎灭活疫苗与减毒活疫苗相结合的免疫策略研究

目的　为合理利用流行性乙型脑炎 (乙脑 )灭活疫苗和减毒活疫苗各自的优点 ,降低预防接种反应的发生率 ,提高免疫学效果 ,开展了乙脑灭活疫苗与减毒活疫苗相结合的免疫策略研究。方法　观察比较两种疫苗单一使用与联合使用的免疫学效果及安全性。结果　联合使用组在疫苗接种后 2 4h的全身中强以上发热反应发生率为 0 .73 % ,局部红晕反应为 1 .46 % ,而单一使用灭活疫苗组的发热反应发生率为 2 .8%。不同观察组疫苗接种后中和抗体几何平均滴度由免疫前的 1∶1 .0 5～1∶3 .35上升至 1∶47.34～ 1∶1 0 1 .30 ,联合使用组的中和抗体阳转率为 97.67% ,明显高于单一使用灭活疫苗组 86 .2 7%的阳转率 (χ2 =3 .89,P <0 .0 5) ,但与单一使用减毒活疫苗组 93 .75 %的阳转率差异无显著性 (χ2 =0 .74,P >0 .0 5)。结论　研究表明对婴幼儿使用乙脑灭活疫苗基础免疫、减毒活疫苗加强免疫有很好的免疫学效果及安全性 ,也是切实可行和比较理想的免疫策略

Study on the strategy of Japanese encephalitis immunization using live attenuated vaccine combined with inactivated vaccine

OBJECTIVE: Using the advantages of Japanese encephalitis live attenuated and inactivated vaccine, to reduce the rate of immunization reaction and to increase the effect, we conducted a study on the strategy of immunization in Japanese encephalitis using live attenuated vaccine combined with inactivated vaccine. METHODS: Observing the safety and immune effects of different groups. RESULTS: Data on side effect showed that the rate of moderate and severe systematic reactions of the group who were inoculated with combined vaccine was 0.73%, with local reaction 1.46% while the combined rate of moderate and severe systematic reaction of the group who were inoculated with inactivated vaccine was 2.8%. Under the detection of serum neutralizing antibody, the GMT rose from 1:1.05 - 1:3.35 before vaccination to 1:47.34 - 1:101.30 after vaccination in the different groups. Neutralizing antibody was detected in 97.67% of the combined group. There was a significant difference by comparing neutralizing antibody seroconversion rate of the combined group with the inactivated group (chi(2) = 3.89, P < 0.05), but no significant difference with attenuated group (chi(2) = 0.74, P > 0.05). CONCLUSION: Results showed that in children who previously had been immunized with two doses of inactivated vaccine, the booster administration of live attenuated vaccine was both effective and safe.