2010年吉安市吉州区扩大免疫规划疫苗接种率的抽样调查

目的 研究分析江西省吉安市吉州区扩大免疫规划疫苗的接种情况.方法 2010年在吉州区随机抽取了315名儿童进行考核,每个接种点入户查阅儿童预防接种证、卡记录和询问家长.结果 吉州区建卡率100.00%,建证率100.00%,卡证相符率81.59%.基础免疫卡介苗接种率100.00%;脊髓灰质糖丸接种率100.00%;百白破全程接种率100.00%;乙肝疫苗全程接种率98.73%.基础免疫乙脑减毒活疫苗接种率96.51%;A群流脑全程接种率95.55%;甲肝减毒活疫苗接种率93.02%;加强免疫乙脑减毒活疫苗接种率91.11%.基础免疫麻风二联疫苗接种率97.46%;加强免疫无细胞百白破三联疫苗接种率91.11%;麻腮风疫苗接种率91.75%.结论 吉州区扩大国家免疫规划疫苗接种工作正在有序开展,原有免疫规划疫苗合格接种率继续保持在95%以上,扩大国家免疫规划新增疫苗合格接种率达到90%以上.     

2013年北京市东城区安定门街道2～3岁组儿童计划免疫接种率调查结果分析

目的为及时掌握安定门街道3个居委会的免疫规划疫苗接种情况,找出薄弱环节,保证扩大国家免疫规划工作继续顺利开展[1]。方法采用批质量保证抽样方法（LOSA）在安定门街道调查2～3岁组适龄儿童30名,进行入户调查现场询问,查看接种证、卡、填写《儿童预防接种入户调查表》。结果疫苗接种率卡介苗96．7％、及时接种率30％,乙肝接种率100％,乙肝首剂及时接种率83．3％,脊髓灰质炎100％、百白破100％、麻风100％、麻腮风100％、A群流脑96．7％、乙脑93．3％、甲肝93．3％。本地儿童与流动儿童接种率比较,流动人口乙肝首剂及时接种率,乙脑、甲肝接种率均低于本市儿童差异有统计学意义（p〈0．05）。     

免疫规划儿童免疫接种率调查

目的 了解高新区免疫规划儿童免疫接种率的状况,为后续制定相应的儿童疾病干预防治措施提供科学依据.方法 根据地区的人口容量,按照概率抽样的方法,随机抽取辖区内45个居民区,在每个居民区再随机查1~3岁的常住儿童,共调查了560名儿童的免疫规划疫苗的接种状况.结果 高新区本地常住儿童免疫规划建卡率为96.76%,建证率100%,所建的卡和证相符率为100%.乙型肝炎疫苗、卡介苗、脊髓灰质炎疫苗、吸附无细胞百白破联合疫苗、乙型脑炎疫苗、麻风疫苗、流脑A（2次剂）疫苗、麻风腮疫苗共八类疫苗的全程合格接种率为95 68%.其中乙型肝炎疫苗96.38%,乙型肝炎疫苗首针及时接种率为96.26%、卡介苗100%、脊髓灰质炎疫苗97 13%、吸附无细胞百白破联合疫苗99.83%、乙型脑炎疫苗95.38%、麻风疫苗94.67%、流脑A（2次剂）疫苗的接种率为92 39%、百白破加强接种率为85.96%、麻风腮疫苗93.34%,结论 高新区儿童免疫规划儿童免疫接种率保持在一个相对较高的水平,但是一些偏远的地区这几种疫苗的接种率和合格率低于全市的平均水平,流脑疫苗的接种率为我高新区最低,因此仍需加强对偏远地区的疫苗接种.     

北海市某社区流动学龄儿童免疫情况调查及影响因素分析

目的了解北海市某社区流动儿童计划免疫接种现状及影响因素。方法对本社区所辖的三所民营小学的新入学流动儿童286人的免疫状况进行调查。结果居住时间超过3年者卡介苗、乙型肝炎、脊髓灰质炎、百白破(百日咳、白喉、破伤风)、麻风、麻腮风(麻疹、腮腺炎、风疹)、流行性乙型脑炎、A群流脑(流行性脑脊髓膜炎)、A+C群流脑、甲型肝炎疫苗等首针及加强接种率远高于居住时间少于1年者,父母是小商贩的儿童接种率高于农民工或其他行业,省内流动儿童略高于省外。结论影响流动学龄儿童接种的因素主要有儿童在辖区居住时间长短及父母从事职业等。     

2013-2015年兴化市城区入托入学儿童预防接种证查验结果分析

目的 了解兴化市城区入托、入学儿童预防接种证查验与疫苗漏种、补种情况,提高我市儿童的疫苗接种率.方法 按照《兴化市2015年入托、入学儿童预防接种证查验及疫苗补种工作实施方案》,收集2013～2015年预防接种证查验报表及资料,进行分类比较和统计分析.结果 兴化市城区托幼机构及小学预防接种证查验率100.00％;持证率99.11％.2013～2015年补种前全程接种率分别是87.98％、88.75％、92.18％,呈逐年上升的态势,3年平均全程接种率89.70％,其中幼儿园占90.78％,小学占89.21％,差异有统计学意义(P＜0.01).11种免疫规划疫苗中,托幼机构漏种率最高的是A+C群流脑疫苗,最低的是乙肝、卡介苗;小学漏种率最高的是白破疫苗,最低的是乙肝、卡介苗.结论 建议采取多种措施,提高预防接种证持有率和疫苗接种率,促进计划免疫工作,预防相关传染病.     

上海市宜川街道流动儿童免疫接种现况与分析

目的：了解上海市宜川街道外来流动儿童免疫接种状况，探讨外来流动儿童免疫规划管理的有效措施和方法。方法：将宜川街道社区卫生服务中心免疫规划软件中的2009年6月—2016年5月0~6岁儿童4383人的数据导出建立数据库，其中本市2686人，流动儿童1697人。比较本市和流动儿童疫苗接种率和及时率。结果：流动儿童迁入和迁出百分比均明显高于本市儿童。流动儿童乙肝、百白破、麻疹疫苗接种率，乙肝、灰苗、百白破、麻疹接种及时率均低于本市儿童（P＜0.001）。结论：流动儿童的免疫规划管理需要社会多部门共同合作，加强网络信息化管理，不断完善流动儿童管理机制，提高免疫规划接种率。     

十五种传染病免费种疫苗

卫生部日前公布了《扩大国家免疫规划实施方案》，扩大国家免疫规划范围，规定在现行全国范围内使用的乙肝疫苗、卡介苗、脊灰疫苗、百白破疫苗、麻疹疫苗、白破疫苗等6种国家免疫规划疫苗基础上，以无细胞百白破疫苗替代百白破疫苗，将甲肝疫苗、流脑疫苗、乙脑疫苗、麻腮风疫苗纳入国家免疫规划，     

2种乙肝疫苗免疫效果比较

目的观察2种乙肝疫苗的免疫效果。方法选择我县2～6岁儿童220例,分为乙肝血源性疫苗组100例,重组基因疫苗组120例。均为上臂三角肌肌内注射。结果2组儿童的免疫效果无统计学意义（P〉0.05）。结论无论是乙肝血源性疫苗还是重组基因疫苗,对儿童均有明显的保护作用,应继续推广普及乙肝疫苗的接种。     

健康宣教对南翔地区看护点流动儿童预防接种率的影响

目的:探讨健康教育对看护点流动儿童预防接种率的影响.方法:2015年采用整群抽样方法选取南翔地区的5所流动儿童看护点的5名卫生老师和826名家长作为干预对象进行规划免疫培训和健康宣教.采用问卷调查观察干预对象对计划免疫相关知识的知晓情况以及乙型肝炎(乙肝)、脊髓灰质炎(脊灰)、百白破、麻疹、乙型脑炎(乙脑)以及流行性脑脊髓膜炎(流脑)等6种疫苗的接种率,并与2013年的资料进行对比.结果:卫生老师及看护点儿童家长对儿童凭证入园知晓率和规划免疫相关知识知晓率均比宣教前有明显提高(30.95%和40.38%比100%和82.28%,P<0.01);乙肝、脊灰、百白破、麻疹、乙脑以及流脑疫苗的接种率分别从2013年的95.14%、80.63%、85.31%、75.94%、78.13%、60.63%提高到100%、100%、100%、100%、100%、80.2%,差异有统计学意义(P<0.05).结论:通过借助政府教育部门的力量,在流动儿童看护点展开计划免疫健康宣教,以及制定相应的制度,明确相应责任,能提高老师和家长对计划免疫的知晓率,同时能提高预防接种率,可取得良好的社会效益.     

护理干预对儿童免疫接种百白破疫苗不良反应的影响分析

百白破疫苗主要为氢氧化铝吸附百日咳菌苗液、破伤风类毒素和白喉类制成的,用于预防白喉、百日咳和破伤风的混合疫苗。百白破疫苗在我国的国家免疫规划中。其在预防应用中针次多、广泛。第一针接种于婴儿满3个月,继第一针后30d内给予第二、三针,并分别在之后的3个月内每月为婴儿注射一针,在婴儿18~24个月时再给予一针加强。长期的应用数据统计表明,儿童免疫接种百白破疫苗发生不良反应的概率极高。所以如何通过护理干预来影响儿童免疫接种百白破疫苗的不良反应成为焦点。本文将对儿童接种前后实施护理干预,减小其不良反应的发生。     

济源市2009年扩大国家免疫规划疫苗报告接种率及其影响因素分析

目的  客观评价济源市2009年扩大国家免疫规划疫苗的报告接种率,并分析其影响因素。方法  按卫生部《预防接种工作规范》规定,运用比较法、差值（D）和比值（R）法进行评价。结果  济源市2009年扩大国家免疫规划疫苗基础免疫报告接种率和调查接种率均>95%。乙型脑炎疫苗、A群脑膜炎球菌多糖疫苗的调查接种率均高于调查合格接种率。D值评价,除乙型肝炎疫苗为可疑外,其余疫苗均为不可信,但所有疫苗的估算接种率均高于报告接种率。R值评价,全市有3个单位出现不可信结果。结论  在进行D值和R值评价时,应充分考虑到超生儿童及流动儿童对结果的影响。此外,应进一步完善和提高常规免疫接种率报告系统和报告质量,提高专业报告人员的工作责任心和业务素质;并经常开展接种率报告评价,及时发现和查明数据偏差的原因。     

两种国产乙型肝炎疫苗预防接种效果分析

目的  了解郑州某高校新生对两种国产乙型肝炎（乙肝）疫苗预防接种的效果。方法  采用随机抽样方法,抽取743名新生分为两组,分别接种重组乙肝疫苗（CHO细胞）和重组乙肝疫苗（汉逊酵母）,剂量均为10μg/0.5ml, 按0、1、6个月免疫程序接种,免疫后2个月,检测血清抗-HBs滴度,比较两种疫苗的抗体阳转率和几何平 均浓度（GMC）。结果  重组乙肝疫苗（CHO细胞）组的抗体阳转率为87.14%,重组乙肝疫苗（汉逊酵母）组的抗体阳转率为97.20%。两组疫苗的抗-HBs GMC分别为1489.72和2265.68 mIU/ml。 结论  国产重组乙肝疫苗（汉逊酵母）预防接种效果良好,应大力 推广使用。     

Combined vaccination against hepatitis A,hepatitis B,and typhoid fever: safety,reactogenicity, and immunogenicity

BACKGROUND: The etiological agents of hepatitis A, hepatitis B, and typhoid fever share similar patterns of global distribution, and cause significant disease burden in travelers to endemic countries. Combined vaccination against all three diseases, based on currently available vaccines, would promote compliance and convenience for travelers. This clinical study evaluated the feasibility of extemporaneously syringe-mixed hepatitis A and B vaccine (Twinrix) and a Vi polysaccharide vaccine (Typherix) in healthy adults, and compared this to concomitant administration of the vaccines in separate arms. METHODS: The mixed dose of vaccine contained at least 720 enzyme-linked immunosorbent assay (ELISA) units of the inactivated hepatitis A antigen, 20 microg of the recombinant hepatitis B antigen and 25 microg of the Vi polysaccharide typhoid antigen in 1.5 mL. The study was conducted in 200 healthy 18- to 45-year-old volunteers. RESULTS: Equivalence between the vaccines mixed before administration and the concomitantly administered vaccines was shown in terms of seroconversion and seroprotection. With the exception of local injection site soreness, which was higher in the mixed administration group, the reactogencity was similar for both groups. In both vaccination groups more than 95% of the subjects were anti-hepatitis A virus and anti-Vi seropositive 1 month after the first vaccination. With regard to hepatitis B, a strong response was achieved in both groups, with more than two-thirds of the subjects protected 2 months after the start of the immunization course. CONCLUSION: These results support the feasibility of extemporaneously syringe-mixed combined hepatitis A and B vaccine with a Vi polysaccharide typhoid vaccine, administered in healthy adults.     

我国A群C群脑膜炎球菌多糖疫苗有效组分质量趋势分析研究

目的 对我国2014—2016年A群C群脑膜炎球菌多糖疫苗有效组分进行质量趋势分析研究。方法 收集2014—2016年国内两家企业的送检A群C群脑膜炎球菌多糖疫苗批签发资料,对疫苗有效组分A群和C群多糖含量检测结果进行趋势分析,同时按规定随机抽取一定批次疫苗进行多糖含量测定,并与企业自检结果进行统计学比较分析。结果 2014—2016年所有送检疫苗批次的生产及检验记录摘要审查符合标准要求;趋势分析结果显示,各企业的A群和C群多糖含量测定结果均在警戒限（平均值±2SD）以内,环比年度统计学比较分析也未发现显著性差异,趋势平稳,一致性较好;中国食品药品检定研究院对不同批次疫苗多糖含量检测结果与企业自检结果无显著性差异。结论 我国的A群C群脑膜炎球菌多糖疫苗产品中多糖含量稳定,批间一致性较好,检验方法可靠,从而确保了上市产品的质量。     

Strategies for development of universal vaccines against meningococcal serogroup B disease: the most promising options and the challenges evaluating them

A vaccine inducing protection against most of the circulating variants of serogroup B meningococcal strains is not yet available. A number of plausible options are currently under investigation. A conjugate vaccine based on a modified capsular polysaccharide might well work, but has safety concerns from molecular mimicry between group B sialic acid and human tissue. Recently, however, the group B capsule has been shown to contain de-N-acetyl sialic acid residues that do not cross react with normal host tissues and can then be the target of bactericidal antibodies. Potentially, this polysaccharide structure could form the basis of a safe and protective group B vaccine. Outer membrane vesicles (OMVs) from Neisseria lactamica avoid the immunodominant and highly strain specific immune response against the PorA protein, and are reported to elicit cross reactive protection in mice against lethality from challenge with meningococcal group B bacteria. However, the serum antibody responses lack bactericidal activity, and the mechanisms of protection are unknown. A number of universal, cross-reactive antigens have been identified through "reverse vaccinology" and successfully tested as recombinant protein vaccines. Promising results have also been demonstrated using OMV vaccines prepared from strains engineered for upregulation of conserved, cross-reactive antigens. This approach takes advantage of experience gained with conventional wild-type OMV vaccines and the large number of new antigens identified through sequencing the genome of N. meningitidis. Initial studies show that the traditional use of detergents to decrease toxicity by extraction of lipopolysaccharides (LPS) should, if possible, be omitted in order to avoid extraction of important lipoproteins. In the absence of detergent extraction, clinical OMV formulations with acceptable toxicity may still be achieved by constructing vaccine production strains with genetically detoxified LPS. Thus, a MenB vaccine might be designed based on non-cross-reactive capsular antigens, OMV vaccines from genetically modified strains, recombinant proteins or a combination of these approaches. Given all of the recent data available and experience gained, the possibility for development of a universal vaccine for prevention of group B meningococcal disease looks promising. For evaluation of vaccine formulations relying on cross-reactive proteins, selection of strains for representation of the global epidemiological situation will be of outmost importance. Defining criteria for establishing and revising such strain collections is currently ongoing and will be a key element in developing and evaluating new protein based vaccines in the time to come.     

早产儿疫苗免疫接种研究进展

目的：疫苗的免疫程序和疫苗使用指导原则是保证疫苗免疫效果的重要环节,也是《疫苗管理法》的重要内容之一。早产儿免疫系统发育不成熟,对于各种疫苗免疫反应低于足月儿。本综述为制定早产儿免疫程序提供参考。方法：本文对在早产儿中使用灭活脊髓灰质炎疫苗、百日咳-白喉-破伤风疫苗、乙型肝炎疫苗、肺炎链球菌疫苗、脑膜炎球菌结合疫苗和流感嗜血杆菌疫苗、轮状病毒疫苗、麻疹、腮腺炎、风疹和水痘疫苗等疫苗的免疫效果、安全性及耐受性研究进展进行了归纳整理。结果：本文对早产儿在接种不同疫苗、采取不同免疫策略时体液免疫和细胞免疫效果的研究进行了归纳总结,结果表明虽然早产儿的免疫功能相对较弱,但参照足月新生儿免疫方案接种疫苗后,大部分早产儿可以具有足够的免疫保护力。结论：本文为疫苗免疫程序的制定提供更全面的理解,为制定疫苗使用指导原则提供参考。     

Meningococcal vaccine development: a novel approach

Neisseria meningitidis is a major world-wide cause of meningitis. Effective capsular polysaccharide (CPS) vaccines that elicit CPS-specific bactericidal (BC) antibodies were previously developed and licensed to protect against meningococcal disease. However, due to their T-cell independent character, CPS vaccines are useless in infants and do not provide immunological memory or long-lasting protection in adults. CPS-protein conjugate vaccines are being developed to improve and broaden vaccine efficacy by creating T-cell dependent antigens. However, group B meningococci (GBM) are responsible for nearly half of meningococcal disease and possess a CPS, composed of polysialic acid, that is poorly immunogenic. N-propionyl (NPr) modification of the GBM polysaccharide (GBMP) has enhanced its immunogenicity, but BC antibodies are not induced at high levels, even when conjugated to conventional protein carriers, unless adjuvants stronger than aluminium hydroxide are used. We have chosen to couple the NPr-GBMP by reductive amination to a recombinant GBM class 3 porin (rPorB), which we have shown to modulate the immune response in animals towards the production of CPS-specific BC antibodies. We have also combined this conjugate with similar CPS-rPorB conjugates for groups A and C meningococci to form a trivalent A/B/C conjugate vaccine. This trivalent meningococcal vaccine has been shown to be safe and highly immunogenic in mice and non human primates, generating CPS-specific BC antibodies for each of the 3 major serogroups, which should provide world-wide protection against meningococcal disease.     

重组人粒细胞刺激因子在《中国药典》、《美国药典》和《欧洲药典》中的质量标准对比分析

目的对比重组人粒细胞刺激因子(rhG-CSF,Filgrastim)在《中国药典》(2010年版)、《美国药典》33版初稿和《欧洲药典》(7.0版)中标准的差异,为国内研发机构在rhG-CSF质量标准的提高研究提供参考。方法按三部药典要求,对rhG-CSF产品进行主要关键指标的检测分析。结果《中国药典》在对该产品的标准描述上不如《欧洲药典》(7.0版)和《美国药典》33版初稿,而《美国药典》33版初稿的rhG-CSF标准要求最高。三部药典存在具体内容的区别。结论提高rhG-CSF现行产品质量标准可参照《美国药典》33版初稿。