接种吸附无细胞百白破联合疫苗局部过敏反应1例报告

患儿男性 ,2 0 0 2年 1 1月 3日出生。于 2 0 0 3年 5月 2 8日在五通桥区疾病预防控制中心接种门诊注射吸附无细胞百白破联合疫苗 (DTa P) ,防疫医生采用常规预防注射消毒方法于右上臂外侧三角肌附着处皮肤消毒后肌肉注射 0 .5 ml。疫苗系武汉生物制品研究所生产 ,批号 2 0 0 2     

1 486例婴幼儿接种两种百白破联合疫苗的副反应比较

[目的]比较全细胞百白破联合疫苗(DTwP)与无细胞百白破联合疫苗(DTaP)在婴幼儿群体中接种后的安全性。[方法]对3~6月龄的婴儿及18~24个月的幼儿进行两种疫苗接种后的副反应观察。[结果]基础免疫接种DTwP后全身反应发生率77.4%,局部反应发生率76.5%;接种DTaP后全身反应发生率15.8%,局部反应发生率15.9%。加强免疫接种DTwP后全身反应发生率42.6%,局部反应发生率31.0%;接种DTaP后全身反应发生率13.3%,局部反应发生率8.0%。[结论]接种DTaP副反应远DTwP为低,更适合婴幼儿使用。     

接种吸附无细胞百白破联合疫苗偶合败血症1例

吸附无细胞百白破联合疫苗 (diphtheria,tetanus and acellular pertussis combined vaccine,adsorbed,DTaP) 是预防儿童百日咳、白喉和破伤风的疫苗。按照国家计划免疫程序,出生3 个月~6周岁儿童必须接种百白破联合疫苗。接种DTaP疫苗后一般无反应,有的出现局部反应：如局部红肿、硬结、疼痛等,全身反应：发热、皮疹、惊厥、小儿烦躁不安、吵闹等,偶有过敏性皮疹、血管神经性水肿、无菌性化脓等,发生败血症的报道罕见。现将2013年8月,湖南省儿童医院在儿童免疫接种中遇到1例接种吸附无细胞百白破联合疫苗后,偶合败血症的病例报道如下。     

1例接种百白破联合疫苗和口服脊灰减毒活疫苗后死亡事件的调查

目的 调查1例接种疫苗后死亡案例,为类似事件的调查处置提供参考.方法 收集疫苗受种方、接种方、生产企业方等相关材料,对患儿接种疫苗后死亡事件进行调查.结果 专家组结合现场调查、查阅资料和现场询问,确定患儿接种疫苗后出现的过敏性休克死亡属于预防接种异常反应.结论 应切实做好接种前问询诊和知情告知工作,严格落实受种者疫苗接...     

北京市2005年接种吸附百白破联合疫苗后107例无菌化脓流行病学分析

目的了解北京市2005年接种吸附百白破联合疫苗(DPT)后无菌化脓病例增多的原因,保证安全接种。方法对北京市2005年接种DPT后107例无菌化脓进行描述流行病学分析。结果北京市2005年共报告107例无菌化脓,发生率为19.58/10万人次。83%(15/18)的区(县)报告了无菌化脓,共涉及6个批号DPT,其中80%的病例涉及2个批号,发生率分别为27/10万人份、15/10万人份。结论北京市2005年接种DPT后无菌化脓病例增多主要原因可能为:①DPT更换生产厂家,部分批号DPT的质量可能存在问题;②预防接种不良反应监测系统敏感性提高。疫苗生产厂家应改善工艺、提高质量,建议使用无细胞百白破联合疫苗。     

接种吸附无细胞百白破疫苗致1例过敏反应

2004年11月15日,天津市宁河县妇幼接种门诊接种山联泰吸附无细胞百日咳、白喉、破伤风联合疫苗（以下简称无细胞百白破疫苗）后,发生1例过敏反应,现将调查处理过程报告如下。     

吸附无细胞和全细胞百白破联合疫苗上市后预防接种安全性的比较分析

目的 评价中国(未包括香港、澳门特别行政区和台湾地区,下同)吸附无细胞百白破联合疫苗(Diphtheria Teta-nus and Acellular Pertusis Combined Vaccine,Absorbed;DTaP)和吸附全细胞百白破联合疫苗(Diphtheria,Tetanus andwhole-cell Pertusis Combined Vaccine,Absorbed;DTwP)上市后预防接种的安全性.方法 通过全国疑似预防接种异常反应(Adverse Events Following Immunization,AEFI)监测系统,收集10个试点省2005～2006年DTaP和DTwP严重不良反应监测数据,采用描述性方法对两种疫苗不良反应的发生特征进行比较分析.结果 中国DTaP和DTwP上市后,严重不良反应总发生率分别为3.5/10万剂和3.3/10万剂;DTaP以过敏反应为主,且第4剂反应危险性高;DTwP以无菌脓肿为主,高危险性反应剂次因反应的临床损害不同而异;部分疫苗品种和批号的反应存在聚集性,DTwP聚集性反应危险高于DTaP.结论 DTaP和DTwP上市后均具有较好的预防接种安全性;聚集性分析显示,DTaP安全性优于DTwP;需进一步加强对每批DTaP或DTwP上市前的质量控制.     

接种百白破联合疫苗出现血管神经性水肿一例报告

2006年11月6日,某儿童在重庆市巴南区某医院预防接种门诊接种吸附无细胞百白破联合疫苗后出现不良反应,我们对该事件进行了现场调查,现将调查情况报告如下。     

全细胞吸附百白破联合疫苗免疫接种反应观察分析

目的了解全细胞百白破联合疫苗(简称wDTP)接种反应的发生情况,更好地评价疫苗的安全性,为今后免疫策略的调整提供依据。方法接种疫苗后1个月内按自制的预防接种异常反应记录表调查。结果局部反应发生率为13.33%,各针次之间的局部反应差异无统计学意义(H=3.60,P>0.05);发热反应发生率为11.32%,各针次间发热反应差异有统计学意义(H=6.61,P<0.05)。结论应严格掌握疫苗接种禁忌症和接种注意事项,尽量减少wDTP接种反应发生,随着扩大免疫规划的实施,逐步推广使用更安全有效的无细胞百白破联合疫苗。     

2018—2021年扬州市无细胞百白破联合疫苗预防接种安全性评价

目的：分析扬州市无细胞百白破联合疫苗（DTap）接种后出现疑似预防接种异常反应（AEFI）的发生特征及分布情况,为进一步评价DTaP疫苗预防接种的安全性提供依据。方法：通过中国免疫规划信息管理系统的AEFI监测系统收集2018年1月1日—2021年12月31日扬州市报告的DTaP疫苗相关AEFI个案数据,采用描述流行病学方法进行分析。结果：2018—2021年扬州市共接种DTaP疫苗365 215剂次,共报告DTaP疫苗相关AEFI个案1 055例,年均报告发生率为288.87/10万剂次,其中,一般反应1 015例,占96.21%,报告发生率为277.92/10万剂次,临床表现主要为发热、红肿、硬结;异常反应38例,占3.60%,报告发生率为10.40/10万剂次,主要为过敏性皮疹和荨麻疹;偶合症最少,共2例,占0.19%,报告发生率为0.55/10万剂次,均为热性惊厥;无心因性反应、疫苗质量事故及预防接种事故发生。9个县（市、区）各年度均有DTaP疫苗相关AEFI个案报告,其中,报告发生例数最多的为江都区,为232例;各月份均有DTaP疫苗相关AEFI个案报告,其中5、6、7月份报...     

接种无细胞百白破引起偶合反应死亡1例报告

目的调查了解务川自治县黄都镇1例接种无细胞白百破疫苗引起死亡的发生情况。方法采用描述流行病学方法进行调查结果接种前儿童家长未告知儿童患感冒,接种无细胞白百破后,引起偶合反应,造成感冒加重,引起重症肺炎死亡。结论免疫规划预防接种过程中,要加强预检,发生偶合反应后,要及时进行救治和报告,减少预防接种偶合反应死亡病例的发生。     

Evaluation of the immunogenicity of a recombinant glycoprotein-based Chandipura vaccine in combination with commercially available DPT vaccine

Chandipura virus (CHPV) belongs to family Rhabdovoridae and has emerged as an encephalitis causing pathogen with high mortality among pediatric population from three Indian states. The recombinant glycoprotein (rGp) was shown to be an excellent vaccine candidate as evaluated in a murine model. As the disease is predominantly rural, to ensure maximum coverage for Chandipura vaccine, an attempt was made to evaluate combination of rGp and a commercially available DPT vaccine (CHP–DPT). When CHP–DPT was used for immunization of mice, 90% seroconversion against rGp with high antibody titers (1:1200 by ELISA and 1:320 by neutralization test) was observed and did not differ from mice immunized with rGp alone (P > 0.05). Similarly seroconversions and antibody titers against DPT were comparable in mice immunized with DPT alone or in combination with rGp. Seroconversions and antibody titers ranged from 90 to 100% and 1:1200 to 1:2400 respectively. Intracerebral challenge with homologous CHPV strain resulted in 90% survival in rGp alone and CHP–DPT groups. Lymphocyte proliferative responses were also comparable. Thus, neither components of the candidate combination vaccine inhibited immune response to the other component. Substantial decrease of CHPV RNA and absence of histopathological changes in the brains of surviving immunized mice after challenge than the unimmunized controls further confirm efficacy of the vaccine even after intracerebral challenge. In conclusion, a combination vaccine seems feasible for use in a restricted area where the disease is endemic and should be subjected to additional studies required for future use in humans.     

接种新配方和原配方吸附百白破混合制剂后的反应和抗体动态比较

比较了接种原配方（含百日咳菌４５亿／ｍｌ）和新配方（９０亿／ｍｌ）吸附百白破混合制剂（ＤＰＴ）后的接种反应和抗体动态。结果证明，新配方制剂能在基础免疫和加强免疫后至少１年内增强抗体的应答反应，提高免疫效果，而且不加重接种后的发热反应和局部中强反应。     

Trust collapse caused by the Changsheng vaccine crisis in China

BackgroundThe public acceptance and implementation of vaccination programs is essential to prevent infectious diseases. However, vaccine adverse events may cause public panic and eventually lead to an increasing number of populations who were hesitant or refuse to participate in these vaccination programs. In 2018, the Changsheng vaccine crisis broke out in mainland China, and 252,600 unqualified DTP vaccines were reported to be used for child vaccination. In this study, we observed media and public reactions toward the vaccine crisis.MethodsThis study conducted Internet surveillance by four mainstream indicators from July 15th to August 7th, including social media (WeChat, Sina Weibo), online news and Baidu search index. We also analyzed the emotional perceptions of people in crisis through an online questionnaire survey.ResultsDuring the crisis, huge number of articles emerged on Internet, 125,882,894 articles (including forwarding) on WeChat friends circle, 1,877,660 Sina Weibo posts, 648,265 online news and 4,986,521 Baidu search indexes. Most of these articles were negative and expressed the public’s weak confidence to the China-made vaccines. Public confidence in vaccines was undermined by the actions of the manufacturer and the government.ConclusionsThe DTP vaccine crisis led to panic about immunization and eroded trust in the immunization program and in the government. Restoring public confidence in Chinese-made vaccines will take a long time, and meticulous management in vaccine production, and strict government regulation will help to alleviate public anxiety about vaccine safety and ultimately restore confidence.     

中国狂犬病疫苗不良反应发生率Meta分析

目的 对中国地区狂犬病暴露后的普通人群全程接种狂犬病疫苗后不良反应发生率进行Meta分析,为开展狂犬病疫苗接种策略改进提供数据支持。方法 计算机检索中国知网、万方数据知识服务平台、维普期刊资源整合服务平台、中国生物医学文献服务系统、PubMed英文数据库和The Cochrane Library中公开发表的有关狂犬病疫苗接种后不良反应的研究文献,检索时限为2000年1月至2016年7月,根据纳入和排除标准收集资料,采用R软件对狂犬病疫苗不良反应发生率进行Meta分析。结果 共纳入29篇文献,纳入文献无明显发表偏倚,其中总调查人数为94 222人,发生不良反应11 020例,不良反应发生率为1.04%～47.78%。狂犬病疫苗总不良反应的合并发生率为9.82%（95% CI：7.58%～12.72%）,局部不良反应的合并发生率为12.05%（95% CI：9.26%～15.69%）,全身不良反应的合并发生率为9.06%（95% CI：7.07%～11.61%）。液体疫苗接种不良反应合并率为32.39%（95% CI：21.88%～47.94%）,冻干疫苗接种不良反应合并率为8.65%（95% CI：4.54%～16.51%）,两组差异有统计学意义（P<0.05）。结论 狂犬病疫苗接种局部不良反应率高于全身不良反应率。液体狂犬病疫苗不良反应率高于冻干狂犬病疫苗,建议采用安全性较好的冻干狂犬病疫苗,逐步替代液体狂犬病疫苗。     

2005～2007年上海市南汇区接种百白破疫苗不良反应监测分析

[目的]分析接种百白破疫苗后不良反应发生情况,寻找减少百白破疫苗接种不良反应的有效措施。[方法]对2005年9月至2007年6月上海市南汇区各级免疫预防机构收集的接种后不良反应资料进行统计分析。[结果]2005年9月至2007年6月,合计接种百白破三联疫苗52 572剂次,发生不良反应137例,发生率为0.26%。其中2005年9~12月百白破三联疫苗不良反应发生率为0.40%,2006年为0.27%,2007年1~6月为0.21%(P<0.05);接种第1剂次为0.11%,第2剂次为0.28%,第3剂次为0.24%,第4剂次为0.47%(P<0.01);接种全细胞疫苗(DTwP)为0.33%,接种无细胞疫苗(DTaP)为0.18%(P<0.01)。[结论]接种百白破三联疫苗后不良反应发生率较高。     

中国1～2岁儿童第二类疫苗接种现况调查分析

  目的   了解中国接种医生疫苗信息获取和二类疫苗推荐行为,为提高接种医生二类疫苗推荐意愿提供建议。  方法  于2019年1月,采用二阶段整群抽样对中国安徽、陕西和深圳3个省（市）的555名接种医生进行线上问卷调查,了解其社会人口学特征、二类疫苗推荐行为、获取疫苗信息的渠道和来源,并对二类疫苗推荐行为进行单因素和多因素分析。  结果   仅有51.53 % 的接种医生经常推荐二类疫苗。通过培训和会议、医务人员、专业书籍和媒体获取疫苗信息的接种医生分别占83.60 %、61.08 %、36.64 %、58.92 %;疫苗信息来源为疾病预防控制中心、疫苗生产厂家和政府的接种医生分别占97.48 %、31.17 %、29.73 %。多因素logistic回归分析结果显示,在深圳工作（OR = 0.66,95 % CI = 0.51～0.85）、职业为护士（OR = 0.65,95 % CI = 0.46～0.92）的接种医生经常推荐二类疫苗的可能性更小;而年龄在45岁以上（OR = 2.04,95 % CI = 1.01～4.11）,获取疫苗信息的渠道为培训和会议（OR = 2.11,95 % CI = 1.62～2.76）、专业书籍（OR = 1.28,95 % CI = 1.08～1.51）,获取疫苗信息的来源为疫苗生产厂家（OR = 1.55,95 % CI = 1.11～2.18）的接种医生经常推荐二类疫苗的可能性更大。  结论  中国接种医生二类疫苗推荐水平较低,需要加强接种医生从培训和会议、专业书籍等渠道获取信息,提高其二类疫苗推荐意愿。     

乙肝疫苗首针及时接种与乙肝疫苗百白破疫苗和麻疹疫苗全程免疫关系的研究

目的研究及时接种乙肝疫苗首针与完成乙肝疫苗、百白破疫苗和麻疹疫苗全程免疫的关系。方法利用2006年全国乙肝血清流调福建省资料,采用χ2检验比较组间各因素差异,logistic回归分析探讨影响完成3种疫苗全程免疫的影响因素,分层分析研究乙肝疫苗政策对上述关系的影响。结果本研究共有1 443名儿童纳入分析,χ2检验显示,乙肝疫苗首针接种不及时与及时组间（〉24hvs.≤24h）儿童完成3种疫苗全程免疫不同,及时组儿童显著高于不及时组儿童（χ2值分别为457.29,、42.96和74.95,P值均〈0.001）。logistic回归分析显示,及时接种乙肝疫苗首针者完成乙肝、百白破和麻疹疫苗全程免疫的OR值（95%CI）分别为24.36（14.46～41.05）、1.71（1.28～2.29）和2.35（1.68～3.30）。城区儿童完成百白破、麻疹疫苗的OR值分别为0.59（0.45～0.77）和0.36（0.26～0.48）。分层分析显示,乙肝疫苗政策有效降低了及时接种乙肝首针与完成乙肝全程免疫的关系（政策实施前后OR分别为68.09和5.67,差异有统计学意义P〈0.001）。结论及时接种乙肝首针能提高乙肝、百白破和麻疹疫苗全程免疫。     

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.     

Human papillomavirus vaccine motivators and barriers among community college students: Considerations for development of a successful vaccination program

BackgroundPrevious interventions in colleges to improve human papillomavirus (HPV) vaccination have not been highly successful. Although barriers have been assessed in traditional colleges, less is known about vaccination barriers in community colleges.MethodsWe approached students aged 18–26 years old enrolled at a community college for an in-person semi-structured qualitative interview on HPV vaccination and health, with questions guided by the Theory of Planned Behavior. Data collection took place between April 2015 and December 2015. Thematic analysis techniques were used to analyze the data.ResultsDuring interviews with 19 students, 4 themes emerged, including: general vaccine attitudes, barriers to HPV vaccination, motivators to HPV vaccination, and social influences. Participants felt that vaccines were beneficial, but were concerned about side effects. They felt that getting the HPV vaccine would be inconvenient, and they did not know enough about it to decide. Most would not trust their friends’ opinions, but would want to know about side effects that their vaccinated friends experienced.ConclusionsSuccessful interventions at community colleges should include several components to increase convenience as well as utilize interactive methods to promote HPV vaccine awareness.