2006年博白县麻疹疫苗强化免疫情况调查

[目的]分析博白县2006年麻疹疫苗（MV）强化免疫效果,探讨控制麻疹策略。[方法32006年对8月至10岁儿童实施MV强化免疫活动。综合分析MV强化免疫现场调查资料、评估报告、法定传染病报告系统资料。[结果]博白县2006年MV强化免疫共接种目标儿童235782人,报告接种率95．20％,快速评估接种率95．71％,免疫后人群麻疹IgG抗体阳性率为97．54％,保护率达90．16％。[结论]博白县2006年MV强化免疫成效显著。维持高水平常规免疫接种率,适时开展MV强化免疫和后续免疫．是有效控制麻疹的措施。     

广东省2009年麻疹疫苗强化免疫接种情况分析

[目的]对广东省2009年实施麻疹疫苗(MV)初始强化免疫的接种情况进行分析,为后续MV强化免疫提供经验。[方法]分析强化免疫期间的现场调查、评估报告和强化免疫前后的麻疹疫情资料。[结果]强化免疫共计接种目标儿童19952519人,报告接种率和快速评估接种率均﹥95%,快速评估接种率高于报告接种率(χ2=8.56,P﹤0.01)。各市报告接种率和快速评估接种率均﹥95%,其中深圳和中山快速评估接种率低于报告接种率,湛江、揭阳和云浮快速评估接种率高于报告接种率。用国家统计局的2008年末广东省人口资料估算接种率为90.19%;用广东统计年鉴2009公布的小学在校生数估算的小学生接种率为83.81%,第一批强化免疫的小学生估算接种率高于第二批,差异有统计学意义(χ2=263151.08,P﹤0.01)。强化免疫活动后的麻疹报告年发病率比强化免疫前下降了93.14%。[结论]本次麻疹疫苗强化免疫接种达到了预期目标,有效控制了广东省麻疹疫情。     

婴儿麻疹胎传抗体及初次接种麻疹疫苗免疫效果的观察

本文对278名5-8月龄儿童麻疹胎传抗体及其麻疹疫苗的免疫应答情况进行了研究。同时对120对新生儿及母亲、282名18-38岁育龄期妇女，观察其麻疹抗体消退情况进行了观察。结果表明：新生儿脐血与其母亲和18。36岁育龄妇女的抗体水平相一致；5-8月龄儿童麻疹胎传抗体阳性率在14．86％-55．71％之间，且7-8月龄阳性率显著低于5。6月龄（x^2=11．69，P〈0．01）；新生儿阳性率及GMT远高于5—8月龄婴儿，不同月龄的婴儿，阳性率及GMT随着月龄的增大，出现下降的趋势；而278名5—8月龄婴儿初免麻疹疫苗后，其免疫成功率为84．89％，GMT平均为1：1154．8，6-8月龄免疫成功率显著高于5月龄的婴儿（x^2=8．55、14、64、25．73，P〈0．01），尤其以8月龄婴儿免疫应答为好。另外，初免麻疹疫苗前IgG抗体滴度对免疫应答结果有明显的影响：180名IgG抗体≤1：200的婴儿，其免疫成功率为86，11％，19名IgG抗体滴度为≥1：800的婴儿，有10名免疫成功。综合以上结果，我们认为预防我市出现麻疹发病向低年龄组转化的趋势，在同时考虑麻疹疫苗免疫成功率及胎传麻疹抗体对麻疹疫苗免疫应答的影响的情况下，我们可以选择两种干预措施，第一种是麻疹疫苗的初免月龄还是定为8月龄为宜，从联合免疫等方面考虑也比较科学合理，对申请结婚的育龄期妇女中接种一针麻疹疫苗，将会有效提高母传麻疹抗体的水平，进而降低婴儿麻疹的发病率，这与国内有关文献报道结论一致。第二种是建议在麻疹流行期内，应急接种可从6月龄开始，从而可为更多的婴儿提供保护性抗体。     

东海县麻疹疫苗效价及基础免疫成功率监测分析

目的考核和评价东海县儿童麻疹疫苗的接种质量和效果，了解冷链系统和疫苗管理情况。方法2006年对东海县63名满8月龄儿童于麻疹疫苗免疫前及免疫后1个月各采集末梢血0．5ml．分离血清．应用血凝抑制试验检测麻疹血凝抑制（HI）抗体。采用组织培养法检测县疾控中心和乡镇接种点麻疹疫苗效价。结果免疫前麻疹HI抗体阳性率为6．35％．免疫后为100％．基础免疫成功率为96．83％，免疫后麻疹HI抗体几何平均滴度为1：122．49。县疾控中心和乡镇接种点麻疹疫苗效价均在10^2.5TCID50/0.1mL以上，均为合格疫苗。结论东海县麻疹疫苗基础免疫成功率为96．83％．高于国家免疫规划规定的免疫成功率≥85％的指标，冷链系统和疫苗管理情况良好，为控制和消除麻疹奠定良好的基础。     

麻疹疫苗再免疫效果的观察

对完成麻疹疫苗基础免疫的54名4～5a儿童进行麻疹疫苗再免疫效果观察显示：再免后1mon抗体阳性率由免前的77．78％提高到100％,GMT由226．75增加到520．79。4～5a年龄组间再免前抗体阳性率差异有显著性（P＜0．05）,再免前和再免后GMT差异均有显著性（P＜O．05）,说明4a儿童麻疹疫苗加强免疫是可取的。同时还发现再免疫成功率随再免前抗体滴度的增加而下降,再免前抗体滴度＜1：200者100％获得成功,≥1：400只有5％获得成功,提示我们麻疹疫苗的加强应根据当地人群免疫水平而决定。     

麻疹疫苗强化免疫控制麻疹流行的效果

黔南州自使用麻疹疫苗 (ＭＶ)以来 ,特别是随着计划免疫工作的逐步深入 ,麻疹流行得到有效控制 ,发病率逐年下降 ,至 1990年下降到 0 6 /10万。但近年来麻疹发病率回升 ,并出现局部村寨点状爆发流行。为探索控制措施 ,我们于1997年 10月选择 1个县作为试点 ,开展ＭＶ强化免疫 ,并进行 2年流行病学效果观察。1 方法 :全州共 12个县 ,选择都匀市为试点 ,其余 11个县市为对照。试点市 1996年前 2年麻疹年平均发病率2 7 44 /10万 ,对照县市 2 8 2 7/10万 ,两组差异无显著性。于1997年 10月中旬对试点市所有 8个月～ 7岁儿童 ,不论户籍和既往免…     

接种麻疹疫苗后怎么还出麻疹

我小孩出生后曾接种过麻疹疫苗，今年九岁了却得了麻疹这是什么原因造成的呢?     

赤峰市麻疹疫苗初始强化免疫后抗体水平调查分析

目的 为了解决赤峰市麻疹疫苗(MV)初始强化免疫抗体水平。方法 在全市计划免疫考核期间，在12个旗县区按年龄组随机抽取454名1～13岁儿童并采集血清，采用酶联免疫吸附试验(ELISA)法测定麻疹抗体。结果显示抗体阳性率为96．7％，保护率为86．1％，GMT为1：1174。结论提示赤峰市MV初始强化免疫效果是肯定的，由此建议为了保持较高的抗体保护率水平，应采取常规免疫和强化免疫相结合的免疫策略，同时加强麻疹病例的监测工作。     

新生儿乙型肝炎疫苗接种状况调查及应对措施探讨

目的:调查六盘水市、安顺市乙型肝炎(乙肝)疫苗首针(HBV1)接种情况,探讨提高HBV1及时接种率措施。方法:分层随机抽样调查新生儿接种情况、孕妇/婴儿母亲及接生/接种医生乙肝免疫预防知识掌握情况。结果:HBV1及时率医院出生儿童远高于在家出生,县级以上医院高于乡镇卫生院。81.10%孕妇/婴儿母亲做过产前检查,53.79%通过产前检查、67.01%通过村医获得乙肝免疫预防知识,79.51%认为村医口头宣传对自己有效;仅82.30%接生/接种医生知道国家对新生儿HBV1实行"谁接生、谁接种"政策,35.88%知道低体重新生儿不是接种禁忌证,56.94%知道新生儿感染乙肝病毒后最易成为慢性携带者,69.86%知道乙肝的传播途径包括围产期传播。结论:出生地点是影响新生儿HBV1及时接种的重要因素,提高住院分娩率,做好在医院出生儿童HBV1及时接种,是提高HBV1及时率的主要措施,乡镇级卫生院是院内出生新生儿及时接种的薄弱环节。应加强产前检查医生及村级防保人员的新生儿HBV接种宣传工作,加强对接生/接种医生乙肝免疫预防知识的培训。     

Genetic polymorphisms in host antiviral genes: associations with humoral and cellular immunity to measles vaccine

Host antiviral genes are important regulators of antiviral immunity and plausible genetic determinants of immune response heterogeneity after vaccination. We genotyped and analyzed 307 common candidate tagSNPs from 12 antiviral genes in a cohort of 745 schoolchildren immunized with two doses of measles-mumps-rubella (MMR) vaccine. Associations between SNPs/haplotypes and measles virus-specific immune outcomes were assessed using linear regression methodologies in Caucasians and African-Americans.Genetic variants within the DDX58/RIG-I gene, including a coding polymorphism (rs3205166/Val800Val), were associated as single-SNPs (p ≤ 0.017; although these SNPs did not remain significant after correction for false discovery rate/FDR) and in haplotype-level analysis, with measles-specific antibody variations in Caucasians (haplotype allele p-value = 0.021; haplotype global p-value = 0.076). Four DDX58 polymorphisms, in high LD, demonstrated also associations (after correction for FDR) with variations in both measles-specific IFN-γ and IL-2 secretion in Caucasians (p ≤ 0.001, q = 0.193). Two intronic OAS1 polymorphisms, including the functional OAS1 SNP rs10774671 (p = 0.003), demonstrated evidence of association with a significant allele-dose-related increase in neutralizing antibody levels in African-Americans. Genotype and haplotype-level associations demonstrated the role of ADAR genetic variants, including a non-synonymous SNP (rs2229857/Arg384Lys; p = 0.01), in regulating measles virus-specific IFN-γ Elispot responses in Caucasians (haplotype global p-value = 0.017). After correction for FDR, 15 single-SNP associations (11 SNPs in Caucasians and 4 SNPs in African-Americans) still remained significant at the q-value < 0.20.In conclusion, our findings strongly point to genetic variants/genes, involved in antiviral sensing and antiviral control, as critical determinants, differentially modulating the adaptive immune responses to live attenuated measles vaccine in Caucasians and African-Americans.     

Immune response to measles vaccine in 6-month-old infants of measles seronegative mothers

Determinants of measles vaccine-induced immune response in infancy include maternal immune status and the infant's age at immunization. In a previously published study, 74% of 19 6-month-old infants developed neutralizing antibody. Two of the infants were born to measles seronegative mothers¹. In order to (1) assess the prevalence of measles seronegativity in a population of US mothers born after 1960 and (2) assess the immunogenicity of standard titer measles vaccine in 6-month-old infants of measles seronegative mothers, mothers with healthy term (≥37 weeks gestation) infants attending well child care clinics at MetroHealth Medical Center were prospectively screened for measles antibody by EIA. If negative, maternal samples were retested for neutralization (NT) antibody. Fifteen of 169 women were seronegative by both assays. Six-month-old infants of 9 of these 15 seronegative mothers were enrolled in the pediatric vaccine study. Serological response of these 9 infants to monovalent measles vaccine (Attenuvax^®) was compared to the responses of 17 6-month-old infants of seropositive mothers and 15 15-month-old toddlers from our previous study. All 9 infants of seronegative mothers became EIA seropositive after the vaccine compared to 9 of 17 6-month-old infants born to seropositive mothers (p = 0.02). Differences in NT seroconversion rates (100% vs 70.6%) were not statistically significant. The comparison group of 15-month-old vaccinees showed 100% seroconversion by both assays. The NT geometric mean titer (GMT) was higher in the 15-month-old toddlers than in the 6-month-old infants born to seronegative mothers (87.2 vs 33.9, p < 0.01), suggesting age-related differences in humoral immune response unrelated to passively transferred maternal antibody.     

A survey on factors affecting acceptance of measles vaccine

The reasons for the low level of acceptance of measles vaccine were investigated through interviews with the mothers at the time of their children enrollment in the first year of attendance at several nursery schools in Milan city and its suburbs. Data were also collected on the natural disease.Only 192 (13.8%) of the 1386 children included in the study had already suffered natural measles and 45 of them before the age of 12 months. Of the total, 10% of the children had been vaccinated, more in the city of Milan than in the suburbs. Approximately one-half of the vaccinations had been administered by family doctors and the other half in Public Health facilities. Less than half of the vaccinations administered in the city of Milan proved to have been registered in Public Health Office records. The frequency of vaccinated children was significantly higher among mothers with higher levels of education than among those with lower levels of education.The reasons for the lack of vaccination most. frequently given by the mothers of the 1247 unvaccinated children were ignorance about the vaccine (38% of the mothers) and the belief that measles is an innocuous disease (36%). These were followed by fear of post-vaccinal reactions and advice against measles vaccine given, in most cases, by family doctors. The frequency of responses for each one of these reasons was significantly different in Milan with respect to the suburbs. This difference was also evident in the comparisons between mothers with higher levels of education with respect to mothers with low levels of education.Corresponding author.     

6月龄与8月龄婴儿接种麻疹疫苗后的血清学效果

[目的 ]　探索麻疹疫苗最佳初免月龄。 [方法 ]　分别选择卢湾、杨浦、南汇 3个区县 6、8月龄健康婴儿192名和 177名 ,给予麻疹疫苗接种 ,并对其免前、免后血清抗体水平进行观察。 [结果 ]　 6月龄婴儿麻疹疫苗免疫后IgG抗体阳转率 92 .6 1% ,GMT 1340 .15 ;8月龄婴儿IgG抗体阳转率 96 .0 0 % ,GMT 1138.11。[结论 ]　如果 8月龄初免前婴儿麻疹发病率高的地区 ,可考虑将初免时间提前至 6月龄     

麻疹病例及人群免疫水平调查分析

目的分析麻疹病例与人群麻疹免疫水平,为控制麻疹提供科学依据。方法用酶联免疫吸附试验(ELISA),对麻疹病例及人群血清分别检测IgM和IgG抗体。结果 316例麻疹,<8个月龄和8个月龄~2岁,占总病例数的66.14%,麻疹疫苗接种率为22.33%;其次为20~岁占16.77%,接种率为9.43%。人群麻疹抗体阳性率最高为15~岁组(100.00%),最低为<2岁组(76.19%);几何平均倒数滴度(GMRT)最高为2~岁组(723.09),最低20~岁组(355.07);GMRT(539.61)高于20~岁组和育龄期妇女(370.23)。结论麻疹病例印证了人群麻疹免疫状况,提示加强常规免疫,做好大年龄人群特别是育龄期妇女的强化免疫。     

临沂市部分人群麻疹抗体水平及麻疹疫苗强化免疫血清学效果监测

目的了解临沂市麻疹疫苗强化免疫的效果和人群麻疹抗体水平.方法随机抽取2个县区1 534名0～39岁健康人,应用酶联免疫吸附试验检测麻疹IgG抗体.结果1 534人中抗体阳性1190人,阳性率77.57%,几何平均滴度(GMT)1:783.1～12岁儿童抗体阳性率最高(85.71%～98.44%),GMT则从6岁开始下降至中低等水平,抗体阳性率有随年龄增长而下降的趋势.观察麻疹疫苗初种8～12月龄儿童188人,免疫成功率为96.81%;麻疹疫苗复种5～7岁儿童186人,免疫成功率61.29%;免疫后抗体GMT初、复种疫苗分别比免疫前提高28.4倍和3.1倍.结论大年龄儿童及成人的麻疹抗体水平仅达到中低水平;不论是初种或复种,免疫前抗体处于中低等水平者其免疫成功率显著高于免疫苗高抗体水平者.     

乙型肝炎疫苗长期免疫对人群乙型肝炎病毒流行状况的影响

目的探讨乙型肝炎（乙肝）疫苗长期免疫接种后整体人群乙肝病毒（HBV）感染状况及其变化趋势。方法采用整群抽样结合横断面调查方法，共收集资料完整的调查对象4686名，采集静脉血并分离血清，用固相放射免疫法检测HBV感染标志。结果整体人群平均HBsAg阳性率为7．5％，抗-HBs为44．5％，抗-HBc为47．8％；0～19岁人群HBsAg和抗-HBc阳性率较≥20岁人群显著下降。乙肝疫苗免疫组的HBsAg阳性率为2．8％，抗-HBc阳性率为12．0％，HBV感染率为12．5％，未免疫组分别为10．2％、69．8％和71．2％。男性平均HBsAg阳性率比女性高，抗-HBc和抗-HBs阳性率男女性别间无差异。0～19岁人群的HBsAg阳性率为2．4％，而20～30岁人群阳性率达到13．6％～17．7％，到60岁开始下降；0～19岁人群的抗-HBs阳性率随年龄增长而明显下降，≥20岁人群的抗-HBs、抗-HBc阳性率均随着年龄增长而呈升高趋势。结论长期开展新生儿乙肝疫苗免疫使人群HBV流行状况发生变化，感染高峰年龄段后移。     

宁波市江东区满周岁流动儿童乙型肝炎疫苗接种情况分析

宁波市江东区自1989年开始在新生儿中推广接种乙型肝炎（乙肝）疫苗,1990年起乙肝疫苗接种纳入儿童计划免疫管理。本文对江东区满周岁流动儿童的分布状况及乙肝疫苗接种情况进行了分析。