国产麻疹-腮腺炎-风疹联合疫苗与麻疹疫苗的免疫效果评价

目的研究探讨国产麻疹-腮腺炎-风疹联合疫苗(MMR)和麻疹疫苗的免疫效果差异性,为下一步更好使用联合疫苗提供依据。方法选择8月龄儿童随机分为两组,分别接种MMR疫苗和麻疹疫苗,于免前免后采血,用酶联免疫吸附法(ELISA)定量检测接种者相应的IgG抗体水平。结果观察对象接种MMR疫苗前后麻疹IgG抗体GMT分别为1.536、27.763,抗体阳转率85.71%;另一组观察对象接种麻疹疫苗前后麻疹IgG抗体GMT为1.205、30.867,抗体阳转率82.14%,两组相比差异无统计学意义。观察对象接种MMR疫苗后风疹IgG抗体和腮腺炎IgG抗体的阳转率都在80%以上。结论国产MMR疫苗具有良好的免疫原性。     

国产冻干麻疹-流行性腮腺炎-风疹联合减毒活疫苗免疫原性及安全性观察

目的观察国产冻干麻疹-流行性腮腺炎(腮腺炎)-风疹联合减毒活疫苗(MMR)的安全性及免疫原性。方法选取18~24月龄儿童210名,每名儿童接种1剂MMR,在接种后30min、6h、24h、48h、72h、7d、9d分别观察接种后临床反应,并于接种前、后6周各采集血清标本1份,用血凝抑制(HI)试验定量检测麻疹、腮腺炎、风疹IgG抗体。结果接种MMR后中、弱发热反应发生率4.29%,在1~2d内消退,无异常反应发生。免疫前麻疹HI抗体阴性儿童,免疫后抗体阳转率100%;免疫前麻疹HI抗体阳性儿童,免疫后抗体≥4倍增长率61.53%;抗体几何平均滴度(GMT)免疫后比免疫前增长3.8倍。免疫前腮腺炎HI抗体阴性儿童,免疫后抗体阳转率83.50%;免疫前腮腺炎HI抗体阳性儿童,免疫后抗体≥4倍增长率53.97%;抗体GMT免疫前1∶1.57,免疫后1∶3.52。免疫前风疹HI抗体均为阴性,免疫后抗体阳转率100%;抗体GMT 1∶487.2。免疫前、后麻疹、腮腺炎、风疹的抗体阳转率及GMT差异均有显著的统计学意义。结论国产冻干MMR具有良好的安全性和免疫原性。     

8月龄儿童接种麻疹-腮腺炎-风疹三联疫苗免疫效果及接种安全性观察

目的观察在8月龄儿童接种MMR的免疫效果和安全性，为在该年龄组用MMR替代麻疹单苗提供依据。方法选定部分合适对象开展MMR接种，在免前和免后6周分别采取外周静脉血1ml，分别作麻疹、风疹和腮腺炎的抗体滴度测定；同时对受种对象跟踪观察接种反应的发生情况。结果在8月龄儿童中开展MMR三联疫苗的接种在免疫效果上麻疹和风疹的免疫效果较好，免疫抗体阳转率分别为98．61％和100％，而其中的腮腺炎抗体阳转率和免疫成功率不高，仅分别为23．21％和31．25％。从接种的安全性来说，发生的局部反应轻微，也未出现严重的全身反应。结论在8月龄儿童开展MMR接种安全性较好，尚需提高MMR中的腮腺炎的免疫应答率。     

不同厂家生产的冻干麻疹-风疹-腮腺炎三联减毒活疫苗免疫效果及安全性观察

目的 为了解不同厂家生产的冻干麻疹-风疹-腮腺炎三联减毒活疫苗免疫效果和安全性。方法 对545名18—24月龄儿童分组接种三种MMR疫苗，观察疫苗接种的安全性，并分别于免前免后采血，用微量血凝抑制法定量检测接种者的HI抗体GMT水平。结果三组观察对象接种MMR后麻疹HI抗体阳转率均在90％以上，风疹HI抗体阳转率均为100％，腮腺炎HI抗体阳转率均在80％左右，三组均无明显差异，疫苗接种后三组对象全身和局部反应轻微。结论国产与进口的三种MMR疫苗均有良好的有效性和安全性，可用于预防麻疹、风疹、腮腺炎。     

麻疹 流行性腮腺炎 风疹联合疫苗2剂免疫的效果观察

为观察麻疹、流行性腮腺炎 (腮腺炎 )、风疹联合疫苗 (MMR) 2剂免疫的效果 ,选择 8月龄已接种 1剂麻疹疫苗、且在 12～ 18月龄已接种 1剂MMR ,无风疹疫苗及腮腺炎疫苗免疫史的健康儿童 110人 ,在 4周岁时进行第 2剂MMR免疫 ,并在免疫前和免疫后 1个月分别采集手指末梢血 0 3ml,检测麻疹IgG抗体、腮腺炎血凝抑制 (HI)抗体、风疹HI抗体。结果显示 :观察对象在 4周岁时进行第 2剂MMR免疫前 ,麻疹IgG抗体阳性率 10 0 0 0 % ,风疹HI抗体阳性率 10 0 0 0 % ,而腮腺炎HI抗体阳性率 5 8 18%。而第 2剂MMR免疫后 ,麻疹IgG抗体阳性率仍为 10 0 0 0 % ,几何平均滴度 (GMT)为 1∶2 6 78,较免疫前≥ 4倍增长率为 14 6 8% ;风疹HI抗体阳性率仍为 10 0 0 0 % ,GMT为 1∶6 11 90 ,较免疫前≥ 4倍增长率为 5 0 4 8% ;腮腺炎HI抗体阳性率为 98 0 0 % ,GMT为 1∶32 4 9,较免疫前≥ 4倍增长率为 6 9 0 9%。表明MMR 2剂的免疫效果较好 ,为了消除麻疹、风疹、先天性风疹综合征及控制腮腺炎 ,上海市应借鉴美国的经验 ,在进一步开展接种MMR流行病学效果调查的基础上 ,适时调整免疫策略 ,采取 2剂MMR接种方案。     

上海市麻疹、流行性腮腺炎、风疹抗体水平调查分析

[目的 ]　了解本市健康人群麻疹、腮腺炎、风疹的抗体水平。　 [方法 ]　采集 0～ 5 0岁健康人群血标本 5 43份 ,检测麻疹、腮腺炎、风疹抗体。　 [结果 ]　小于 8月龄组麻疹抗体GMT最低 ,接种麻疹疫苗后抗体GMT显著升高 (P<0 .0 0 1) ;小于 8月龄组及 8月龄组风疹抗体水平最低 ,1岁接种疫苗后风疹抗体显著升高 (P <0 .0 0 1) ,但随着年龄的增长抗体水平有所下降 ,抗体阳性率维持在 85 %以上 ;小于 8月龄组及 8月龄组流行性腮腺炎抗体水平最低 ,1岁以上各年龄组抗体水平显著上升 (P <0 .0 0 1)。　 [结论 ]　上海市现阶段实行麻疹疫苗、MMR疫苗的接种程序比较合理和有效 ,但应该进一步开展上海市育龄期妇女风疹抗体水平调查和MMR疫苗免疫持久性观察 ,研究预防未及龄儿童麻疹疫苗免疫策略、育龄期妇女接种风疹疫苗免疫策略 ,预防先天性风疹综合征     

陕西省儿童风疹、腮腺炎抗体水平检测

目的 了解陕西省健康儿童麻疹、风疹、腮腺炎的抗体水平.方法 采集1～14岁健康儿童血标本225份,检测麻疹、风疹、腮腺炎抗体.结果 麻疹抗体阳性率维持>94%.城市儿童风疹和腮腺炎抗体几何平均浓度(GMC)1～2岁组最高(27.74%,28.94%),随年龄增长呈下降趋势;农村儿童风疹和腮腺炎体阳性率1～2岁组最低(24.2%,21.2%),随年龄增长呈上升趋势.结论 陕西省健康儿童对风疹和腮腺炎的免疫力较低,有必要对所有1岁儿童接种麻风腮三联疫苗.     

国产麻疹流行性腮腺炎风疹联合疫苗初免效果及免疫程序探讨

目的为观察麻疹、流行性腮腺炎(腮腺炎)、风疹联合疫苗(MMR疫苗)的安全性和免疫原性,并探讨其免疫程序.方法选择91名8月龄儿童,接种MMR疫苗,观察接种后局部反应和全身反应,并检测接种后6周血清麻疹、腮腺炎、风疹抗体阳转率和几何平均滴度(GMT).结果91名8月龄儿童接种MMR疫苗后,有8名儿童发生一过性发热,2名儿童发生皮疹,2名儿童发生局部弱反应.麻疹、风疹、腮腺炎血凝抑制(HI)抗体阳转率分别为98.61%、100.00%、74.07%,GMT分别为145.25、1248.71、14.29.结论MMR疫苗对8月龄儿童接种具有较好的安全性和免疫原性,将其初免月龄定为8月龄儿童是可行的.     

乙型肝炎疫苗初次免疫正常应答和高应答新生儿在幼儿期加强免疫对免疫保护持久性影响的配对病例对照研究

目的 探讨乙型肝炎(乙肝)疫苗加强免疫对初次免疫(初免)正常应答和高应答新生儿免疫持久性的影响。方法 选择乙肝疫苗初免正常应答和高应答新生儿,在其幼儿期(2~3岁)时加强免疫3剂次者作为加强免疫组,按照1:1匹配原则随机选择性别、居住乡镇相同的未加强免疫者作为未加强免疫组;于初免5年后采血检测抗-HBs和抗-HBc。结果 加强免疫组和未加强免疫组初免5年后抗-HBs阳性率分别为97.39%(224/230,95%CI:94.41%~99.04%)和53.91%(124/230,95%CI:47.24%~60.48%),几何平均抗体浓度(GMC)分别为1140.02(95%CI:887.46~1464.46) mIU/ml和11.53(95%CI:8.73~15.23) mIU/ml;两组5年随访抗体阳性率和GMC值的差异均有统计学意义(P<0.05)。两组HBV突破性感染率分别为0.87%(2/230)和2.17%(5/230),差异无统计学意义(P>0.05)。多因素分析表明,初免5年后抗-HBs阳性率与是否加强免疫和初免时抗-HBs水平独立相关,OR值分别为38.75(95%CI:16.23~92.54)和3.06(95%CI:1.51~6.17)(P值均<0.05)。结论 乙肝疫苗初免正常应答或高应答儿童在幼儿期加强免疫可有效提高抗体持久性,但对预防HBV感染可能无明显作用。     

广东省肇庆市2012年全人群麻疹、风疹、流行性腮腺炎抗体水平调查

目的了解肇庆市全人群麻疹、风疹、流行性腮腺炎抗体水平,为控制相应疾病、改善免疫策略提供科学依据。方法按分层随机原则抽取肇庆市三个县区2012年全人群血清标本共319份,用酶联免疫吸附试验定量检测麻疹、风疹、流行性腮腺炎Ig G抗体水平。结果肇庆市2012年全人群麻疹抗体阳性率为88.40%、抗体几何平均浓度(Geometric Mean Concentration,GMC)为1167.95m IU/ml;风疹抗体阳性率为78.06%、GMC为146.10IU/ml;流行性腮腺炎抗体阳性率为74.92%,GMC为447.96U/ml。人群麻疹、风疹抗体阳性率在不同县区、年龄段、性别、城乡之间没有统计学差异;流行性腮腺炎抗体阳性率在城乡之间没有统计学差异,在不同县区、不同年龄段、性别之间有统计学差异(X~2=9.760,P0.05;X~2=36.509,P0.05;X~2=5.575,P0.05);低龄儿童麻疹、风疹、流行性腮腺炎抗体阳性率和GMC偏低,20~29岁年龄段人群麻疹、风疹抗体阳性率和GMC不高。结论肇庆市全人群对麻疹、风疹、流行性腮腺炎疾病已建立一定的免疫屏障,但应加强对低龄儿童的预防接种工作,及时为8~11月龄儿童接种麻疹风疹联合减毒活疫苗(MR)、1.5岁以上儿童接种麻腮风联合减毒活疫苗(MMR);建议为20~29岁育龄期妇女接种MR或MMR,进一步提高全人群防病水平。     

Antibodies to measles,mumps, and rubella virus in Thai children after two-dose vaccination at 9 months and 2.5 years: A longitudinal study

IntroductionThailand changed the schedule of childhood measles–mumps–rubella (MMR) vaccination in 2014, moving the second dose from the age of 6 years to 2.5 years. There are currently no data on antibody responses to the MMR vaccine since this recommendation.Material and methodsWe investigated antibody responses in a cohort of children who received two doses of MMR vaccine at the ages of 9 months and 2.5 years that was originally established to evaluate antibody levels to Bordetella pertussis antigens (ClinicalTrials.gov no. NCT02408926). Infants were born to mothers who previously received tetanus–diphtheria–acellular pertussis vaccine at 27–36 weeks of gestation. Anti-measles, -mumps, and -rubella virus IgG levels were measured at birth (cord blood) and the ages of 2 and 7 months (before the first MMR vaccination); 18 and 24 months (9 and 15 months, respectively, after the first dose); and 36 months (6 months after the second dose) using commercially available enzyme-linked immunosorbent assay kits.ResultsAt 7 months of age, 96.2%, 99.6%, and 98.8% of infants had no protection against measles, mumps, and rubella, respectively. Levels of antibody against all three antigens increased significantly after the first but not the second dose. At 6 months after two-dose vaccination, 97.4%, 84.8%, and 78.7% of children remained seroprotected against measles, mumps, and rubella, respectively.ConclusionsMaternally derived antibodies to measles, mumps, and rubella virus disappeared by the age of 7 months in Thai children. Two-dose MMR vaccination at 9 months and 2.5 years of age induced robust immune responses against these viruses.     

Antibody persistence in children aged 6–7 years one year following booster immunization with two MMR vaccines applied by aerosol or by injection

ImportanceIn a previous study on booster vaccination, we reported that two aerosolized MMR vaccines were as safe and immunogenic as injectable vaccines containing the same antigens. We now present results of antibody persistence one year after immunization.ObjectiveTo assess the antibody persistence for measles, mumps, and rubella one year following booster immunization.MethodsWe performed clinical and serological follow-up of participants in a previous study of Mexican children aged 6–7 years, in which participants were randomized to four groups receiving, by aerosolized or by injection, the MMR SII vaccine (Serum Institute of India), or the MMR II (Merck Sharp & Dhome). We evaluated the antibody persistence by PRN test for measles and by ELISA for rubella and mumps. The occurrence of clinical events was evaluated via periodic visits of a nurse team to children’s schools and homes.ResultsOf the 260 initial participants, 241 completed one-year follow-up. There were only statistically significant differences in baseline seropositivity for mumps. One year after immunization, seropositivity in all groups was 100% for measles and rubella. The seropositivity rank for mumps was from 90.3% for the injected vaccine MMR II to 96.6% for vaccine MMR SII applied by aerosol; these differences were not statistically significant. With exception of the aerosolized vaccine MMR SII for the geometric mean titer (GMT) for measles, all study groups presented declination of GMT for the three viruses. The difference between the aerosolized vaccines MMR SII and MMR RII was statistically significant for mumps antibodies. Only mild clinical events were identified.ConclusionUnder conditions of no endemic transmission for measles and rubella, and of low circulation of mumps virus, school-aged children remained seropositive to the three viruses one year following booster immunization.The study was registered under CMN 2010-005 number at COFEPRIS (National Regulatory Authority).     

麻疹-流行性腮腺炎-风疹联合减毒活疫苗与流行性腮腺炎减毒活疫苗免疫学效果比较

目的比较麻疹-流行性腮腺炎（流腮）-风疹联合减毒活疫苗（Measles,Mumps and Rubella Combined Attenuated Live Vaccine;MMR）与流腮减毒活疫苗（Mumps Attenuated Live Vaccine,MuV）的免疫学效果。方法在宝鸡市选取18-24月龄未患过流腮、无MuV或含流腮成分疫苗免疫史、无接种禁忌证的健康儿童作为观察对象,将其按照所属乡分为两组,采集免疫前血清后分别接种MMR和MuV,1个月后采集免疫后血清检测流腮免疫球蛋白（Immunoglobulin,Ig）G。结果接种MMR的流腮IgG阳性率由免疫前的9.4%上升至98.8%,阳转率为98.8%,几何平均浓度（Geometric Mean Concentration,GMC）由免疫前的54.8单位（Unit,U）/毫升（ml）上升到1380.8 U/ml,增长24.2倍。接种MuV的流腮IgG阳性率由免疫前的8.3%上升至94.0%,阳转率为89.3%,GMC由免疫前的70.5 U/ml上升到611.1 U/ml,增长7.67倍。结论接种MMR和MuV均有良好的对流腮的免疫学效果。     

麻疹-流行性腮腺炎-风疹联合减毒活疫苗流行性腮腺炎组份免疫效果观察

目的对麻疹-流行性腮腺炎（流腮）-风疹联合减毒活疫苗（Measles,Mumps and Rubella Combined Atteruated Live Vaccine,MMR）中,流腮组份的免疫效果进行观察评价。方法对接种MMR后,流腮组份免疫学效果进行分析评价,并追踪观察记录2年内受种人群及本地人群中流腮发病情况。结果接种MMR前,流腮抗体几何平均滴度（Geometric Mean Titer,GMT）为1∶6.87,免疫后GMT为1∶26.35,免疫后GMT是免疫前GMT的3.8倍,免疫前、后GMT差异有统计学意义（Z=-6.22,P〈0.001）。免疫前、后流腮抗体阳性率分别为64.63%、95.12%,差异有统计学意义（χ2=23.71,P〈0.001）。免疫前、后流腮抗体阴性者与阳性者GMT和免疫前相比差异均有统计学意义（Z=-4.40,P〈0.001;Z=-4.84,P〈0.001）。免疫前流腮抗体阴性者与阳性者接种MMR后,免疫成功率分别为86.21%、54.72%,差异有统计学意义（χ2=8.266,P=0.004）。对受种人群及本地人群进行为期2年的流腮发病追踪观察,在受种人群中未发现流腮病例报告。结论在3-6岁儿童中接种MMR,对于预防流腮效果良好,产生的保护效果至少能维持2年。     

Mutual interference on the immune response to yellow fever vaccine and a combined vaccine against measles, mumps and rubella

A randomized trial was conducted to assess the immunogenicity and reactogenicity of yellow fever vaccines (YFV) given either simultaneously in separate injections, or 30 days or more after a combined measles-mumps-rubella (MMR) vaccine. Volunteers were also randomized to YFV produced from 17DD and WHO-17D-213 substrains. The study group comprised 1769 healthy 12-month-old children brought to health care centers in Brasilia for routine vaccination. The reactogenicity was of the type and frequency expected for the vaccines and no severe adverse event was associated to either vaccine. Seroconversion and seropositivity 30 days or more after vaccination against yellow fever was similar across groups defined by YFV substrain. Subjects injected YFV and MMR simultaneously had lower seroconversion rates - 90% for rubella, 70% for yellow fever and 61% for mumps - compared with those vaccinated 30 days apart - 97% for rubella, 87% for yellow fever and 71% for mumps. Seroconversion rates for measles were higher than 98% in both comparison groups. Geometric mean titers for rubella and for yellow fever were approximately three times higher among those who got the vaccines 30 days apart. For measles and mumps antibodies GMTs were similar across groups. MMR's interference in immune response of YFV and YFV's interference in immune response of rubella and mumps components of MMR had never been reported before but are consistent with previous observations from other live vaccines. These results may affect the recommendations regarding primary vaccination with yellow fever vaccine and MMR.     

An evaluation of measles, mumps and rubella vaccine in a population of Yorkshire infants

In October 1988 combined measles, mumps and rubella (MMR) vaccination replaced monocomponent measles as part of the routine childhood vaccination programme in the United Kingdom. Prior to this policy change a study was undertaken in 335 children aged 15 months, to evaluate the clinical reactions and immunogenicity of the new combined MMR vaccine (Trimovax, Immravax, Merieux), in comparison with an established monocomponent measles vaccine (Rouvax, Merieux). Parents were asked to select whether their child should receive MMR vaccine or measles monocomponent; over 95% chose MMR. Children who were given the MMR vaccine had seroconversion rates of 96% for measles, 97% for mumps and 100% for rubella, whilst those who received monocomponent measles vaccine had a seroconversion rate of 100%. The number of side effects reported was similar with both vaccines; all were mild and self-limiting. The results from this study confirm the efficacy and low reactogenicity of MMR vaccine and support its use as part of the routine childhood immunisation programme in the United Kingdom.     

Duration of the immune response to MMR vaccine in children of two age-different groups

A combined vaccine against measles, mumps and rubella (MMR) was administered to both a group of children aged 10–12 months simultaneously with booster doses of compulsory diphtheriatetanus toxoids and oral poliovirus vaccine and a group of children aged 15–24 months who had previously received booster doses of the compulsory vaccines.Apart from one subject belonging to the second group who was non responder and one from the same group who did not seroconvert against the mumps virus alone, 5 to 6 weeks after MMR vaccine administration we found protective levels of antibodies against measles, mumps and rubella viruses in all children. The follow up of both groups at 3 years did not reveal difference between the two groups. Protective levels of serum antibodies against measles and mumps were found in the two groups, altough a significant decline of rubella antibodies was shown (p < 0.05).Since the immunogenicity of the vaccines in the two groups did not differ, we recommend that the scientific community reconsider the vaccination schedule until now recommended. In our opinion the MMR vaccine should be administered simultaneously with booster doses of diphtheria-tetanus toxoids and oral poliovirus vaccine at 10–12 months of age because this policy improves parents' compliance, markedly reduces community costs and simplifies routine immunization schedule.     

Seroprevalence of Antibodies to Measles, Mumps, and Rubella among Thai Population: Evaluation of Measles/MMR Immunization Programme

Stored serum specimens, from four regions of Thailand, of healthy children attending well baby clinics and of healthy people with acute illnesses visiting outpatient clinics were randomly sampled and tested for IgG antibody to measles, mumps, and rubella (MMR). The immunity patterns of rubella and mumps fitted well with the history of rubella and MMR vaccination, seroprotective rates being over 85% among those aged over seven years. A high proportion of younger children acquired the infection before the age of vaccination. MMR vaccination should preferably be given to children at an earlier age. For measles, 73% seroprotective rates among children, aged 8-14 years, who should have received two doses of measles/MMR vaccine, were lower than expected. This finding was consistent with the age-group reported in outbreaks of measles in Thailand. The apparent ineffectiveness (in relation to measles) of MMR immunization of 1^st grade students warrants further studies.Key words: Antibodies, Immunization, Measles, Measles vaccine, Mumps, MMR vaccine, Rubella, Seroepidemiologic studies, Seroprevalence, Vaccination, Thailand     

冻干麻疹-腮腺炎-风疹三联活疫苗免疫安全性及免疫学效果观察

目的 观察卫生部北京生物制品研究所研制的麻疹-腮腺炎-风疹（北京MMR）疫苗的免疫学效果。方法 分别选择10-12岁，2-2.5岁和8-12月龄儿童，接种北京MMR（实验疫苗），并与进口MMR疫苗，麻疹疫苗，腮腺炎疫苗和风疹疫苗（对照疫苗）相比较，开展该疫苗的免疫安全性和免疫原性观察研究。结果 在32名2岁以上较大龄儿童接种北京MMR疫苗无副反应发生后，对104名8-12月龄婴儿接种该疫苗，仅有6.7%和1.9%的儿童分别发生一过性发热（中低反应）和皮疹，无其他不良反应发生，北京MMR疫苗免疫接种后，其麻疹，风疹，腮腺炎HI抗体阳转率分别为100%，100%和85.7%;GMT分别为41，320和6.1，分别与对照疫苗相比，差异多无显著性。结论 北京MMR疫苗具有与目前使用的麻疹疫苗，腮腺炎疫苗，风疹疫苗及进口MMR疫苗相同的免疫安全性和免疫原性，且可以作为麻疹的基础免疫和复种疫苗使用。