国产麻腮风联合减毒活疫苗的稳定性观察

目的  观察国产麻腮风联合减毒活疫苗（麻腮风疫苗）的稳定性。方法  取24批上海生物制品研究所有限责任公司（上海公司）2008－2017年生产的麻腮风疫苗,按照国家食品药品监督管理局批准的麻腮风疫苗注册标准和中国药典的要求进行各项检定：在0个月进行热稳定性试验;在0和18个月进行鉴别试验,外观、水分、无菌、异常毒性检查,牛血清白蛋白残留量、抗生素残留量（2010年10月以后）、细菌内毒素（2013年12月以后）、pH值和渗透压摩尔浓度检测（2015年12月以后）;在0、6、12、18个月进行病毒滴定。同时对新、老车间生产的各3批疫苗进行加速稳定性与长期稳定性试验,重点考察水分和病毒滴度。结果  麻腮风疫苗在有效期内各项指标检定结果均符合注册标准和药典要求。质量可比性研究结果显示新老车间生产的疫苗质量相似。疫苗中水分都不高于3.0%,麻疹、腮腺炎、风疹病毒滴度分别为3.3～4.3 、4.6～5.6 、3.3～4.3 半数细胞培养感染量/ml。结论  上海公司10年间生产的麻腮风疫苗质量稳定、安全有效。     

器官移植受者接种麻疹、腮腺炎、风疹系列疫苗的有效性和安全性研究

器官移植受者术后易于感染许多疫苗可预防疾病,存在预后不良的风险,甚至可因严重感染而威胁生命。接种麻疹、腮腺炎、风疹（麻腮风）系列疫苗能有效降低器官移植受者术后的麻疹、腮腺炎和风疹发病率。此文综述了器官移植受者接种麻腮风系列疫苗的有效性和安全性,以期为器官移植受者制定个性化麻腮风系列疫苗免疫接种程序提供参考。     

麻疹-腮腺炎-风疹联合减毒活疫苗生产场地变更的质量可比性研究

目的  比较生产场地变更前后生产的麻疹-腮腺炎-风疹联合减毒活疫苗（麻腮风疫苗）的关键质量指标及其变化趋势。 方法   新老车间同步各生产3批麻腮风疫苗,比较新老车间生产的疫苗的关键指标及其变化趋势,同时对新老车间生产的疫苗进行稳定性和安全性比较研究。 结果   新老车间生产的疫苗成品的关键质量指标均符合相关规定的要求,其中新车间生产的疫苗的水分为1.6%~1.8%,其麻疹、腮腺炎和风疹病毒滴度分别为4.1~4.3、4.8~5.0 和3.9~4.1 lgCCID₅₀/ml,与老车间生产的疫苗（水分为1.6%~2.1%,麻疹、腮腺炎和风疹病毒滴度分别4.0~4.3、4.8~5.0和4.1~4.2 lgCCID₅₀/ml）相似。新老车间生产的疫苗成品的稳定性和安全性实验结果均符合相关规定的要求,且新老车间生产的疫苗的稳定性实验结果相似,新老车间生产的疫苗的抗生素残留量（t＝3.46,P>0.05）和牛血清白蛋白残留量（t＝2.00,P>0.05）间的差异无统计学意义。 结论   麻腮风疫苗生产场地变更未对其制品质量产生影响。     

两种不同取样方式测定麻腮风类减毒活疫苗病毒滴度的评价

目的：比较麻腮风类减毒活疫苗的两种取样方式测定疫苗各组分滴度是否存在差异。方法：采用多支疫苗混合滴定和单支疫苗滴定两种方法对国内上市的麻腮风类疫苗进行检测，对两种方法测定的结果平行比对。结果：单支疫苗滴定后的均值与多支疫苗混合后的检测结果基本一致； 腮腺炎疫苗的支间滴度差异略高，麻疹、风疹疫苗的支间滴度差异较小。结论：目前使用的多支混合滴定的检测方法能够满足对麻腮风类疫苗质控的要求，但单支滴定法对工艺改进更有指导意义。     

接种麻腮风疫苗诱发血小板减少性紫癜1例案例分析

目的分析1例接种麻腮风疫苗诱发生小板减少性紫癜案例,总结处理经验教训。方法对病例开展一系列完整流行病学调查。结果本例为接种麻腮风疫苗诱发血小板减少性紫癜。结论本病例接种麻腮风疫苗1 d后出现发热、接种部位及全身皮肤黏膜广泛出血,表现为针尖大小的出血点和瘀点、瘀斑等症状,血小板计数在50×10~9/L以下,经诊断为血小板减少性紫癜,属于预防接种异常反应,主要治疗方法为应用糖皮质激素和丙种球蛋白进行治疗,愈后良好。提示,应重点加强对县、乡级预防接种人员及临床医师进行疑似预防接种异常反应的诊断和处理能力培训,避免给受种者健康造成危害。     

老年病患者护理风险因素探讨及管理策略

目的 为老年病患者提供安全、优质的护理服务,降低护理风险系数,提高护理质量。方法根据老年病患者的特点,通过识别与分析患者现存和潜在的护理风险,提出有效的风险管理策略,指导临床规避和化解护理风险。结果护理风险发生率降低,护理人员提高了风险防范意识,促进护理管理质量。结论对老年病患者实施护理风险管理尤为重要;健全管理机制、优化工作流程是基础;提高护理人员风险防范意识及对风险评估能力是关键。     

病毒性疫苗生产过程的质量风险分析

文章结合质量风险管理理念，识别病毒性疫苗生产过程的风险，降低产品风险，保证疫苗质量。以GMP、ICH Q9、WHO TRS981附录质量风险管理指南为基础，以病毒性疫苗为例，选用鱼骨图对生产过程进行识别，选用FMEA法对识别出的风险进行评估。对识别出的风险提出风险控制措施，及监管检查建议。质量风险管理伴随疫苗生产全过程，使用适当的风险评估工具可有效识别过程风险，为企业生产和监管检查提供建议，有效防控风险。     

新兵接种麻腮风疫苗的免疫效果、影响因素及认知研究

目的:了解部队新兵接种麻腮风疫苗（MMR）的免疫效果、影响因素及对预防接种的态度。方法:采用整群抽样的方法选择驻广东某部2017年9月入伍的2个新兵营作为研究对象。选择新兵营一396人开展麻腮风联合减毒活疫苗免疫效果及影响因素研究,选择新兵营二473人开展疫苗的认知调查。对新兵接种MMR前后的抗体滴度进行检测,并开展问...     

医药短信息

国内 卫生部近日发表声明，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、麻疹疫苗和白破疫苗等6种国家免疫规划疫苗基础上，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，对适龄儿童进行常规接种。     

麻疹减毒活疫苗生产工艺优化

目的 调整优化现行麻疹疫苗原液生产工艺,为提高麻疹疫苗及其联合疫苗质量提供参考。方法 应用10层细胞工厂(CF10)、三种不同感染复数(MOI)和两种换液次数制备麻疹单价疫苗及其联合疫苗,并取2020年北京生物制品研究所有限责任公司疫苗一室生产的麻腮风联合减毒活疫苗原液商业批的连续三批为对照组,通过比较活细胞数、细胞存活率来确认各组间基线一致性,通过比较麻疹病毒滴度与细胞病变程度、麻腮风成品中麻疹病毒滴度及其热稳后滴度来评估优化后的工艺效果。结果 各组细胞悬液所含活细胞数与存活率均符合国家规定,具有较好的基线一致性。其中E组滴度均数和标准差波动幅度较理想,一收滴度为(5.77±0.07)lgCCID₅₀/ml,二收滴度为(6.00±0.08)lgCCID₅₀/ml,原液滴度为(5.97±0.05)lgCCID₅₀/ml,E组病变程度更高、面积更大、分布更均匀,与滴度结果相匹配。热稳试验后各组滴度均有不同程度下降,E组方案制备的MMR中麻疹单基滴度和热稳下降幅度较理想,单基滴度为(4.23±0.07) lgCCID     

基于产品生命周期的疫苗质量风险管理研究

目的：明确产品生命周期各阶段质量风险管理重点工作及控制措施,为产品全生命周期质量风险管理提供有力保障。方法：以GMP、PIC/s GMP附件20、ICH Q8、ICH Q9、ICH Q10、ICH Q12、WHO质量风险管理指南为基础,运用归纳总结及分析评估方法,对疫苗产品生命周期各阶段的质量风险管理进行研究。结果：通过质量风险管理研究,明确了生命周期不同阶段影响疫苗质量的关键因素,以满足科学和法规符合性为基础,提出具体控制措施,有效防控质量风险。结论：质量风险管理伴随疫苗产品全生命周期,任何一个阶段的质量风险管理工作都需重视并认真执行,采取科学合规的控制措施,可达到有效防控质量风险的目的。     

Live attenuated measles, mumps, rubella, and varicella zoster virus vaccine (Priorix-Tetra)

The live attenuated tetravalent vaccine against measles, mumps, rubella, and varicella zoster viruses (MMRV) is a combination of the measles, mumps, and rubella (MMR) vaccine and the varicella zoster virus vaccine. The immunogenicity after each dose of a two-dose vaccination course of MMRV vaccine was generally similar to that of two doses of separately administered MMR plus varicella zoster vaccines, or a single dose of separately administered MMR plus varicella zoster vaccines followed by a dose of MMR vaccine, in infants aged 9-24 months. In infants aged 9-24 months administered a two-dose course of MMRV vaccine, geometric mean titers for antibodies against all vaccine antigens increased after the second dose relative to the first dose, with the increase being most pronounced for varicella zoster virus antibodies (10- to 21-fold). MMRV as the second vaccination was immunogenic in children aged 5-6 years who had previously received either MMRV or MMR as the first vaccination at 12-24 months of age. The immunogenicity for measles, mumps, rubella, and varicella zoster viruses, in terms of seropositivity and antibody titers, was not altered when MMRV was coadministered with a booster dose of diphtheria, tetanus, acellular pertussis, hepatitis B, inactivated poliovirus, and Haemophilus influenzae type b conjugate vaccine in infants aged 12-23 months. Nor was the immunogenicity of the latter vaccine altered by coadministration. The tolerability profile of MMRV vaccine was comparable to that of separately administered MMR plus varicella zoster vaccines or of MMR vaccine alone. Injection-site redness and fever (rectal temperature > or =38degreesC or axillary temperature > or =37.5degreesC) were the most frequent adverse events in both groups.     

疫苗经营企业存在的问题及对策

目的分析疫苗经营存在的风险,探讨加强疫苗经营质量监管的政策措施。方法从疫苗经营活动中企业经营动机和存在的问题入手,抓住疫苗经营风险的主要环节,有针对性地进行阐述和分析。结果与结论必须加强对疫苗经营的质量管理,强化对疫苗经营企业、人员、设备、记录等的管理,保证冷链完整,提高疫苗监管效率,保障疫苗供应。     

Aseptic meningitis following mumps vaccine. A retrospective survey by the French Regional Pharmacovigilance centres and by Pasteur-Mérieux Sérums & Vaccins

Since 1989 many case series and observational studies of aseptic meningitis (AM) associated with the use of live attenuated mumps vaccines containing the Urabe AM9 strain have been reported worldwide. The aim of this retrospective reported AM in France following mumps vaccination with monovalent or multivalent vaccines containing the Urabe strain. Fifty-four cases of AM were reported to the Regional Pharmacovigilance centres or to the manufacturer from the time each vaccine was launched up until June 1992. Twenty cases were temporally associated with the administration of a monovalent mumps vaccine and 34 with a trivalent measles, mumps and rubella vaccine (MMR). A mumps virus was isolated in four cases in the cerebrospinal fluid and an Urabe-like strain was characterized twice by polymerase chain reaction (PCR). A probable mumps origin was assumed in 17 other cases where the patients presented with other clinical or biological signs of mumps infection. The clinical outcome of AM, known in 87% of the population, was always favourable. The global incidence of mumps vaccine-associated AM was 0.82/100,000 doses, which is significantly lower than the incidence in the unvaccinated population. Even considering that the actual incidence of AM is much higher when assessed by active surveillance studies, the risk/benefit ratio of mumps vaccine remains in favour of vaccination.     

FMEA法在药品生产偏差处理过程中的应用

目的：结合质量风险管理理念,制定偏差处理流程,研究失效模式与影响分析(FMEA)法在偏差处理过程中的应用。方法：以两个实际偏差事件为例,阐述FMEA法在药品生产偏差处理过程中的应用。结果与结论：FMEA法通过对风险事件失效模式赋值来确定风险的等级,再对风险进行排序。在偏差处理流程中,FMEA法的应用主要体现在风险评估、风险控制及风险评审3个方面,它能够将风险结果量化,可为风险是否可控提供数据证明。在偏差处理过程中合理运用FMEA法,可不断提高企业偏差处理有效性,完善质量管理体系,保证产品质量。     

Post-licensure safety of the meningococcal group C conjugate vaccine

Passive surveillance reports of adverse events following meningococcal group C conjugate vaccine (MCCV) in the United Kingdom suggested a possible increased risk of convulsions and purpura. To investigate this further, hospital admissions for convulsions and purpura were obtained for the period November 1999 to September 2003 in children from the South East of England and these were linked to vaccine records for MCCV, Diphtheria/Tetanus/Pertussis vaccine (DTP) and Measles/Mumps/Rubella vaccine (MMR). A total of 1,715 children with convulsions and 363 with purpura were successfully linked to vaccination records. The self-controlled case-series method was then used to investigate whether there was any epidemiological evidence of an increased risk of convulsions or purpura following vaccination. The results showed that there was no evidence of an increased relative incidence (RI) of convulsions in the two weeks following MCCV with RI estimates (95% confidence intervals) of 0.57 (0.36-0.86), 1.03 (0.62-1.69) and 0.81 (0.51-1.30) for children aged <1, 1, 2-17 years respectively. There was also no increased relative incidence of purpura in the 4 weeks following MCCV, with an overall RI of 1.15 (0.80-1.67). There was evidence of an increased risk of convulsions and idiopathic thrombocytopenic purpura following MMR vaccination as previously documented.     

基于mRNA疫苗产品生产技术探讨监管检查关注要点

目的:探讨提升商业化mRNA疫苗生产质量水平以降低风险、提升获益,确保疫苗生产过程符合法规要求,并推进监管领域相关标准、技术指南的完善.方法:通过分析mRNA疫苗生产技术特点,梳理mRNA疫苗产品各个生产环节中的质量风险点,综述相关领域研究进展,并探讨mRNA疫苗生产现场监管检查的一些要点.结果 与结论:mRNA疫苗生...     

Dispelling vaccine myths: MMR and considerations for practicing pharmacists

ObjectivesTo discuss information surrounding the erroneous association between the measles–mumps–rubella (MMR) vaccine and autism spectrum disorders (ASDs) and to provide pharmacists with information to dispel vaccine myths.Data sourcesPharmaceutical and medical literature and public media (e.g., newspapers).SummaryThe diagnosis of ASDs is on the rise, and many speculations have been made as to the cause, including the MMR vaccine. A small case series article published inThe Lancet in 1998 and later retracted has been the center of the controversy over whetherthe MMR vaccine causes ASDs. New definitive research demonstrates no link, and medical organizations state that evidence does not support a link between the MMR vaccine and ASDs.ConclusionPharmacists can play a role in providing up-do-date information to patients to dispel myths concerning vaccine safety. Accurate peer review remains an important step to ensure correct information is given to health care providers and the public.