邹城市儿童乙型肝炎疫苗接种效果评价

目的评价邹城市新生儿接种乙型肝炎(乙肝)疫苗后的免疫效果。方法自1990年起每年随机抽查50～60名儿童检测接种后的乙肝病毒表面抗体(抗-HBs)阳性率,并调查人群乙肝发病率。1999年采用随机抽样的方法,用酶联免疫吸附试验对人群乙肝病毒表面抗原(HBsAg)携带率进行了调查。结果乙肝疫苗免疫后,儿童保护性抗-HBs的阳性率为90.63%,0～15岁儿童的乙肝发病率明显下降。HBsAg携带率呈下降趋势,儿童尤为明显,从接种前4年平均阳性率13.14%下降到最近4年的0.39%,下降了97.03%。加强免疫和未加强免疫儿童的抗-HBs几何平均滴度(GMT)和保护性抗-HBs的阳性率之间差异均有极显著的统计学意义(χ2=12.35,t=4.51;P均0.01)。结论新生儿实行乙肝疫苗接种可以取得良好的免疫效果,同时加强免疫对维持较高抗-HBs水平阳性率和GMT是有利的。

An Evaluation on Immune Effect of Hepatitis B Vaccine in Newborns in Zoucheng City

OBJECTIVE An evaluation on hepatitis B （HB）vaccine immune effect in newborns in Zoucheng City during 1990--2000 was made. METHODS The newborns in Zoucheng have been vaccinated universally with hepatitis B vaccine since the expanded program on immunization（EPI）was carried out in 1990. The plasma-derived HB vaccine was used in 1990--1997, while the CHO cell recombinant HB vaccine was used in 1997--2000. The vaccine coverage rate was 91.11% in 1990, and a rising tendency was noticed since 1990.50-60 children were sampled randomly and the positive rate of protective anti-HBs was detected. Also, for evaluating the immune efficacy, the incidence of hepatitis B was surveyed. The positive rate of HBsAg was detected by ELISA. Meanwhile, the efficacy of boosting of HB vaccine was evaluated. RESULTS The positive rate of protective anti-HBs was 90.63% since the newborns were vaccinated universally, and there was no significant difference between the female and the male. The incidence of hepatitis B declined in 0-15 year old children when compared with the children of same age before immunization. The HBsAg carrier rate declined annually, especially evident in children. The average HBsAg carrier rate of these children in recent four years was 0.39%, it decreased by 97.03% as compared with 13.14% in children of the same age four years before immunization. The positive rates of protective anti-HBs and GMT had significant statistical difference between boosted and untoasted children. CONCLUSION the data indicated that the immune effect of HB vaccine was significant, and it is benefit to maintain a higher protective level of anti-HBs and GMT through boosting of HB vaccine.