肾综合征出血热疫苗免疫后血清学监测

目的 监测肾综合征出血热(HFRS)疫苗免疫接种人群血清抗体水平变化并评价疫苗血清学效果。方法 以村为单位,16～60岁健康者(删除既往患HFRS者、外出>9个月及疫苗禁忌症者)为观察对象,按接种和对照各半的原则随机分组,接种组共10 460人,对照组16 159人。采用间接免疫荧光法测特异性IgG荧光抗体,用微量细胞病变中和试验测中和抗体。结果 接种前血清抗体阴性者全程接种后2周荧光抗体阳转率为100.0％(67/67,95％CI:96.3～100.0),中和抗体阳转率为44 4％(8/18,95％CI:22.0～69.0),几何平均滴度分别为72.1和4.6。1年后进行加强免疫,加强免疫前、免疫后2周,免疫后1年、1.5年、2年、3年和5年,荧光抗体阳性率分别为28.6％、83.3％、75.0％、53.1％、22.6％、10.0％、55.0％;中和抗体阳性率分别为14.8％、55.6％、35.0％、31.3％、26.0％、10.0％、50.0％。免疫(感染)增强反应需要进一步研究。结论 HFRS疫苗免疫效果良好,血清抗体持续时间较长。

Serological surveillance on hemorrhagic fever renal syndrome after vaccination

Objective To observe the serological and epidemiological efficacy of hemorrhagic fever renal syndrome (HFRS) vaccine in Zhejiang province. Methods Immunofluorecent antibody assay and Mcro-CPE method were used to test specific IgG antibody and the titer of neutralizing antibody. Results Two weeks after the injection of the third dose, the sero-conversion rates by both immunofluorecent antibody test (IgG) and neutralization test were 100.0%(67/67)(95% CI: 96.3-100.0) and 44. 4% (8/18) (95% CI: 22. 0-69. 0) with geometric mean titers(GMTs) 72. 1 and 4. 6 respectively. The rates of seroconversion of immunofluorescent antibody by immunofluorescence antibody assay (IFA) were 28. 6%, 83. 3%, 75. 0%, 53. 1%,22. 6%, 10. 0% and 55. 0% before reinforcement, two weeks, one year, one year and a half years, two years, three years and five years after reinforcement. The rates of neutralizing antibody seroconversion by the Mcro-CPE method were found as 14. 8%, 55. 6%, 35. 0%, 31. 3%, 26. 0%, 10. 0% and 50. 0% respectively. We found some antibody dependent immunization enhancement phenomenon among the inoculated population, but further observation was needed. Conclusion HFRS vaccine was immunologically effective and the duration of serous antithey last long.