Response to different measles vaccine strains given by aerosol and subcutaneous routes to schoolchildren: a randomised trial
Response to different measles vaccine strains given by aerosol and subcutaneous routes to schoolchildren: a randomised trial
复制标题
DOI：
10.1016/s0140-6736(99)95140-1
复制
发表时间：
2000-03-04
期刊：
影响因子：
168.9
通讯作者：
Bennett, JV
中科院分区：
文献类型：
--
作者：
Dilraj, A;Cutts, FT;Bennett, JV
背景麻疹疫苗的持续控制需要一剂以上。气溶胶途径被认为是更免疫原性的加强剂量比传统的皮下注射，所以我们做了一个随机比较试验的气溶胶和皮下麻疹疫苗在南非schoolchilds.Methods 4327名学童（年龄5-14岁），分配由块随机化的教室，收到标准滴度剂量的施瓦茨或埃德蒙顿-萨格勒布麻疹疫苗皮下或气溶胶。在接种前、接种后1个月和1年采集用于抗体测定的血样。主要终点（抗体滴度在1个月和1年）进行了比较groups.Findings 992儿童抗体滴度数据可用于所有时间点。接种Edmonston-Zagreb疫苗的385名儿童中有14名（3.6%）在接种后1年血清阴性，而接种Edmonston-Zagreb皮下疫苗的326名儿童中有28名（8.6%），接种施瓦茨皮下疫苗的281名儿童中有39名（13.9%）。在1个月时，326名（84.7%）接受气雾剂Edmonston-Zagreb疫苗的儿童发生了不良血清转化，相比之下，257名（78.8%）接受皮下注射Edmonston-Zagreb疫苗的儿童和176名（62.6%）接受皮下注射施瓦茨疫苗的儿童发生了不良血清转化。在1个月时，施瓦茨气雾剂组的511名儿童中只有116名（22.7%）发生血清转化;该气雾剂疫苗在雾化2分钟后没有可检测到的效力。没有严重的副作用：每组中约有5%的儿童在接种后2周内出现皮疹。解释使用现有设备和适当稳定的疫苗的气雾剂接种方法是有效和可接受的。这种形式的提供适用于大规模运动，避免了与注射有关的风险，并有助于根除麻疹。
Background More than one dose of measles vaccine is necessary for the sustained control of measles. The aerosol route is thought to be more immunogenic for booster doses than traditional subcutaneous injections, so we did a randomised comparative trial of aerosol and subcutaneous measles Vaccines in South African schoolchildren.Methods 4327 schoolchildren (aged 5-14 years), assigned by block randomisation of classrooms, received standard titre doses of either Schwarz or Edmonston-Zagreb measles Vaccines subcutaneously or by aerosol. Blood samples for antibody assay were collected before vaccination, at 1 month, and 1 year after vaccination. The main endpoints (antibody titres at 1 month and 1 year) were compared between groups.Findings 992 children had antibody titre data available for all timepoints. 14 (3.6%) of 385 children who received Edmonston-Zagreb vaccine by aerosol were seronegative 1 year after vaccination, compared with 28 (8.6%) of 326 children who received Edmonston-Zagreb subcutaneous vaccine and 39 (13.9%) of 281 children who received Schwarz subcutaneous vaccine. At 1 month, 326 (84.7%) children who received aerosol Edmonston-Zagreb vaccine bad seroconverted, compared with 257 (78.8%) who received subcutaneous Edmonston-Zagreb vaccine and 176 (62.6%) who received subcutaneous Schwarz vaccine. At 1 month, only 116 (22.7%) of 511 children in the Schwarz aerosol group had seroconverted; this aerosol Vaccine had no detectable potency after 2 min of nebulisation. There were no serious side-effects: about 5% of children in each group had a rash within 2 weeks of vaccination.Interpretation An aerosol vaccination method that uses currently available devices and a suitably stable vaccine is effective and acceptable. This form of delivery is adaptable to mass campaigns, avoids the risks associated with injections, and could help measles eradication.