MULTIPLE ANTIGEN IMMUNIZATION OF INFANTS AGAINST POLIOMYELITIS, DIPHTHERIA, PERTUSSIS, AND TETANUS
MULTIPLE ANTIGEN IMMUNIZATION OF INFANTS AGAINST POLIOMYELITIS, DIPHTHERIA, PERTUSSIS, AND TETANUS
复制标题
婴儿针对脊髓灰质炎、白喉、百日咳和破伤风的多重抗原免疫
作者：
C. D. Barrett;I. McLean;J. Molner;E. A. Timm;C. Weiss
本研究旨在确定婴儿期开始使用含有针对所有四种疾病的成分抗原的多重抗原进行针对脊髓灰质炎、白喉、破伤风和百日咳的免疫接种的最早年龄。初次注射时受试者的年龄范围为 1 天至 6 个月大。所有患者均间隔 4 周注射四次 0.5 毫升的 DPT-脊髓灰质炎抗原，然后在 6 个月后注射第五剂（0.5 毫升）相同的材料。对照组在前四剂中每月接受 0.5 毫升 DPT 抗原，但在第五剂中注射 DPT-脊髓灰质炎疫苗（0.5 毫升）。
虽然很明显，对于脊髓灰质炎和百日咳免疫，与初次接种时婴儿的年龄有关，存在渐进反应，但显然，3个月大的婴儿对主动免疫的反应能力与6个月大的婴儿非常接近。尽管接受研究的大多数 3 个月大婴儿的学前母体抗体水平极高，但 90% 的婴儿表现出对所有三种脊髓灰质炎病毒类型的免疫反应的明确证据。
根据凝集素滴度测量，百日咳抗体反应在 3 个月大的婴儿中与 6 个月大的婴儿中一样好。 2个月大的婴儿在小学后阶段的反应相对较差，但在加强后间隔期间与较大婴儿的反应相当。没有迹象表明对百日咳免疫的反应因所研究的四价抗原中包含百日咳抗原而受到损害。
无论初次接种时的年龄如何，白喉和破伤风抗毒素滴度均优异。
结果表明，每月注射四剂百白破-脊髓灰质炎联合抗原将克服高水平母源抗体对脊髓灰质炎免疫的干扰，并且最早可在出生后第三个月开始第一批注射。然而，重要的是，在这一系列初次接种后，应在约 6 个月内进行相同抗原制剂的加强剂量，以增强基本免疫力。
This study was designed to determine the earliest age in infancy at which immunization against poliomyelitis, diphtheria, tetanus, and pertussis can be started using a multiple antigen containing component antigens against all four diseases. Subjects ranged in age from 1 day old through 6 months old at time of initial injection. All were given a series of four injections of 0.5 ml of DPT-polio antigen 4 weeks apart followed by a fifth dose (0.5 ml) of the same material 6 months later. A control group received 0.5 ml of a DPT antigen at monthly intervals for their first four doses, but were given a DPT-polio injection (0.5 ml) for their fifth dose.
Although it is evident that there is a progressive response in relation to age of the infant at time of initial inoculation, in respect to poliomyelitis and pertussis immunization, it was apparent that the capacity of the 3-month-old infant to respond to active immunization closely approximates that of the 6-month-old. Ninety per cent showed definite evidence of an immune response to all three poliovirus types despite extremely high levels of preprimary maternal antibody in the majority of 3-month-old infants under study.
Pertussis antibody response, as measured by agglutinin titers, was as good in the 3-month-old as in the 6-month-old infants. The response in the 2-month-old infants was relatively poor at the postprimary stage but was equivalent to that of the older infants at the postbooster interval. There was no indication that response to pertussis immunization was impaired by the inclusion of pertussis antigen in the quadrivalent antigen under study.
Diphtheria and tetanus antitoxin titers were excellent regardless of age at initial inoculation.
The results indicate that four doses of DPT-polio combined antigen given at monthly intervals will overcome the interference of high levels of maternal antibody in respect to poliomyelitis immunization and that the primary series of injections may be started as early as the third month of life. It is important, however, that this primary series of inoculations be followed by a booster dose of the same antigen preparation in about 6 months in order to reinforce the basic immunity.