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目的评价脊髓灰质炎(简称脊灰)病毒灭活疫苗(Inactivated poliovirus vaccine,IPV)在中国婴儿中的免疫持久性。方法选择广西壮族自治区平乐县11个乡(镇)的372名健康婴儿,随机分为2组:176名婴儿分别于2、3、4月龄接种1剂IPV疫苗,196名婴儿分别于2、3、4月龄口服1粒脊髓灰质炎减毒活疫苗糖丸(Oral poliovirus vaccine,OPV)。两组均于基础免疫后1个月及18月龄时采集静脉血,采用微量中和试验检测血清中抗Ⅰ、Ⅱ、Ⅲ型脊灰病毒中和抗体(Neutralizing antibody,NA)滴度。结果两组婴儿接种疫苗后18月龄时血清抗脊灰病毒Ⅰ、Ⅱ、Ⅲ型NA几何平均滴度(Geometric mean titer,GMT)均明显低于基础免疫后1个月。18月龄时IPV组血清抗脊灰病毒Ⅰ、Ⅱ、Ⅲ型NA阳性率明显低于基础免疫后1个月,且差异均有统计学意义(P均<0.001);OPV组差异无统计学意义(P=0.111)。IPV组部分婴儿在18月龄时血清抗脊灰病毒Ⅰ、Ⅱ、Ⅲ型NA滴度小于1︰8,比例分别为11.4%、17.1%和18.2%。结论 IPV基础免疫后至18月龄时,婴儿抗脊灰病毒抗体保护水平下降,需进行加强免疫。
Objective To evaluate the immune persistence of poliovirus vaccine (IPV) in infants in China. Methods A total of 372 healthy infants from 11 townships (towns) in Pingle County of Guangxi Zhuang Autonomous Region were randomly divided into two groups: 176 infants received one IPV vaccine at 2, 3, and 4 months of age respectively and 196 infants at 2 Oral poliovirus vaccine (OPV) was administered orally once a day for 3 or 4 months. Venous blood was collected at 1 month and 18 months after the basal immunization in both groups. Neutralizing antibody (NA) titers against serums of type I, II and III were detected by micro-neutralization assay. Results The mean geometric mean titer (GMT) of serum anti-poliovirus type Ⅰ, Ⅱ and Ⅲ at 18 months after vaccination were significantly lower than those at 1 month after basic immunization. The positive rate of serotypes of anti-poliovirus Ⅰ, Ⅱ and Ⅲ in IPV group was significantly lower at 18 months than that at 1 month after basic immunization (all P <0.001), but there was no significant difference in OPV group Significance (P = 0.111). The serum anti-poliovirus type I, II and III NA titers of some infants in the IPV group were less than 1︰8 at 18 months of age with the proportions of 11.4%, 17.1% and 18.2%, respectively. Conclusion After IPV basic immunization to 18 months of age, infant protection against poliovirus antibody levels decreased, need to be boosted.