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宁波市江北区和镇海区自 1994年起对满 5周岁儿童普遍进行乙型肝炎 (乙肝 )疫苗加强免疫 (1针 ) ,加强免疫接种率 >90 % ,至今已实行了 6年。为评价乙肝疫苗加强免疫的效果 ,在上述两个区和未实行加强免疫的宁海县 ,采用整群随机抽样法抽取 1989～ 1998年出生的儿童 90 1人和 398人 ,采血检测乙肝病毒表面抗原 (HBsAg)和抗体 (抗 -HBs)、乙肝病毒核心抗体 (抗 -HBc) ,观察两组儿童阳性率和抗体滴度的差别。结果显示 :加强免疫组 5～ 6岁儿童抗 -HBs的阳性率 (89 90 %和 83 33% )显著高于未加强免疫组的同龄儿童 (6 5 2 2 %和 6 1 2 2 % ) ,但随着年龄增长阳性率趋于接近 ,10岁组前者抗 -HBs阳性率为 6 7 0 1% ,后者 5 3 38%。加强免疫 2年抗 -HBs几何平均滴度 (GMT)达 71 79%mIU/ml,至 6年时降为 45 0 0mIU/ml,未加强免疫组儿童的抗 -HBs是持续下降 ,初免10年时其滴度为 2 6 97mIU/ml。加强免疫组和未加强免疫组儿童的HBsAg和抗 -HBc阳性率无明显差异。由此可见 ,对 5周岁儿童实施加强免疫可使抗 -HBs总体水平短期内明显升高 ,持续时间有所延长 ,但对儿童乙肝病毒感染无明显影响。因此认为 ,在儿童乙肝疫苗基础免疫后 10年内无需普遍实施加强免疫 ,5岁加强免疫在时机上不完全合理。
Jiangbei District and Zhenhai District of Ningbo City have strengthened the immunization of hepatitis B (hepatitis B) vaccine (1 dose) for children over 5 years old since 1994, and the vaccination rate is over 90%. So far, it has been practiced for 6 years. In order to evaluate the effect of hepatitis B vaccine in strengthening immunity, a total of 901 children and 398 children born in 1989 ~ 1998 were collected by cluster random sampling method in Ninghai County and Ninghai County which did not implement booster immunization. Blood samples were collected to detect hepatitis B virus surface antigen (HBsAg) and antibodies (anti-HBs), hepatitis B virus core antibody (anti-HBc), the positive rate of the two groups of children and antibody titer differences. The results showed that the positive rates of anti-HBs in children aged 5 to 6 years (89 90% and 83 33%) in the booster group were significantly higher than those in the non-booster group (65.22% and 62.2% However, the positive rate of anti-HBs in the 10-year-old group was 67.07%, while the latter was 53.38%, as the positive rate of age tended to approach. The anti-HBs geometric mean titer (GMT) increased from 71 79% mIU / ml to 45 0 0 mUU / ml at 2 years after 2 years of booster immunization. The anti-HBs in children without boosting decreased continuously, Its annual titer is 2667mIU / ml. There was no significant difference in the positive rates of HBsAg and anti-HBc in children with and without intensive immunization. This shows that the five-year-old children to strengthen the immune anti-HBs can make the overall level of anti-HBs significantly increased in the short term, the duration has been extended, but no significant effect on children with hepatitis B virus infection. Therefore, in the 10 years after the basic hepatitis B vaccine for children, there is no need for the general implementation of booster vaccination, and the 5-year-old booster immunization is not entirely timely in terms of timing.