接种流行性乙型脑炎灭活疫苗偶合川崎病1例

目的分析流行性乙型脑炎灭活疫苗受种者发生川崎病的原因是否与接种该疫苗有关。方法收集并分析疫苗受种者的预防接种资料、住院病历资料,组织市级预防接种异常反应调查诊断专家组进行调查诊断。结果疫苗质量合格,接种过程符合工作规范。该患者先后在数家医院进行住院治疗和门诊治疗,根据临床体征和辅助检查,川崎病诊断成立。川崎病的发生与接种乙脑灭活疫苗只是时间上的巧合。结论该患者的情况属于接种流行性乙型脑炎灭活疫苗偶合川崎病。     

接种乙脑疫苗引起的异常反应

流行性乙型脑炎灭活疫苗 (以下简称乙脑疫苗 )可预防流行性乙型脑炎。为预防此病 ,于 1995年 4月份对全镇 1— 15岁儿童进行了乙脑疫苗预防接种。在接种过程及接种后 ,部分儿童出现了较强反应 ,且反应率较高。经调查分析认为 ,此系一起由乙脑疫苗接种引发的预防接种异常反应。现报告如下 :1 材料和方法1 1　疫苗来源及接种　本次接种乙脑疫苗系上海生物制品研究所提供 ,由省防疫站冷藏保存逐级发放。疫苗批号为 94 12 14— 1,效期 96 11;止痛剂为硫酸氢钠 ,批号为 830 80 6— 2 8,无效期。接种对象为 1— 15岁儿童 ,接种方法按“乙脑疫苗接…     

乙脑疫苗接种引起群体异常反应的调查

目的　查明接种乙脑疫苗引起群体性异常反应的性质 ,并探讨发病的原因。方法　采用现场流行病学调查的方法 ,结合实验室检查和临床表现进行诊断分析。结果　冻干流行性乙型脑炎减毒活疫苗共接种 6～ 11岁小学生 14 8名 ,出现反应 71人 ,总的反应率是 4 8%。主要症状是“头晕、头疼、恶心、腹疼”等 ,但大部分学生的主要症状与体征不符。各班级反应人数分布与年级、年龄呈现明显的正相关 (P <0 .0 5 ) ,在性别分布之间未见明显的差异。结论　该小学集体接种乙脑疫苗引起的群体性异常反应为癔病 ,发生的主要原因是对接种乙脑疫苗不良反应的不当宣传及惧怕注射 ,引起学生心理恐惧 ,在体质较差者出现异常反应后 ,其它学生因恐惧、谣言等所致     

乙脑疫苗应急接种影响乙脑流行特征分析

目的 评价乙脑疫苗应急接种对乙脑流行特征影响,探讨乙脑防制策略.方法 对应急接种资料及乙脑疫情进行分析.结果 全市共发放乙脑疫苗211280人份,接种适龄儿童195230人,接种率达99.71%.无严重接种反应发生.由于应急接种,2003年乙脑发病流行期比1990～2002年乙脑流行期缩短.讨论 乙脑应急接种控制乙脑流行效果显著,在乙脑流行期接种乙脑疫苗安全,可行.建议将乙脑纳入计划免疫,必要时可扩大接种对象年龄范围.     

一起疫苗接种副反应的调查处置

目的为了解事件发生原因,为以后类似事件处理积累经验。方法句容市崇明社区卫生服务中心积极进行了流行病学调查。结果在5d共接种478例,副反应发生6例,副反应发生率为1.26%,接种疫苗包括乙脑流脑、百白破、水痘、糖丸、乙脑等常规疫苗,疫苗产地均正规。结论此次副反应是由于儿童群体对江苏康友医用器械有限公司生产的批次为20110325的注射器敏感引起。     

接种乙型脑炎疫苗致不良反应个案报道系统评价

流行性乙型脑炎(乙脑)是我国常见的急性传染病之一,病死率较高。接种乙脑疫苗是目前预防乙脑流行的最有力的措施。但乙脑疫苗所致的不良反应屡有报道,有研究认为接种乙脑疫苗发生不良反应占所有疫苗不良反应的70．33％。本文对乙脑疫苗的不良反应个案报道进行系统评价,为初步了解接种乙脑疫苗的各种不良反应类型,进而为探讨乙脑疫苗不良反应发生的原因以及降低不良反应的措施提供参考,现将研究结果报告如下:     

乙脑疫苗接种情况调查

1998年与1999年两个年度中,821名儿童乙脑疫苗在初种与夏种的过程中发现多例疫苗接种后有反应。根据接种记录和接种反应的现象分析,发现与年龄有自接关系,现报告如下。 1 接种对象、材料和方法 1.1 对象 1998～1999年利津路管区内一岁、两岁儿童。 1.2 疫苗 1998年使用的乙脑疫苗为卫生部上海生物制品研究所生产的批号为960233-2、有效期为99、2,每支     

关于接种乙脑疫苗发生癔病性群体反应的报告

我们于1994年5月在城子小学进行乙脑疫苗预防注射时发生了癔病性群体反应,现报告如下: 5月12日上午,对该校适龄学生进行乙脑疫苗预防注射。所用疫苗是卫生部上海生物制品厂生产的,接种剂量0.5毫升,接种部位是左上臂三角肌肌肉注射。共注射172名,下午78名学生诉说头痛、头晕、腹痛,还有1名诉说四肢无力。市防疫站调查,确诊为癔病性群体反应。处理方法是暗示疗法、分散治疗、对症处理。至5月16日全部痊愈。预防2个月,无复发,无后遗症。     

疫苗预防接种反应报告系统与报表分析

目的:为掌握我省各种疫苗免疫预防接种反应的发生情况,科学评价全省免疫预防策略。方法:于2002年建立了疫苗预防接种反应报告系统,实施零病例月报制度。结果:全年报告接种反应273例,主要集中在4、5月份,占总数的69.96%。在所用的29种疫苗中,报告发生接种反应的疫苗有13种,以地鼠肾细胞制备的乙脑灭活疫苗和百白破三联混合制剂发生的反应居多,分别占70.33%和20.15%。其临床表现以皮疹和局部反应为主,各占51.28%和16.12%。结论:加强免疫预防接种反应的监测和防范有助于我国计划免疫工作的实施。     

流行性乙型脑炎减毒活疫苗与灭活疫苗免疫效果及人体接种反应观察

目的:比较乙脑减毒活疫苗和灭活疫苗的免疫效果和安全性。方法:选择光泽县1～2周岁应初免的儿童264名,分组接种乙脑减毒活疫苗和乙脑灭活疫苗,观察人体接种反应,采用细胞蚀斑减少中和试验检测免疫前及免疫后乙脑中和抗体。结果:减毒活疫苗组抗体阳转率和抗体几何平均滴度(GMT)分别为91.30%和1∶20.22;灭活疫苗组为64.38%和1∶16.51。经统计学分析,减毒活疫苗组抗体阳转率和阳性抗体(GMT)均高于灭活组。经观察,减毒活疫苗组和灭活疫苗组人体反应均为发热和接种部位轻度红肿,发热率分别为8.51%和8.13%,中、强反应率为2.13%和0.81%,红肿率为1.42%和0.81%。所有发热及轻度红肿者均于24小时恢复正常。结论:乙脑减毒活疫苗免疫效果好,免疫针次少,安全性好,是现阶段预防乙脑比较理想的疫苗,适宜推广使用。     

Japanese Encephalitis: Defining Risk Incidence for Travelers to Endemic Countries and Vaccine Prescribing From the UK and Switzerland

Background.  Large numbers of Western travelers visit countries endemic for Japanese encephalitis (JE). The risk of infection is unknown. This study attempts at estimating a risk incidence for visitors from two European countries with the available data.
Methods.  Using the total number of case reports between 1978 and 2008, the number of visits made by European tourists to endemic regions, and total doses of vaccines sold in the two study countries, the risk incidence of JE in travelers was estimated. The proportion of vaccinated visitors to endemic regions was retrieved from the data of two travel clinics (in London and Basel) and related to vaccine prescribing in UK and Swiss travelers.
Results.  In 2004, an estimated 0.16% to 0.3% of UK and Swiss travelers were vaccinated against JE, with no surveillance reports of JE cases. Between 116,000 and 152,000 European travelers would receive vaccination. More than 99% travel to endemic countries without vaccination. Only 40 cases of JE infection have been reported in travelers for the past 30 years. The risk incidence is thus 1.3 per year in 7.1 million visits of the 17 million European travelers who are at a potential risk of JE infection.
Conclusions.  This study and the analysis of the existing literature support the recommendation that all travelers should be informed about the risk of JE infection but also suggest that there is no evidence for justifying a general recommendation for JE vaccination in travelers to endemic areas.     

Vero细胞乙型脑炎灭活疫苗的研制

目的 以Vero细胞为基质,研制安全有效的乙型脑炎灭活疫苗.方法 将经Vero细胞适应的乙型脑炎病毒P3株接种Vero细胞,培养后收获病毒液.采用β-丙内酯灭活,通过超滤浓缩、硫酸鱼精蛋白沉淀、蔗糖密度梯度离心等方法纯化病毒,最终配制成预防乙型脑炎病毒感染的疫苗.通过临床试验考察疫苗的安全性及免疫原性.结果 该疫苗的主要考核指标,如病毒滴度、总蛋白含量、Vero细胞DNA残留量、效价等均符合国家标准.临床观察结果显示,接种本疫苗后局部及全身反应轻微;各年龄组乙型脑炎病毒中和抗体阳转率均>90%.结论 采用本法制备的疫苗安全有效.     

Immunogenicity and protection of oral influenza vaccines formulated into microparticles

Influenza is a deadly disease affecting humans and animals. It is recommended that every individual should be vaccinated annually against influenza. Considering the frequency of administration of this vaccine, we have explored the oral route of vaccination with a microparticulate formulation. Microparticles containing inactivated influenza A/PR/34/8 H1N1 virus with Eudragit S and trehalose as a matrix were prepared using the Buchi spray dryer. Particle size distribution of microparticles was measured and the bioactivity of vaccine in a microparticle form was analyzed using a hemagglutination activity test. Furthermore, the efficacy of microparticle vaccines was evaluated in vivo in Balb/c mice. Analysis of serum samples showed that microparticles resulted in enhanced antigen‐specific immunoglobulin G (IgG), IgG1, and IgG2a antibodies. Upon challenge with homologous and heterologous influenza viruses, microparticle vaccines showed significantly increased levels of protection. Use of microparticles to deliver vaccines could be a promising tool for the development of an oral influenza vaccine.     

De bereiding van vaccins

A survey is given of the production methods of bacterial and viral vaccines. Bacterial vaccines include those based on a suspension of live bacteria, like BCG, inactivated bacterial suspensions, like pertussis, and toxoids like tetanus. Viral vaccines described include the live vaccines, like rubella vaccine and inactivated vaccines, like polio vaccine. Special attention is devoted to modern large-scale production methods which became essential with the introduction of national vaccination programmes. New developments are described including the preparation of purified or subunit vaccines. The problem of obtaining the relevant immunogenic fractions is recognised. In keeping with this thorough knowledge of. the pathogenesis of the infectious disease is felt essential. The succesful development of polysaccharide vaccines, including a pneumococal vaccine, is mentioned. Finally, the possible application of the recombinant DNA technique for the production of vaccines is discussed.     

Role of macrophages in early protective immune responses induced by two vaccines against foot and mouth disease

Foot and Mouth Disease (FMD) is an acute disease of cloven-hoofed species. We studied the protection and early immune response induced in the murine model by vaccines formulated with inactivated virus and two different adjuvants.The presence of IMS12802PR or ISA206VG adjuvants yielded protection against viral challenge at early times post vaccination and induced FMDV-specific, but non neutralizing, antibody titers. In vivo macrophage depletion in vaccinated mice severely decreased the protection levels after virus challenge, indicating a central role of this cell population in the response elicited by the vaccines. Accordingly, opsonophagocytosis of FITC-labelled virus was augmented in 802-FMDVi and 206-FMDVi vaccinated mice. These results demonstrate the ability of the studied adjuvants to enhance the protective responses of these inactivated vaccines without the increase in seroneutralizing antibodies and the main role of opsonization and phagocytosis in the early protective immune responses against FMD infection in the murine model.     

Immunogenicity of a scalable inactivated rotavirus vaccine in mice

Inactivated rotavirus vaccine is a safe and effective potential vaccine for the prevention of rotavirus infection among children, but no approved licensed vaccine is available now. In this study, a scalable inactivated rotavirus vaccine, prepared in Vero cells cultured by microcarrier fermentation, inactivated by formalin and absorbed by Al(OH)(3) adjuvant, was vaccinated into the six weeks-old female Balb/c mice by intramuscular injection. After twice immunization at interval of three weeks, both humoral and cell-mediated immune responses were assessed by ELISA, microneutralization assay and EISPOT assay. The results indicated that the scalable inactivated rotavirus vaccines induced not only high serum IgG antibody and neutralizing antibody responses, but Th1 and Th2 cytokine-secreting cell responses in mice immunized by the inactivated rotavirus vaccines. These results suggest that the scalable inactivated rotavirus vaccine has good immunogenicity, which provided the base for the scaled development of inactivated rotavirus vaccine in the future.     

Chronic vaccination with a therapeutic EGF-based cancer vaccine: a review of patients receiving long lasting treatment

Therapeutic vaccines continue to be one of the most active fields in cancer research. However, despite clear evidence of antitumor effect in laboratory animals, and despite the ability of current vaccine candidates to elicit tumor specific antibodies and T-cells in humans, objective responses in the clinical trials are rare. The role of therapeutic vaccines in advanced cancer patients, if any, would be to decrease the rate of disease progression and to increase survival and quality of life. Due to the redundant regulatory loops contracting the immune response to antigens that cannot be eliminated, such a role would require chronic vaccination, which is at first sight at odds with the classic experience of vaccinology. During the last decade our team has been developing a therapeutic vaccine for advanced lung cancer, which consists in human recombinant Epidermal Growth Factor (EGF) chemically conjugated to a carrier protein from Neisseria meningitides. Several clinical trials have been carried out, showing increase in anti-EGF antibody titters, decrease in plasma EGF concentration and survival advantage in vaccinated patients. In the present paper we review data from 58 patients who were vaccinated monthly for more than one or two years. Long term vaccination was feasible and safe, and there was no evidence of cumulative toxicity. Patients kept high anti-EGF antibody titters during all the time of vaccination, without evidence of immune response exhaustion. Continued vaccination increased the probability to get a high antibody response, which has been previously shown to be, in turn, associated with a better survival. Observations done in this series of patients suggest that long term therapeutic vaccination is a feasible strategy, worth to be further explored in the aim of transforming advanced cancer into a chronic disease.     

Vaccine delivery to animals

For many years vaccination of animals has been practiced to prevent infectious diseases using inactivated organisms or modified live organisms. The live vaccines were effective but lacked safety. The vaccines made with inactivated organisms required an adjuvant to induce an immune response that was not as effective as either the clinical disease or live vaccines. An 'ideal' vaccine would induce effective immunity specific for the type of infection, have long duration, require minimal or no boosters, have impeccable safety, would not induce adverse reactions, and be easy to administer. The desire to meet these criteria, and especially safety, has resulted in the development of vaccines that do not depend on the use of the viable disease agent. The emphasis on subunit or inactivated vaccines that meet the desired criteria of a perfect vaccine has resulted in a critical need for better adjuvants and delivery systems. This has resulted in a technological innovation revolution with development of a wide array of different technologies to generate effective vaccines. This review will describe the historical relevance of adjuvants used for parenterally administered inactivated/subunit vaccines as well as describe some of the exciting technological advances including adjuvants (ISCOMS), delivery systems (recombinant vectors, microparticles), and novel approaches (transgenic plants, naked DNA) that are currently being, or will be used in the future, in the search for better, more effective vaccines that meet the current and future needs of veterinary medicine.     

Combined vaccination against hepatitis A,hepatitis B,and typhoid fever: safety,reactogenicity, and immunogenicity

BACKGROUND: The etiological agents of hepatitis A, hepatitis B, and typhoid fever share similar patterns of global distribution, and cause significant disease burden in travelers to endemic countries. Combined vaccination against all three diseases, based on currently available vaccines, would promote compliance and convenience for travelers. This clinical study evaluated the feasibility of extemporaneously syringe-mixed hepatitis A and B vaccine (Twinrix) and a Vi polysaccharide vaccine (Typherix) in healthy adults, and compared this to concomitant administration of the vaccines in separate arms. METHODS: The mixed dose of vaccine contained at least 720 enzyme-linked immunosorbent assay (ELISA) units of the inactivated hepatitis A antigen, 20 microg of the recombinant hepatitis B antigen and 25 microg of the Vi polysaccharide typhoid antigen in 1.5 mL. The study was conducted in 200 healthy 18- to 45-year-old volunteers. RESULTS: Equivalence between the vaccines mixed before administration and the concomitantly administered vaccines was shown in terms of seroconversion and seroprotection. With the exception of local injection site soreness, which was higher in the mixed administration group, the reactogencity was similar for both groups. In both vaccination groups more than 95% of the subjects were anti-hepatitis A virus and anti-Vi seropositive 1 month after the first vaccination. With regard to hepatitis B, a strong response was achieved in both groups, with more than two-thirds of the subjects protected 2 months after the start of the immunization course. CONCLUSION: These results support the feasibility of extemporaneously syringe-mixed combined hepatitis A and B vaccine with a Vi polysaccharide typhoid vaccine, administered in healthy adults.