Sabin株脊髓灰质炎灭活疫苗与不同剂型Ⅰ型Ⅲ型脊髓灰质炎减毒活疫苗序贯接种的抗体滴度比较

  目的  比较Sabin株脊髓灰质炎灭活疫苗(Sabin strain-based inactivated poliovirus vaccine，sIPV)与不同剂型Ⅰ型Ⅲ型脊髓灰质炎减毒活疫苗(bivalent types Ⅰ and Ⅲ oral poliovirus vaccine，bOPV)序贯接种的抗体滴度。  方法  选择柳州400名2月龄婴儿，按1:1:1:1随机分为sIPV+2bOPV糖丸、sIPV+2bOPV液体、2sIPV+bOPV糖丸、2sIPV+bOPV液体4组，按0 d、28 d、56 d免疫程序接种疫苗。检测免前、免后28 d脊灰中和抗体滴度。  结果  序贯程序相同时，1剂sIPV糖丸组与液体组免后Ⅰ型抗体滴度分布差异有统计学意义(Z=-2.589，P=0.010)，Ⅱ型(Z=-0.331，P=0.741)和Ⅲ型(Z=-1.556，P=0.120)差异均无统计学意义(均有P>0.05)；2剂sIPV糖丸组与液体组免后Ⅰ型(Z=-1.249，P=0.212)、Ⅱ型(Z=-1.658，P=0.097)和Ⅲ型(Z=-1.436，P=0.151)抗体滴度分布差异均无统计学意义(均有P>0.05)。剂型相同时，2剂sIPV组与1剂sIPV组各型抗体滴度分布差异均有统计学意义(均有P < 0.05)(1剂sIPV液体组与2剂sIPV液体组:Ⅰ型:Z=-2.766，P=0.006；Ⅱ型:Z=-9.137，P < 0.001；Ⅲ型:Z=-5.529，P < 0.001。1剂sIPV糖丸组与2剂sIPV糖丸组:Ⅰ型:Z=-3.748，P < 0.001；Ⅱ型:Z=-7.660，P < 0.001；Ⅲ型:Z=-6.030，P < 0.001)。  结论  bOPV糖丸和液体剂型免疫效果相似，各地接种部门应结合疫苗效果、接种对象特征和人口密度，选择适宜剂型接种；如sIPV供应充足，建议优先选择2剂sIPV序贯程序完成脊灰基础免疫接种。

Comparing the antibody titers of sequential program of Sabin strain-based inactivated poliovirus vaccine followed by bivalent types 1 and 3 oral poliovirus vaccine in different dosage forms

  Objective  To evaluate the antibody titer distributions after primary vaccination by different sequential schedules of Sabin strain-based inactivated poliovirus vaccine(sIPV) and bivalent oral attenuated live poliomyelitis vaccine against types 1 and 3 (bOPV) in Drug Candy(DC) form or liquid dosage form.  Methods  Eligible infants of 2 months old selected in Liuzhou were assigned randomly in a ratio of 1:1:1:1 to 4 groups as following: sIPV+2bOPV(DC), sIPV+2bOPV(liquid), 2sIPV+bOPV(DC), 2sIPV+bOPV(liquid), and were vaccinated at 0, 28, 56 days. Polio neutralizing antibody titers against poliovirus types 1, 2 and 3 were tested prior to Dose 1 and at 28 days after Dose 3.  Results  The antibody titer distribution for type 1 was statistically different between sIPV+2bOPV(DC) and sIPV+2bOPV(liquid) (Z=-2.589, P=0.010) while no significant differences were detected between the two groups for type 2(Z=-0.331, P=0.741) and type 3(Z=-1.556, P=0.120). There were no significant differences between 2sIPV +bOPV(DC) and 2sIPV+bOPV(liquid) for the distributions(All P>0.05) (type 1:Z=-1.249, P=0.212; type 2:Z=-1.658, P=0.097; type 3:Z=-1.436, P=0.151). In the same dosage forms with different sequential schedules, the antibody titer distributions were significantly different between 2 doses sIPV and 1 dose sIPV groups(All P < 0.05)(sIPV+2bOPV(liquid) vs 2sIPV+bOPV(liquid): type 1:Z=-2.766, P=0.006; type 2:Z=-9.137, P < 0.001; type 3:Z=-5.529, P < 0.001. sIPV+2bOPV(DC) vs 2sIPV+bOPV(DC): type 1:Z=-3.748, P < 0.001; type 2:Z=-7.660, P < 0.001; type 3:Z=-6.030, P < 0.001).  Conclusions  Different dosage forms have similar immune effects, so appropriate dosage forms should be selected for vaccination according to the effectiveness, characteristics of subjects and the population density. In the case of sufficient supply of sIPV, 2 doses sIPV sequential program should be the first choice to complete the primary immunization.