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目的比较不同脊髓灰质炎(简称脊灰)疫苗免疫程序基础免疫后的血清学反应。方法选择广东省中山市居住的无疫苗接种禁忌的健康婴儿,在其2、3、4月龄时各接种1剂脊灰灭活疫苗(inactivated poliovirus vaccine,IPV)或口服脊灰疫苗(oral polio vaccine,OPV),按照接种程序的不同,将观察对象分为全程OPV组(O-O-O)、全程IPV组(II-I)、1剂IPV+2剂OPV组(I-O-O)、2剂IPV+1剂OPV组(I-I-O)。基础免疫完成后1个月时采集静脉血,以微量中和试验测定血清中脊灰病毒中和抗体。结果 3剂疫苗免疫后,除I-O-O组1份血清标本Ⅲ型抗体为阴性外,其余标本均产生了针对3个型别脊灰病毒的中和抗体。与I-I-I组比较,I-O-O组和I-I-O组产生了更高的抗体几何平均滴度(geometric mean titer,GMT),除与I-O-O组的Ⅲ型抗体GMT差异无统计学意义(P>0.05)外,差异均具有统计学意义(P<0.05或P<0.001);与O-O-O组比较,除I-I-O组的Ⅰ型抗体GMT较低外(P<0.001),I-O-O组和I-I-O组均获得了相近(P>0.05)或更高(P<0.05)的抗体GMT;I-I-O组Ⅰ型中和抗体GMT明显低于I-O-O组(P<0.05),Ⅱ型和Ⅲ型中和抗体GMT高于I-O-O组,但差异无统计学意义(P>0.05)。结论 IPV/OPV序贯免疫可提供与全程OPV免疫相似或更高的针对脊灰的免疫保护;为减少OPV相关脊灰同时维持高水平的免疫屏障,推荐采用I-I-O序贯程序。
Objective To compare the serological responses after immunization with different poliovirus (polio) vaccines. Methods Healthy infants without contraindications to vaccination were enrolled in Zhongshan City, Guangdong Province. They were inoculated with one inactivated poliovirus vaccine (IPV) or oral polio vaccine at 2, 3 and 4 months of age (OPV group) (OOO), full IPV group (II-I), 1 IPV + 2 OPV group (IOO), 2 IPV + 1 agent OPV group (IIO). Venous blood was collected one month after the completion of the basal immunization, and neutralizing antibodies to poliovirus in serum were measured by a micro neutralization test. Results After 3 doses of vaccine were immunized, except for 1 type Ⅲ antibody in I-O-O group, the other three types of antibodies produced neutralizing antibodies against 3 types of poliovirus. Compared with group III, IOO group and IIO group had a higher geometric mean titer (GMT), and there was no significant difference except GMT with type III antibody of IOO group (P> 0.05) (P <0.05 or P <0.001). Compared with the group OOO, the group IOO and the group IIO had similar GMT except the type I antibody of IIO group (P <0.05) (P <0.05). The GMT of type I neutralizing antibody in group IIO was significantly lower than that in group IOO (P <0.05). The type II and type III neutralizing antibodies were higher in GMT than in group IOO, but the difference was not statistically significant Significance (P> 0.05). Conclusion IPV / OPV sequential immunization can provide similar or higher immune protection against polio than whole-cell OPV immunization. To reduce OPV-related poliovirus while maintaining high level of immune barrier, I-I-O sequential procedure is recommended.