不同年龄人群接种人用狂犬病疫苗的接种反应及免疫应答

目的观察不同年龄人群接种人用狂犬病疫苗的接种反应及免疫应答。方法选择身体健康、无犬伤史及狂犬病疫苗接种史的627名观察对象进行免疫原性检测,按生理发育状态分为5组:1～3岁组、4～6岁组、7～16岁组、17～40岁组和≥4l岁组,分别于免疫前、首针免疫后14和45 d,抽取静脉血,分离血清,采用快速荧光灶抑制试验(Rapid fluorescence focusinhibition test,RFFIT)检测血清中抗狂犬病病毒抗体效价,并计算抗体几何平均滴度(GMT)。在所有免疫原性受试者中随机抽取225名,进行接种反应观察。结果 225名观察对象接种人用狂犬病疫苗后的局部总反应率为5.15%,全身总反应率为4.42%,反应程度均为弱、中反应,无高强度及严重不良反应的病例报告。免疫前所有样本血清抗体GMT均≤0.2 IU/ml,抗体均为阴性;首针接种人用狂犬病疫苗后14 d,各年龄组人群抗体阳转率均达100%,但抗体GMT各组间差异有统计学意义(P<0.05),其中4～6岁组和7～16岁组较高,分别为9.42和9.01 IU/ml,1～3岁组和≥41组较低,分别为6.11和6.35 IU/ml,而4～6岁组与7～16岁组及1～3岁组与≥41岁比较,差异均无统计学意义(P>O.05);首针接种人用狂犬病疫苗后45 d,各年龄组人群的抗体阳转率仍为100%,各年龄组平均GMT在14.8～16.40 IU/ml之间,差异均无统计学意义(P>0.05)。结论不同年龄组人群接种人用狂犬病疫苗后临床反应轻微,免疫应答良好。但3岁以下婴幼儿及老年人抗体产生的时间有延迟的趋势,建议老年人及婴幼儿在接种人用狂犬病疫苗第l、2针时,应适当增加剂量,以提高血清抗体阳转率及免疫成功率。

Adverse reaction and immune response in populations at various ages after immunization with rabies vaccine for human use

Objective To observe the adverse reaction and immune response in populations at various ages after immunization with rabies vaccine for human use.Methods A total of 627 healthy subjects without history of injury by dogs or rabies vaccination were selected and divided into five age groups.Venous blood samples were collected before and 14 and 45 d after the first vaccination respectively,from which sera were separated and determined for antibody titer against rabies virus by rapid fluorescence focus inhibition test(RFFIT),and GMT was calculated.Of the subjects,225 were selected and observed for adverse reactions.Results The total local and systemic adverse reaction rates in 225 subjects were 5.15% and 4.42% respectively.All the reactions were mild or moderate,while no severe or serious adverse reactions were reported.All the serum samples before vaccination were negative for antibody(GMT ≤ 0.2 IU/ml).All the antibody positive rates in populations of various age groups were 100% 14 d after the first vaccination.However,the GMTs of antibodies showed significant difference in various groups(P < 0.05),which were high in the populations at ages of 4 ～ 6 and 7 ～ 16 years(9.42 and 9.01 IU/ml respectively,P > 0.05)and low in those at 1 ～3 and not less than 41 years(6.11 and 6.35 IU/ml respectively,P > 0.05).All the antibody positive rates in various groups were still 100% 45 d after the first vaccination,while the GMTs were 14.8 ～ 16.40 IU/ml,which showed no significant difference(P > 0.05).Conclusion Mild adverse reactions and good immune responses were induced by rabies vaccination in populations at various ages.However,the antibody productions in infants at age of less than 3 years and in the aged were prone to be delayed.It is suggested that the dosages of rabies vaccine for the first and second vaccinations in infants and the aged should be added properly so as to increase the serum antibody positive rate and the success rate of immunization.