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[Immune response and post inoculation reactions of simultaneous administration of hepatitis B vaccine with routine vaccine in children, III. Immune response and post inoculation reactions of simultaneous administration of hepatitis B vaccine and BCG, meningococcus group A polysaccharide vaccine].

The results of the immune response and post inoculation reactions of simultaneous administration of BCG, meningococcus group A polysaccharide vaccine and hepatitis B vaccine were reported. 360 newborn babies (1-3 days of age) were divided into five groups. The babies in group No. 1 were vaccinated with hepatitis B vaccine alone, babies in group No. 2 were vaccinated with BCG for scarification within 3 days after delivery and meningococcus group A polysaccharide vaccine in 6 months of age; babies in group No. 3 were vaccinated with hepatitis B vaccine, BCG for scarification and Meningococcus group A polysaccharide vaccine simultaneously, babies in group No. 4 were vaccinated with intradermal BCG and Meningococcus group A polysaccharide vaccine separately, babies in group No. 5 were vaccinated with hepatitis B vaccine, intradermal BCG and meningococcus group A polysaccharide vaccine simultaneously. The results of the immune response of the combination of hepatitis B vaccine with BCG, meningococcus group A polysaccharide vaccine were similarly to the immune response observed after immunization of each vaccine alone in children. The general post inoculation reactions of all vaccines were mild. There was no significant difference among all 5 groups. The data showed that children could be immunized with hepatitis B vaccine, BCG and meningococcus group A polysaccharide vaccine simultaneously.

Antibodies, Viral

Clinical trial of live measles vaccine given alone and live vaccine preceded by killed vaccine. Fourth report to the medical research council by the measles sub-committee of the committee on development of vaccines and immunisation procedures.

Follow-up of 5000 children given a single dose of live attenuated measles vaccine (Schwarz strain) when aged 10 months to 2 years shows a high level of protection in comparison with an unvaccinated group. This protection has been maintained for 12 years. Measles in vaccinated children was less severe as well as less frequent throughout the period. There is no evidence from the follow-up so far that a further injection of vaccine is needed; this has been confirmed by measles haemagglutination-inhibiting antibody estimations in a sample of the children.

Antibodies, Viral

[A comparison of the serological effects of classical cholera vaccine and of purified fraction vaccine, with or without simultaneous yellow fever vaccine (author's transl)].

In order to test whether simultaneously administered cholera vaccine has a depressive effect on yellow fever vaccine, a controlled trial was undertaken on school-age children in the South-Central Province of Cameroun. In addition to this principle objective, the study also permitted a comparison of the serological response in subjects vaccinated with classical cholera vaccine and in those vaccinated with a purified fraction vaccine, either with or without simultaneous yellow fever vaccine. The evaluation was measured by changes in vibriocidal antibodies and cholera agglutinins 30 days after vaccination. Only subjects without cholera antibodies prior to the study, were included. 1) Results obtained by assay of vibriocidal antibodies. It was confirmed that, no matter which cholera vaccine was used, the simultaneous administration of yellow fever vaccine had no influence on the percentage of subjects showing a significant rise in vibriocidal antibodies (4-fold increase in titre) following vaccination. In addition, in this study the purified fraction vaccine resulted in a significantly higher rate of seroconversion than did the classical vaccine. However, in comparison to other studies using classical cholera vaccine, our figures for seroconversion after purified fraction vaccine show very little, if any, differences. 2) Results obtained by assay of agglutinating antibodies. When measured by this method, there was a high frequency of non-reactors to the vaccines. This may be attributed to the date of the post vaccination blood speciment (30th day after vaccination). It has been shown that agglutinins decay rapidly after the 15th day following clinical cholera. Thus, the late date of the second speciment after vaccination could explain why we were unable to show any difference in the level of agglutinin after either classical or purified cholera vaccination. The simultaneous administration of the yellow fever vaccine did not influence the titre of agglutinins induced by the classic cholera vaccine. On the other hand, using the association, the seroconversion rate as observed on the 30th day post vaccination was significantly higher than that observed when the fraction was administered alone. If one accepts the generally admitted specificity of the agglutination reaction after clinical disease, two hypotheses can be considered: a) the yellow fever vaccine has an adjuvant effect for the production of antibodies induced by the purified fraction vaccine, or b) the addition of yellow fever vaccine has a retarding effect on the elimination of the agglutinins which, in the natural disease, are rapidly eliminated. Further studies to verify these hypothesis should be undertaken.

Adolescent

Evaluation of two kinds of smallpox vaccine: CVI-78 and calf lymph vaccine. I. Clinical and serologic response to primary vaccination.

A comparative study of two smallpox vaccines, standard calf lymph vaccine, and an attenuated vaccine, CVI-78, was performed in 95 children. Primary vaccination with CVI-78 resulted in a more attenuated response than primary vaccination with standard vaccine. Sixty-one percent of those vaccinated with CVI-78 and 96 percent of those vaccinated with standard vaccine developed a major dermal reaction; 16 percent of those vaccinated with CVI-78 and 89 percent of those vaccinated with standard vaccine developed post-vaccination neutralizing antibodies. Twenty-seven percent of the children vaccinated with CVI-78 demonstrated neither a dermal nor serologic postvaccination response, whereas only 2 percent of those vaccinated with standard vaccination demonstrated no postvaccination response.

Allantois

[Immunization of healthy children with mumps-rubella bivalent live vaccine and simultaneous vaccination with mumps-rubella and varicella vaccines].

Bivalent virus vaccine, containing rubella TCRB-19 strain and mumps NK-M46 strain (MR vaccine), was administered to a total of 95 healthy children who had already received measles vaccine or had been infected with wild measles virus. The seroconversion rates for rubella and mumps viruses in subjects having no antibody to rubella or to mumps virus were 99% (75/76) and 97% (63/65), respectively, at 6-8 weeks after vaccination. The seroconversion rates for both rubella and mumps in vaccinees initially seronegative to both viruses were 95% (56/59). Immune responses after MR vaccine injection were comparable to those after administration of monovalent rubella or mumps vaccine. Clinical reactions observed in some subjects who received MR vaccine were mild fever (3.6%), exanthem (8%), lymphadenopathy (1.8%), and swelling of the parotis region (1.8%). MR vaccine could be simultaneously injected with varicella vaccine at the opposite site producing no adverse effect on immune response. Our results indicate that MR vaccine is a safe and effective vaccine, especially for children who have had wild measles or who have received measles vaccine.

Adolescent

A/New Jersey/76 influenza vaccine trial in seronegative schoolchildren: comparison of a subunit vaccine with a whole-virus vaccine.

In the present vaccination trial, 202 seronegative schoolchildren comprising both sexes and aged 11 to 12 years were vaccinated i.m. in the upper arm with either the subunit vaccine at a dosage of 600 CCA or 200 CCA or with a whole-virus vaccine at a dosage of 200 CCA, using the double-blind procedure. Both vaccines were prepared from the strain A/New Jersey/76 (x 53a-recombinant). The vaccination was followed four weeks later by a booster injection. In tests of local and systemic reactogenicity, it was found that at both dosages the subunit vaccine caused a low frequency of minor adverse reactions. The whole-virus vaccine was marked by a significantly higher rate of adverse reactions, whether of the local or systemic variety. The whole-virus vaccine had, however, a higher immunogenicity than the subunit vaccine, and due to the relatively high rate of adverse reactions it causes, it is not recommended for the vaccination of seronegative children. Because of its low reactogenicity, the subunit vaccine can be given at higher dosage, and it is a matter for consideration whether a better antibody response might not result from two booster injections.

Antibodies, Viral

[Measles vaccination with split vaccines and living vaccines (author's transl)].

Two vaccination groups were observed over four years. One group received multiple preliminary vaccinations with measles split vaccine and were subsequently immunised with measles live vaccine. The second group received live vaccine only. The protection from the live vaccine, with and without the preliminary vaccination, must be considered very good, while the protection of a preliminary vaccination with split vaccine is only sufficiently effective for 1 1/2 to 2 years. All children-whether pre-vaccinated with split vaccine or not-should be protected against measles with live vaccine from the second year of life.

Age Factors

Evaluation of two kinds of smallpox vaccine: CVI-78 and calf lymph vaccine. II. Clinical and serologic observations of response to revaccination with calf lymph vaccine.

Revaccination with standard calf lymph vaccine was performed on 26 children who had received a primary vaccination with an attenuated smallpox vaccine, CVI-78, and 22 children who had received primary vaccination with standard calf lymph. Revaccination resulted in a vesicular reaction in 96 percent of those who had been vaccinated previously with CVI-78 and 73 percent of those vaccinated previously with standard calf lymph. All children had a positive hemagglutination-inhibition (HI) antibody titer either after primary vaccination or revaccination. Only 65 percent of those initially vaccinated with CVI-78 vaccine had positive neutralizing antibodies after revaccination. All children who received primary vaccination with standard calf lymph had postrevaccination neutralizing antibodies. The children who had neither a dermal nor a serologic response after primary vaccination responded as primary vaccinees on challenge with standard calf lymph.

Animals

Vaccination of chickens against Marek's disease with the turkey herpesvirus vaccine using a pneumatic vaccinator.

A pneumatic vaccinator has been successfully used to administer cell-associated turkey herpesvirus (HVT) vaccine without a loss in titer due to the pressure required to administer the vaccine. Laboratory studies have also shown that chickens vaccinated with graded doses of the HVT vaccine using doses as low as 41 PFU offered protection against Marek's disease (MD) when compared to the unvaccinated controls. The pneumatic vaccinator has also been successful in administering a combination of HVT vaccine and tissue culture fowl pox vaccine. Vaccinated birds were protected against challenge with virulent MD virus as well as fowl pox virus. Antibiotics such as spectinomycin pentahydrate or lincomycin hydrochloride monohydrate and spectinomycin sulfate tetrahydrate were used in combination with the HVT and fowl pox vaccine and none of the antibiotics appear to have an adverse effect on the efficacy of either vaccine.

Animals

Safety, tolerability, and immunogenicity of concurrent administration of Haemophilus influenzae type b conjugate vaccine (meningococcal protein conjugate) with either measles-mumps-rubella vaccine or diphtheria-tetanus-pertussis and oral poliovirus vaccines in 14- to 23-month-old infants.

In 1985, the first capsular polysaccharide (polyribosylribitol-phosphate [PRP]) vaccine for Haemophilus influenzae type b was licensed and recommended for routine use in children between 24 and 60 months of age. In the United States, approximately 75% to 90% of invasive disease due to H influenzae type b occurs in infants younger than 24 months, a population for whom H influenzae type b polysaccharide vaccine is inadequately immunogenic and protective. In an effort to enhance the immunogenicity of H influenzae type b polysaccharide vaccine for children in the most susceptible age groups, conjugate vaccines have been developed in which the capsular PRP of H influenzae type b has been bound to a variety of carrier proteins, thereby conferring the vaccines with thymic-dependent attributes. One such conjugate vaccine, in which the carrier protein is diphtheria toxoid (PRP-D), was licensed in 1987 and has been recommended since 1988 for routine use in children 18 months of age and older. A second conjugate vaccine, in which an oligosaccharide derivative of H influenzae type b capsular PRP is coupled to CRM, a nontoxic mutant diphtheria toxin (oligo-CRM), was licensed in 1988 and is a sanctioned alternative to PRP-D. Another investigational conjugate vaccine, in which the polysaccharide is linked to the outer membrane protein of Neisseria meningitidis group B (PRP-OMPC), has been demonstrated to be both safe and immunogenic when administered in a two-dose schedule to 2- to 6-month-old infants. However, anti-PRP antibody levels decline significantly during the ensuing 10 to 15 months; they rise significantly in response to booster doses of either PRP or PRP-OMPC administered 10 to 15 months after the initial priming doses of PRP-OMPC.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Bacterial

Two trials of an acellular DTP vaccine in comparison with a whole-cell DTP vaccine in infants: evaluation of two PT doses and two vaccination schedules.

The present trials being carried out in Switzerland and Turkey, the reactogenicity and immunogenicity of acellular DTP vaccines containing either 25 micrograms or 8 micrograms of PT and 25 micrograms of FHA were compared with those of a conventional whole-cell DTP vaccine during a primary vaccination course following either a 0-1-2 schedule starting at three months of age (Switzerland) or a 0-2-4 schedule starting at two months of age (Turkey). The whole-cell vaccine was associated with significantly more local reactions than the acellular vaccines; general reactions were also more frequent among whole-cell recipients. The 25 micrograms PT dose vaccine was no more reactogenic than the 8 micrograms PT dose vaccine. There was no evidence of increases in frequencies of local or general reactions from one acellular vaccine dose to the next. The 25 micrograms PT dose acellular DTP vaccine resulted in immune responses to all four antigens (PT, FHA, diphtheria and tetanus toxoids) at least equivalent to those observed with whole-cell vaccination. Significantly lower anti-PT antibody levels were seen with the 8 micrograms PT dose vaccine.

Antibodies, Bacterial

Measles vaccine efficacy: influence of age at vaccination vs. duration of time since vaccination.

To evaluate the recent decision of the Advisory Committee on Immunization Practice to increase the recommended age for initial measles vaccination from 12 to 15 months, we carried out a case control study of vaccine failure in a recent measles epidemic. Compared to children vaccinated at ages 15 months or older, we found an increased risk of vaccine failure among those vaccinated at 12 to 14 months (relative risk = 19.2, 95% confidence interval = 4.6 to 80.1). In order to sort out the influence of age at vaccination from elapsed time since vaccination, we subjected the data to discriminant analysis. Age at vaccination subsumed all of the effect of duration of time since vaccination. Thus, we find no evidence of waning immunity over time.

Age Factors

Measles vaccination. VIII. The occurrence of antibodies against virus envelope components after immunization with inactivated vaccine. Effects of revaccination with live measles vaccine.

Children immunized with 4 doses of formalin-inactivated vaccine and/or purified hemagglutinin prepared from Tween 80-ether (TE) treated material were subjected to a follow-up 8-9 years after the last dose of vaccine. 11 out of 27 children had clinical and/or serological signs of infections with wild measles virus during the 8 to 9 years post-booster period. 10 out of the 11 children with infections had non-hemagglutinating-inhibiting (HI) hemolysis-inhibiting (HLI) antibodies demonstrable in their sera after removal of HI antibodies by absorption with TE antigen. In contrast 13 out of 16 vaccinees without detectable signs of infection lacked non-HI HLI antibodies. 10 out of these 13 children were vaccinated with further attenuated live measles virus. There were no clinical reactions to faccination. 4 vaccinees with low pre-vaccination HI antibody titers showed significant rises of antibody titers including non-HI HLI antibodies. In the remaining children no take of the live vaccine could be demonstrated. Thus HI antibodies of a certain minimal concentration can block the replication of vaccine virus even in the absence of non-HI HLI antibodies. However, since it will be difficult to establish these conditions by sue of available inactivated vaccines it is recommended that future vaccine products should include both major virus envelope surface components, the hemagglutinin and the hemolysin.

Antibodies, Viral

[Comparison of duck embryo vaccine and Hempt's vaccine for rabies vaccination (author's transl)].

For many years, Hempt's vaccine has been used in Germany for vaccination against rabies. In recent years the duck embryo vaccine has been gradually introduced in its place. From 1970 to 1975, 658 consultations were undertaken at the Hospital of the Tropical Institute at Hamburg because of the risk of rabies. 267 persons had to undergo vaccination, 159 of them being treated with Hempt's vaccine and 108 with duck embryo vaccine. Side effects of a more severe type were not seen in either group. Disadvantages of the duck embryo vaccine are that more individual inoculations are necessary, significantly more frequent and more persistent local and general vaccination reactions occur and that there is a delayed, possibly weaker formation of antibodies.

Animals

Immunogenicity and reactogenicity of rhesus rotavirus vaccine given in combination with oral or inactivated poliovirus vaccines and diphtheria-tetanus-pertussis vaccine.

Immunogenicity and reactogenicity of the oral rhesus rotavirus vaccine (RRV) were assessed among 72 infants (6 weeks old) in Lahore, Pakistan, from August to December 1985. Special emphasis was placed on the possible interaction or interference caused by giving RRV at the time infants received their first polio immunization. RRV was given to the infants at the same time as diphtheria-tetanus-pertussis (DTP), oral poliovirus vaccine (OPV), or inactivated poliovirus vaccine (IPV). The immune response to RRV was assessed by plaque-reduction neutralization 3 weeks after immunization and serum immunoglobulin (Ig) G and IgA antibody levels to poliovirus type 1 were tested by enzyme-linked immunosorbent assay (ELISA) after polio immunizations. Of the infants in the group given RRV with OPV, 50% had a two- to four-fold rise in neutralization titre against rotavirus, compared with 22% in the group given RRV with DTP and 20% in the group given RRV and IPV (P less than 0.05). Interference by live oral polio vaccination in the response to RRV seems unlikely. We observed no significant difference in rates of seroconversion of IgG antibodies to poliovirus type 1 among infants aged 18 and 21 weeks who received RRV and OPV (81%), RRV with delayed OPV (67%), or RRV and IPV (59%). Administration of RRV was safe and was not associated with adverse reactions in the 6 weeks old infants. The low rate of seroconversion to rotavirus suggests that a more antigen-rich vaccine or multiple doses of the same vaccine might produce a better immune response.

Antibodies, Viral

[Results of preventive rabies vaccination with a concentrated vaccine of the PM/WI38-1503-3M rabies strain cultured on human diploid cells. Preparation of mixed antirabies-antitetanus hyperimmune immunoglobulin by plasmapheresis of blood taken from vaccinated veterinary students].

Many thousands of people in France and abroad have already benefited from preventive rabies vaccination by means of a vaccine obtained from culture on human diploid cells, perfected ten years ago by R. Lang, the Institut Mérieux and the Wistar Institute. In addition to being well tolerated, the serological efficacy of this vaccine is such that 100% of the vaccines observed had a seroconversion after only two injections at an interval of one month. However, a booster dose should be given 6 to 12 months after the first injection, and a further booster 3 to 5 years later or on request in case of known contamination. These boosters, combined with an anti-tetanus booster, induce such high antibody titers--between 10-100 and even 1000 I.U./ml--that it is easy to obtain substantial batches of combined anti-rabies and anti-tetanus immunoglobulin from a small number of volunteers. The complete efficacy of this new vaccine reduces the number of systematic post-vaccinal serologic controls and its innocuity is such that an extended preventive vaccination programme may be carried out, for instance in the case of children living in areas known to be dangerous.

Adult