摘要：目的 研究新生儿乙型肝炎(乙肝)疫苗接种的远期效果和加强免疫的必要性。方法 对上海市南市区1986年出生时接种乙肝疫苗的儿童至少隔年随访一次，抽血检测HBsAg、抗-HBc和抗-HBs。在第5年，对同年出生但未接种过乙肝疫苗的邻近行政区儿童进行调查，以此作为外对照计算疫苗的远期保护效果。结果 11年HBsAg阳性率在0.46%～0.98%之间，平均0.70%(25/3 578)，大大低于免前本底对照和外对照，而且没有随免后时间的延长而升高的趋势。同外对照相比首针接种后5年的保护效果为85.42%(95%可信区间：70.11%～100%)。结论 新生儿首针接种后11年内无加强免疫的必要，是否或何时加强，尚需进一步随访。

    

LIN Ximin^* , XU Zhiyi,OU-YANG Peiying, et al.

Department of Epidemiology,School of Public Health,Shanghai Medical University,Shanghai 200032

Abstract：Objective To evaluate the long-term efficacy of hepatitis B(HB) vaccination in newborns and the need for a booster dose. This research is one of the longest HB vaccine follow-up studies in the world with its subjects came from a program of universal infant HB vaccination.Methods Children who were born in 1986 and immunized with hepatitis B vaccine at birth were followed up at least once a year. Serum HBsAg, anti-HBc and anti-HBs were tested. At the 5^th year after the first dose the prevalence of hepatitis B infection in the children in other district who were also born in 1986 and remained unvaccinated was surveyed as external controls. Random sampling was applied and the possible bias was analyzed. The trends of the positive rates of serum HBsAg, anti-HBs and anti-HBc in the immunized cohort were studied. With external control, the long-term efficacy of HB vaccination was calculated. Results The positive rates of HBsAg in the vaccine group from the first to eleventh year were 0.46%-0.98% and way below than those of baseline and external control. HBsAg rates in the cohort at different ages were similar with an average of 0.70%(25/3 578). The long-term efficacy of newborn vaccination was 85.42% (95% confidant interval:70.11%-100%). Conclusions The efficacy of HB vaccine was long-lasting and a booster dose was not necessary at least up to age 11 years.
Key words： Hepatitis B vaccine Follow-up study Hepatitis B surface antigen

为评价乙肝疫苗的远期效果 ......