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Mumps vaccine

vaccine

Epidemic parotitis Is created by Mumps virus Caused by parotid gland Acute characterized by swelling Respiratory infectious disease 。 The incidence of the disease is mainly children and adolescents, mostly in winter and spring. The disease is widespread in China, with frequent local outbreaks. Mumps virus RNA type Paramyxoviridae 。 It contains two antigenic components, namely virus particle antigen and Soluble antigen 。 The clinical manifestations are parotid gland enlargement and pain, which can affect unilateral or bilateral parotid glands, and can also invade other gland organs, causing Orchitis , membrane Adenitis 、 Oophoritis 。 Mumps virus can also cause meningitis and myocarditis , but also the day after tomorrow Acquirability deaf This kind of deafness is often irreversible. Inoculation of mumps virus reducing activity vaccine Good preventive effect can be achieved.

In the 1960s, U.S.A Microbiologist Maurice Hilleman He invented the commonly used mumps vaccine and named it after his daughter Jeryl Lynn. Later, Hillman further developed MMR vaccine （ MMR ）。^[1-3]

Chinese name: Mumps vaccine
Foreign name: Mumps vaccine
Viruses: Mumps virus

Disease: Epidemic parotitis
Affected population: Mainly children and teenagers
Time of onset: Winter and spring

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ten Research progress

Basic Introduction

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Mumps vaccine

Epidemic parotitis Mumps is caused by mumps virus Respiratory infectious disease 。 Mumps is known as Chinese medicine Mumps As early as 640 BC, there were records about this disease in medical books. In 1934, Johnson and Goodpasture were inoculated with infectious materials to remove bacteria monkey It can cause parotitis. In 1946, Beveridge took samples from patients with mumps and inoculated chicken embryos Yolk sac , successfully detached to Mumps virus 。 Human is the only mumps virus Natural host 。 Mumps patients and health Poison carrier It's the disease Infectious agent 。 Mumps mainly occurs in children and adolescents, especially in patients aged 5-15 years old, and rarely in those under 2 years old and over 40 years old. Mumps often occur in winter and spring, but infection can occur throughout the year. Often nursery , kindergartens, schools and recruits. The epidemic occurs about every two years. Lifetime immunity can be obtained after a single infection, but individual patients with low antibody levels can also be re infected.

parotid gland Saliva or respiratory tract of patients and healthy people with virus Secretory fluid Droplet meridian Airborne transmission 。 The tableware or toys contaminated by the saliva of patients and healthy people with poison can also cause infection if they come into contact with the mouth of the susceptible person in a short time. This disease incubation period 14-21 days, with an average of 18 days. Virus invasion Upper respiratory tract Mucosa grows and propagates locally, passes through blood flow to parotid gland and other organs, and can also pass through oral cavity Parotid duct It spreads to the parotid gland and expels the virus from 6 days before the parotid gland enlargement to 5 days or more after the onset of the disease. The virus can also be discharged from conjunctival secretions and urine. Viruses can also be found in patients' white blood cells in the first 1-2 days of the onset. After infection of pregnant women, the virus can cause congenital infection of the fetus through the placenta, thus causing fetal malformation. Adolescent women After infection, it can be secondary to parotitis Oophoritis , causing Menstrual disorder and Infertility Illness. Adolescent male patients, which can be complicated Orchitis 。 Most serious complication yes Meningoencephalitis , can also be concurrent pancreatitis 、 myocarditis 、 mastitis Etc.

Vaccine history

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In 1948, the United States approved an inactivated mumps vaccine And was used between 1950 and 1978. The immunity induced by this vaccine Duration Short, poor protection effect. In the 1960s, U.S.A Microbiologist Maurice Hilleman The commonly used mumps vaccine was invented for research and development Epidemic parotitis Vaccinal Viruses It was extracted from his daughter, Jeryl Lynn, so the vaccine was named after her daughter, Jeryl Lynn.^[1-3] Since then, Hillman further developed MMR vaccine （ MMR ）。^[1-4]

Later, Japan front Soviet Union 、 Switzerland And the United States Live attenuated vaccine 。 different Mumps virus Strain is used to develop various vaccines. Moreover, even if the same parent strain of virus is used passage Process Cell culture medium and Production process Different vaccine preparations are not exactly the same. All Live attenuated mumps vaccine All are lyophilized dosage forms, which must be diluted before use.

Mumps vaccine

The Jeryl – Lynn strain vaccine was approved in the United States in 1967, and the United States recommended routine vaccination of the Jeryl – Lynn strain vaccine in 1977. Over the past 30 years, the Jeryl Lynn strain vaccine is the only mumps vaccine used in the United States, and nearly 500 million doses have been distributed worldwide. The virus is propagated in eggs containing embryos and then used Chicken embryo Cells Culture to prepare vaccine 。 In 1955, the number of mumps cases reported in the United States was about 1% before the use of vaccine. Industrialized country The results of the study showed that the seroconversion rate was 80 – 100% after one dose of Jeryl – Lynn vaccine. Outbreaks in the United States Research It shows that the Jeryl – Lynn strain vaccine can prevent clinical mumps Efficiency Between 63% and 96%.

RIT 4385 strain vaccine RIT 4385 strain mumps vaccine Dominant clone of vaccine from Jeryl – Lynn strain. Of two vaccines Comparative study It was found that their seroconversion rates were similar (96% of RIT 4385 strain vaccine and 97% of Jeryl Lynn strain vaccine), but Jeryl Lynn strain vaccine induced Antibody titer It is significantly higher than RIT 4385 strain vaccine. Because there is no comparative clinical study of the two vaccines Control experiment The clinical significance of the above differences is still unclear.

Leningrad-3 vaccine Former Soviet Union Successful development, virus first guinea pig Renal cell Multiplication, then Japan quail embryo culture medium Middle generation. Since 1980, the former Soviet Union's National immunization programme The vaccine has been used all the time. The seroconversion rate of Leningrad-3 vaccine in children aged 1-7 years old was 89-98%, and the protective effect was 92-99%. And, in Russia When parotitis broke out in the Federation, the results of a test on 113967 children aged 1-12 years showed that, Emergency vaccination This vaccine The protective effect reached 97%.

Leningrad – Zagreb strain vaccine Croatia Further study on Leningrad-3 strain using chicken embryonic fiber cells Attenuation The new strain is named Leningrad – Zagreb strain, which is used for vaccine production in Croatia and India. Millions of children around the world have received the vaccine. Croatia's research shows that its clinical protective effect is equivalent to that of Leningrad-3 strain vaccine.

Urabe Am9 attenuated live vaccine was first approved for marketing in Japan, and then in Belgium , France and Italy Approved. Urabe Am9 strains vaccine Or eggs with embryos Amniotic cavity Inoculation or chicken embryo cell culture preparation. The vaccine has been used successfully in some countries, and the seroconversion rate of children aged 12-20 months after vaccination is 92- 100% 。

Mumps vaccine

British Comparative experiment (Jeryl – Lynn strain vaccine and Urabe Am9 strain vaccine, with MMR Combined vaccine Formal inoculation) showed that four years after inoculation Serum antibody The positive rate was 85%, and that of Jeryl Lynn strain vaccine was 81%. stay Canada Similar studies have shown that the positive rate of serum antibody of Urabe Am9 strain vaccine is 93% and that of Jeryl Lynn strain vaccine is 85% 5-6 years after inoculation. other vaccine Rubini strain vaccine was first used in 1985 Switzerland Approved for marketing, virus strain user Diploid cell line It was subcultured continuously in eggs containing embryos, and then adapted to the MRC-5 human diploid cell line. Many studies have shown that the seroconversion rate and effect of Rubini strain vaccine are much lower than Urabe Am9 strain vaccine and Jeryl Lynn strain vaccine. Therefore, WHO It is suggested that Rubini strain vaccine should not be used in national immunization programs.

China has produced and used more than 100 million doses of S79 mumps vaccine. In addition, only when Local areas Small scale application includes Hoshino strain, Torii strain, Miyahara strain and NKM-46 strain of attenuated mumps vaccine The report says that the immunogenicity of these vaccines is similar to that of Urabe Am9 strain vaccine. Several mumps vaccines, including Jeryl Lynn strain vaccine, Urabe Am9 strain vaccine and Leningrad-3 strain vaccine, all contain more than one virus clone. Between vaccine virus clones Difference pair The possible significance of protection effect or safety is not clear. Mumps vaccine has univalent and bivalent（ measles -Mumps) and trivalent (MMR) forms. Most countries use MMR to prevent mumps.

As of December 2005, more than 80% of the 110 countries that have included mumps vaccine in their national immunization plans have adopted two doses of mumps vaccine Immunization procedures 。 The first dose is usually administered at the age of 12-18 months, and the second dose should be administered at least one month later Revaccination 。 Most children have received the second shot before entering school (about 6 years old). Since the 1990s, China began to use a large number of live attenuated mumps vaccine developed by China.

Compositional traits

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Mumps vaccine

use Mumps virus S79 Attenuated strain Inoculate chicken embryo cells, culture, harvest virus liquid and add appropriate stabilizer after Freeze-drying make. Freeze dried vaccine by cheese Colored loose body, dissolved into Orange 。 Vaccine producing countries Drug supervision and management The department determines the minimum content of attenuated mumps virus that each dose of vaccine should contain. Different manufacturers in mumps vaccine Different stabilizers are used in some Hydrolyzed gelatin , some use sorbitol , and some use both.

Vaccination target

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This vaccine Applicable to all mumps aged over 8 months Susceptible person 。

usage method

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Use the attached Sterilized water for injection dissolution vaccine For post use, the vaccine before and after dilution should be kept away from light, and the diluted vaccine must be stored in the cold chain once Immunization Those that are not used up at the end of the activity or 6 hours after dilution must be discarded (according to the first condition). On the outside of the upper arm the deltoid Attachment subcutaneous injection 0.5ml。

Immune effect

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Mumps vaccine

Inject one dose of detoxification activity vaccine After that, the titer of neutralizing antibody in cells reaches more than 1:2, which can be considered as Vaccine immunization success. Immunization success rate 80%~90%. The effective protection period of antibody can reach 10 years. However, the subsequent outbreak investigation showed that the long-term protective effect of one dose of mumps vaccine was lower (60-90%).

Inoculation reaction

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Mumps vaccine

commonly mumps vaccine Of Adverse reactions Slight and rare. The most common reactions are parotitis and Low fever 。 see occasionally Orchitis Homophony Neurogenic deafness 。 Moderate rarely occurs fever , once reported Aseptic meningitis However, the reported incidence varies greatly (for example, from 1/400 to 1/500000). Vaccine related Sterility meningitis The difference in incidence not only reflects the vaccine strain It is different from the formula diagnostic criteria and clinical practice The difference is related to. Passive monitoring Is difficult to find Tardiness Sterile meningitis. Aseptic meningitis usually occurs 2-3 weeks after vaccination, with a median interval of 23 days (ranging from 18-34 days). Some meningitis patients can see cerebrospinal fluid white blood cell Increased, but no obvious clinical symptoms.

contraindication

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mumps vaccine There are few contraindications. Like all live attenuated vaccines, mumps vaccines cannot be used for severe cases immunodeficiency or Low immune function The. Vaccination is contraindicated during pregnancy, but it is not caused by those pregnant women who have received mumps vaccine Fetal injury Report of. For vaccine components such as new Mycomycin Or people with gelatin allergy cannot be vaccinated with mumps vaccine.

matters needing attention

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Mumps vaccine

Ampoule Cracks, unclear labels Freeze dried vaccine Do not use if it turns red or becomes turbid after dissolution; When opening ampoules and injecting, do not use disinfectant Vaccine exposure; After the ampoule is opened, the vaccine should be used up within 1 hour. If it is not used up, it should be discarded; Injected Gamma globulin Those with mumps can be vaccinated after an interval of 1 month; Recent use Immunosuppressant People should not be vaccinated with this vaccine, but should be vaccinated at least every 2-4 weeks.

Storage and transportation conditions and validity period

mumps vaccine The validity period is one and a half years from the date when the virus titration is qualified. Freeze dried vaccine - 20 ° C before use Cryopreservation Or store and transport at 2~8 ℃.

Research progress

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May 10, 2008 in the United States Arizona The research report released at the 16th annual meeting of the American Children's Otolaryngology Society held by Scottsdale pointed out that local administration of Epidemic parotitis vaccine It can effectively alleviate the recurrence of most children respiratory tract Papilloma (RRP)。

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