Analysis Of Immunization Effect Of Hepatitis B Vaccination In School Students Aged 15-18

Purpose:To observe the immune effect of hepatitis B vaccine in 15-18 year old school students,and to explore the factors influencing the immune response ability of the body after hepatitis B vaccine inoculation and the feasibility of strengthening the immunization of students without（weak）response.This could provide lessons for improving response to hepatitis B vaccination and reducing viral hepatitis type B（HBV）infection.Methods:（1）The cluster sampling method was adopted to select 1134 students aged 15-18from a vocational college as the research objects;（2）By Enzyme-Linked Immuno Sorbent Assay（ELISA）,5ml of peripheral venous blood of all the tested students was taken to detect HBs Ag and anti-HBs.At the same time,solid phase radioimmunoassay（Micro-SPRIA）was used to detect anti-HBsin students with negative anti-HBs.（3）In order to understand the effect of HCV overlapping infection on the immune response after hepatitis B vaccination,an equal number of people were selected in the high response group and no（weak）response group as the control;（4）T lymphocyte subsets were detected in students with successful immunization and those with failed immunization（no/weak response）;（5）Univariate and multivariate Logistic analysis was used to analyze the factors affecting immune response.（6）200 students with negative antibodies were selected for intensive vaccination according to the procedures of 0,1,6,and peripheral venous blood was used for anti-HBsdetection by SPRIA method 1 month after vaccination.Results:1.A total of 1134 questionnaires were distributed in this study,among which 1104were valid,accounting for 97.35%of all questionnaires（1104/1134）.Gender ratio:Among 1104 valid questionnaires,565 were male and 539 were female.There was no significant difference（χ²=1.225,P=0.268）2.Among 1104 students who had received hepatitis B vaccine,the positive rate of anti-HBswas 73.55%（812/1104）,and the non-（weak）response rate was 26.45%（292/1104）.3.According to the results of HBVDNA examination,the positive detection rate of HBVDNA was 5.00%in high responders and 23.75%in no（weak）responders,and the difference between the two was statistically significant（P<0.05）.4.Through the univariate analysis of the influence of immune-response ability of vaccinators,the gender of vaccinators and exercise were not related to the immune-response ability of the body（P>0.05）,while the non-vaccination,the presence of genetics,the absence of vaccination discomfort and the error of vaccination procedures were positively correlated with the occurrence of no（weak）response ability after vaccination.According to the univariate analysis results of post-vaccination response ability of vaccinators,excluding gender and exercise（P>0.05）factors,the multivariate analysis results showed that no vaccination,genetic,no discomfort after vaccination and the error of vaccination procedures were independent risk factors of post-vaccination response ability.5.CD4⁺%and CD8⁺%in high response group were significantly higher than those in no（weak）response group,and the difference between groups was significant（P<0.05）,but there was no significant difference in CD3⁺%between the two groups.6.The concentration of IFN-γin high response group was higher than that in no（weak）response group,and the difference was statistically significant（P<0.05）;The concentration of IL-4,IL-12 and IL-18 was higher than that of no（weak）response group,and the difference was not statistically significant（P>0.05）.7.Among all the students without（weak）response,200 students were randomly selected for booster vaccination,170 students completed the whole immunization,170students after booster vaccination were tested by SPRIA foranti-HBs,among which 159students had anti-HBs≧10MIU·ml^-1.The positive conversion rate was（159/170）93.53%.Conclusion:The application effect of hepatitis B vaccine in school students is better.Unvaccinated,genetic,no discomfort after vaccination and the error of vaccination procedure are independent risk factors for the occurrence of no（weak）response ability after vaccination.According to the above risk factors,relevant effective measures are formulated,and no（weak）response population is given to strengthen immunization,which is conducive to improving the success rate of vaccination.At the same time,it can effectively reduce the occurrence of HBV infection.