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Sohn, Park, Lee, Roh, Ki, Choi, and Kim: Persistency of Neutralizing Antibody to Inactivated Mouse Brain Derived Nakayama Japanese Encephalitis Vaccine and Current Observations of Booster Vaccination and Advers e Events
Original Article

Korean J Pediatr Infect Dis 2001;8(2):150-159.

Published online: 23 January 2001

DOI: https://doi.org/10.14776/kjpid.1994.8.2.150

Persistency of Neutralizing Antibody to Inactivated Mouse Brain Derived Nakayama Japanese Encephalitis Vaccine and Current Observations of Booster Vaccination and Advers e Events

Young Mo Sohn, M.D., Ji Ho Park, M.D., Jin Soo Lee, M.D., Hye Ok Roh, M.D., Moran Ki, M.D.∗, Bo Yul Choi, M.D.†, Young Ho Kim, M.D.†

1Department of Pediatrics, College O Medicine, Yonsei University, Seoul,

∗Department (f Preventive Medicine College o Medicine’ Eulj i University, Dagon,

†Dep artment f Preventive Medicine, College C Medicine, Hanyang University, Seou

†Map o Public Health Center Seoul, Korea

Lead author: Youngmo Son, Department of Pediatrics, Yeongdong Severance Hospital, Yonsei University Tel : 02)3497-3350 Fax : 02)3461-9473 E-mail : youngmo@yumc.yonsei.ac.kr

Copyright © 2001 The Korean Society of Pediatric Infectious Diseases

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose :

We need to reconsider booster vaccination schedule of Japanese encephalitis vaccination. To do that we evaluate the long-term immunogenicity and the incidence of adverse events with inactivated mouse brain derived Nakayama Japanese encephalitis vaccine.

Methods :

We tested neutalizing antibody for 311 elementary school students by plaque reduction neutralizing test(PRNT) at USAMC-AFRIMS(United States Armed Forces Research Institute of Medical Science/Department of Virology). We evaluated vaccine related adverse events by spontaneous reporting prospectively among 15,487 vaccinees who were vaccinated at public health center and 2,277 elementary school students who were immunized previously by a questionnaire and school health record.

Results :

According to the time interval from the last booster injection of 311 children, PRNT antibody titers gradually decreased as the interval increased; 239 mIU/mL, 188 mIU/ mL, 134 mIU/mL, 49 mIU/mL each at 6, 18, 30, 42 months after the last booster injection. The seropositivity rates were 98%, 99%, 95.6%, 71.4% each at 6, 18, 30, 42 mons after the last booster injection. There were 21(0.13%) cases with systemic reactions among 15,487 vaccinees who had visited the hospital by prospective passive reporting system at public health center. According to the questionnaires and school health records in elementary school students, local induration and pain were 17.4% and 14.8%, respectively. Systemic reactions including fever, vomiting, rash were reported in few cases.

Conclusion :

Biannual booster vaccination that has been recommended so far should not be necessary. Surveillance for adverse events with inactivated mouse brain derived Nakayama vaccine should be strengthened to better assess the number of cases and reactions associated with immunization.

Keywords: JEV, Vaccination, Neutralizing antibody, Persistency

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Table 1.
Neutralizing Antibody Seropositive Rate Among the Vaccinees who had been Immunized with Booster Injection
Group Time interval from the last booster injection Seropositive rate (No. of positive cases/ No. of cases) 95% CI PRNT Ab titer (mIU/mL) (GMT)∗ 95% CI
1 6 month 98.1(152/155) 94.5~99.6 239 197~291
2 18 month 99.0(103/104) 94.8~99.9 188 144~245
3 30 month 95.6(43/45) 84.9~99.5 134 90~198
4 42 month 71.4(5/7) 29.0~96.3 49 9~284

∗ P<0.01

Table 2.
Immunization Rate According to a School Health Records and a Questionnaire
  Health records Questionnaire
No. of subjects Immunization rate(%) No. of subjects Immunization rate(%)
City 1313 61.8 1,170 93.8
County 964 27.9 736 92.9
Total 2277 47.5 1,906 93.5

P =0.038

Table 3.
Immunization Rate According to School Health Records and Questionnaires at 1995 and 1996
Confirmed by health record No. of subjects Confirmed by questionnaire
Not V∗.at 95, 96 V∗. at 95 only V∗. at 96 only V∗. both at 95 & 96
Not V∗. at 95, 96 589 14.3% 33.3% 14.4% 38.0%
V∗. at 95 only 647 9.6% 30.3% 9.0% 51.2%
V∗. at 96 only 462 9.5% 12.3% 23.2% 55.0%
V∗. both at 95 & 96 45 4.4% 11.1% 8.9% 75.6%

∗ V. :vaccinated

Table 4.
Immunization Rate According to Sex in Preschool Children
  No. of subjects Immunization rqate(%)
Male 1,176 48.5
Female 1,101 46.4
Total 2,277 100.0

P>0.05

Table 5.
Immunization Rate According to Year of School Entrance
Year No. of subjects Immunization rate
1996 331 26.6
1995 330 54.5
1994 325 29.5
1993 424 53.5
1992 418 52.2
1991 449 46.1
Total 2,277 47.5

P=0.711

Table 6.
Booster Immunization Rate According to Year of School Entrance
Year No. of subjects Immunization rate according to a number of booster injection(%)
One Two Three Four Five Six Six
96 235 98.3          
95 254 89.4 9.1        
94 306 40.5 58.2 1.3      
93 414 5.6 28.5 65.2 0.2    
92 402 3.2 10.7 33.1 48.8 4.2  
91 437 1.6 2.5 14.0 41.9 38.9 1.1
Total 2,048 30.5 18.2 22.9 18.6 9.1 0.2

P<0.05

Table 7.
Immunization Rate According to Year of School Entrance and Year of the Last Booster Vaccine Injection
Year of school entrance Immunization rate at each year of school entrance(%) Immunization rate at each year of the last booster vaccine injection(%)
1996 1995 1994 1993 1992 1991 1990
96 91.2 68.3 52.6 54.4 41.7 36.6 27.2 21.8
95 95.3 59.8 58.5 49.1 44.8 32.7 26.4 20.9
94 93.2 76.5 55.4 52.9 45.5 36.0 30.2 27.4
93 94.1 56.7 59.2 50.0 50.7 38.7 31.8 28.8
92 93.3 70.0 64.8 64.1 57.2 52.6 43.5 38.0
91 93.8 55.3 65.9 63.3 59.7 52.3 50.6 41.2
Total 93.5 62.6 59.9 56.1 50.8 42.4 36.0 30.6

p<0.05

Table 8.
Place where the Subjects were Vaccinated at 1996
Place of immunization No. of subjects %
Clinic, Hospital 208 14.1
Public health center 370 25.1
School 885 60.1
Others 9 0.7
Total 1,472 100.0

P<0.01

Table 9.
Adverse Events after Inactivated JE Vaccine from May to June in 1995 at Public Health Center
Case Name Age Sex Date of vaccination Onset of symptom Symptom Treatment
1 SSY 10 M 5/16 5/17 Fever(38.7°C) Hospital visit
2 JEH 6 F 5/16 5/17 Fever(38.7°C) Hospital visit
3 KSB 12 F 5/17 5/18 Syncope 3 min. after the injection Resuscitation, recover
4 SHJ 15 F 5/17 5/18 Vomiting Medication
5 SMS 7 M 5/17 5/19 Fever, Swelling on injection site Medication
6 NYH 8 F 5/17 5/19 Fever Hospital visit
7 SDK 4 M 5/17 5/19 Fever, Vomiting Hospital visit
8 SSJ 13 F 5/18 5/19 Fever(39.0°C) Hospital visit
9 SSC 9 F 5/18 5/19 Fever(38.5°C) Hospital visit
10 LJY 5 M 5/18 5/19 Fever(38.5°C) Hospital visit
11 LKJ 7 M 5/22 5/23 Fever(38.5°C) Hospital visit
12 LJH 5 F 5/23 5/24 Fever(38.5°C) Hospital visit
13 AJH 7 M 5/24 5/25 Swelling on inj ection site, Urticaria Medication
14 CHC 9 M 5/24 5/25 Swelling on inj ection site, Urticaria Medication
15 LMH 14 F 5/24 5/27 Fever, Sore throat, Cough Hospital visit
16 LJY 5 F 5/29 5/29 Fever Hospital visit
17 HKJ 15 M 6/9 6/10 Swelling on inj ection site, Urticaria Hospital visit
18 ANM 8 M 6/13 6/13 Vomiting Medication
19 MJY 10 F 6/15 6/16 Swelling on inj ection site Medication
20 KYS 9 M 6/19 6/20 Vomiting, Diarrhea Hospital visit
21 LAR 9 F 6/21 6/22 Fever, Swelling on injection site Hospital visit
Table 10.
Adverse Events after Inactivated JE Vaccine from May to June in 1996 at Primary School Children Survey
Adverse events %
Local erythema, induration 17.4
Injection site pain 14.8
Fever 4.3
Dizziness, headache 1.8
Hospival visit 0.8
Abdominal pain, vomiting 0.6
Skin rash 0.3
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