Korean J Pediatr Infect Dis.  2013 Dec;20(3):131-138.

Immunogenicity and Protective Effectiveness of Japanese Encephalitis Vaccine: A Prospective Multicenter Cohort Study

• Kim DH
• Hong YJ
• Lee HJ
• Choi BY
• Kim CH
• Park JO
• Kang JH
• Choi BJ
• Kim JH
• Ahn YM
• Ju YR
• Jeong YE
• Han MG

Abstract

PURPOSE
This study aimed to study the antibody response of Japanese encephalitis vaccination in children using different kinds of vaccines (inactivated vaccine, live attenuated vaccine or interchanged) and evaluate the effectiveness of the vaccines to provide the basis of efficient immunization schedule of Japanese encephalitis.
METHODS
Measurement of the neutralization antibody (NTAb) titers following Japanese encephalitis vaccination using different vaccines for 170 children, 2-6 year of age, who visited six university hospitals and are confirmed by immunization records.
RESULTS
Among 170 children who were given primary immunization on Japanese encephalitis, 103 children were given inactivated vaccine, 64 children were given live attenuated vaccine and 3 children were given interchangeably. NTAb titers were more than 1:10 in all children of three groups. The geographic mean antibody titer was 322 in inactivated vaccine group and 266 in live attenuated vaccine group. However, there was no significant difference between two groups. In both groups, the NTAb titer showed the peak at 1-4 months after the third immunization and declined. The NTAb titers of three children who were given two kinds of vaccines alternately were 1:135, 1:632, and 1:2511, respectively.
CONCLUSION
According to the results of this study in children younger than 6 years old, there is no significant difference in effectiveness between inactivated and live attenuated vaccines. However, further studies for the changes of antibody titers for a longer period of time on larger population are required.

Keyword

Japanese Encephalitis; Vaccination; Effectiveness; Neutralizing Antibody

MeSH Terms

Antibodies, Neutralizing
Antibody Formation
Asian Continental Ancestry Group*
Child
Cohort Studies*
Encephalitis, Japanese*
Hospitals, University
Humans
Immunization
Immunization Schedule
Prospective Studies*
Vaccination
Vaccines
Vaccines, Attenuated
Antibodies, Neutralizing
Vaccines
Vaccines, Attenuated

Reference

1. Chambers TJ, Hahn CS, Galler R, Rice CM. Flavivirus genome organization, expression, and replication. Annu Rev Microbiol. 1990; 44:649–688.

2. Erlanger TE, Weiss S, Keiser J, Utzinger J, Wiedenmayer K. Past, present, and future of Japanese encephalitis. Emerg Infect Dis. 2009; 15:1–7.

3. Endy TP, Nisalak A. Japanese encephalitis virus: ecology and epidemiology. Curr Top Microbiol Immunol. 2002; 267:11–48.

4. Halstead SB, Jacobson J, Dubischar-Kastner K. Japanese encephalitis vaccines. In : Plotkin SA, Orenstein WA, Offit PA, editors. Vaccines. 6th ed. Philadelphia: Elsevier Saunders Co;2013. p. 312–351.

5. Department of Health. Japanese encephalitis. In : Salisbury D, Ramsay M, Noakes K, editors. Immunisation against infectious disease. 3rd ed. London: TSO Co;2013. p. 201–208.

6. Hong YJ. The Japanese encephalitis vaccine: worldwide and korean status. Korean J Pediatr Infect Dis. 2008; 15:108–114.

7. Sohn YM. The background and changes of inactivated Japanese encephalitis vaccine schedule. Korean J Pediatr Infect Dis. 2000; 7:56–70.

8. Calisher CH, Monath TP. Togaviridae and Flaviviridae: the alphaviruses and Flaviviruses. In : Lennette EH, Halonen P, Murphy FA, editors. Laboratory diagnosis of infectious diseases. 2nd ed. New York: Springer-Verlag;1988. p. 414–434.

9. Korea Center for Disease Control and Prevention. Japanese encephalitis in Korea since 2001. Public Health Wkly Rep. 2008; 1:289–292.

10. Korea Center for Disease Control and Prevention. Activity of Japanese encephalitis virus in the Republic of Korea 2012 [Internet]. Osong: Division of Arbovirus;c2013. Cited 2013 Apr 25. Available from: http://www.cdc.go.kr/CDC/cms/cmsFileDownload.jsp?fid=31&cid=20762&fieldName=attach1&index=1.

11. Hsu TC, Chow LP, Wei HY, Chen CL, Hsu ST. A completed field trial for an evaluation of the effectiveness of mouse-brain Japanese encephalitis vaccine. In : Hammon WMcD, Kitaoka M, Downs WG, editors. Immunization for Japanese Encephalitis. Amsterdam: Excerpta Medica;1972. p. 285–291.

12. Hoke CH, Nisalak A, Sangawhipa N, Jatanasen S, Laorakapongse T, Innis BL, et al. Protection against Japanese encephalitis by inactivated vaccines. N Engl J Med. 1988; 319:608–614.

13. Yang SE, Pan MJ, Tseng HF, Liau MY. The efficacy of mouse-brain inactivated Nakayama strain Japanese encephalitis vaccine-results from 30 years experience in Taiwan. Vaccine. 2006; 24:2669–2673.

14. Poland JD, Cropp CB, Craven RB, Monath TP. Evaluation of the potency and safety of inactivated Japanese encephalitis vaccine in US inhabitants. J Infect Dis. 1990; 161:878–882.

15. Sohn YM, Pyun BY, Lee HJ, Kang JH, Hong YJ, Oh SH, et al. Report of study result regarding effective level of antibody persistence rate after Japanese B encephalitis vaccination. Korean J Pediatr. 1995; 38:730–731.

16. Oya A. Japanese encephalitis vaccine. Acta Paediatr Jpn. 1988; 30:175–184.

17. Aihara H, Takasaki T, Matsutani T, Suzuki R, Kurane I. Establishment and characterization of Japanese encephalitis virus-specific, human CD4(+) T-cell clones: flavivirus cross-reactivity, protein recognition, and cytotoxic activity. J Virol. 1998; 72:8032–8036.

18. Van der Vliet D, Simon de Fanti A, Murri S, Lapidus N, Goujon C, Zeller H, et al. Long-term seroprotection against Japanese encephalitis using an inactivated vaccine (Jevax). Med Trop (Mars). 2010; 70:155–157.

19. Ku CC, King CC, Lin CY, Hsu HC, Chen LY, Yueh YY, et al. Homologous and heterologous neutralization antibody responses after immunization with Japanese encephalitis vaccine among Taiwan children. J Med Virol. 1994; 44:122–131.

20. Hennessy S, Liu Z, Tsai TF, Strom BL, Wan CM, Liu HL, et al. Effectiveness of live-attenuated Japanese encephalitis vaccine (SA 14-14-2): a case-control study. Lancet. 1996; 347:1583–1586.

21. Sohn YM, Park MS, Rho HO, Chandler LJ, Shope RE, Tsai TF. Primary and booster immune responses to SA 14-14-2 Japanese encephalitis vaccine in Korean infants. Vaccine. 1999; 17:2259–2264.