「同時接種・接種間隔」 について - mhlw.go.jp

1 29 4 27 18 1 26 4 2 MR BCG 27 DPT-IPV DT Hib 13 23 A B HPV 6 3 2 ( ) 4 VPD 5 2 4 5 6 BCGHib 2015 DPT-IPV6 * * The National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention.

2 11 thed. of Epidemiology and Prevention of Vaccine-Preventable Diseases 2009 (Pink Book). 2009 Public Health Foundation, Washington, DC*King GE, HadlerSC. Simultaneous Administration of childhood vaccine; an important health public policy that is safe and efficacious. PediatrInfect Dis J 1994;13: 394-407.*Lewis M, Ramsey DS, Suomi SJ. Validating current immunization practice with young infants. Pediatrics 1992;90: : MMWRJ anuary 28, 2011 General Recommendations on Immunization Recommendations of the Advisory Committee on Immunization Practices (ACIP) administration of vaccines is defined as administering more than one vaccine on the same clinic day, at different anatomic sites, and not combined in the same syringe. Experimental evidence and extensive clinical experience provide the scientific basis for administering vaccines simultaneously.

3 Simultaneously administering all vaccines for which a person is eligible at the time of a visit increases the probability that a child, adolescent, or adult will be vaccinated fully by the appropriate ageReferenceNational Vaccine Advisory Committee. Standards for child and adolescent immunization practices. Pediatrics 2003;112:958 : MMWRS eptember 19, 1986 / 35(37);577-9 Recommendation of the Immunization Practices Advisory Committee NewRecommended Schedule for Active Immunization of Normal Infants and Children. large, randomized, double-blind trial has recently been completed , and sufficient data are now available to recommend the simultaneous administration of MMR, DTP, and OPV to all children 15 months old or older who are eligible to receive these A, Long FF, Lischner HW, et al. Simultaneous administration of measles-mumps-rubella (MMR) with booster doses of diphtheria-tetanus-pertussis (DTP) and poliovirus (OPV) vaccines(unpublished data).

4 *It should be noted that simultaneous administration ofMMR, DTP, and OPV was previously recommended for children who were behind schedule in receiving their immunizations. This recommendation was based on the demonstrated safety and efficacy of other vaccine combinations ( , DTP and measles, or MMR and OPV).9 CDC: MMWRJ anuary 28, 1994 / Vol. 43 / No. RR-1 General Recommendations on Immunization Recommendations of the AdvisoryCommittee on Immunization Practices (ACIP). evidence and extensive clinical experience have strengthened the scientific basis for administering certain vaccines simultaneously13-16). Many of the commonly used vaccines can safely and effectively be administered Deforest A, Long SS, Lischner HW, et al. Simultaneous administration ofmeasles-mumpsrubella vaccine with booster doses of diphtheria-tetanus-pertussis and poliovirus 1988;81:237-46.

5 14. CDC. MMWR 1991;40( ) Dashefsky B, Wald E, Guerra N, Byers C. Pediatrics Giammanco G, LiVolti S, Mauro L. Vaccine : MMWRF ebruary 8, 2002 / Vol. 51 / No. RR-2 ACIP/AAFPR ecommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP) evidence and extensive clinical experience have strengthened the scientific basis for administering vaccines simultaneously ( , during the same office visit, not combined in the same syringe). Simultaneously administering all vaccines for which a person is eligible is critical, including for childhood vaccination programs, because simultaneous administration increases the probability that a child will be fully immunized at the appropriate 12 1996 13 CDC: Vaccine Administration.

6 Vaccine Administration Guidelines from Pink Book Appendix: 14 DPT DPT Hib DPT 6 23 1 18 16 Hib, PCV7 2011 3 24 10 Hib PCV 2011 4 1 17 18 19 6 3 1 20 Hib DPT

7 ( 115 3 570-577 2011 DPT DPT DPT PRP III DPT 7 DPT 21 Hib DPT Vol 41 No,4 DPT PRP III DPT DPT DPT DPT DPT DPT DPT 22 Hib 2016 :65.)

8 162 172 1093 3504 DPT DPT 23 Hib Hib ( 2010 39 C (2 ) 6038 2010 6 3590 2448 DPT2013( ) MR 158( ) 76( ) 54( ) 42 ( ) 39 C 24 (PCV7) (PCV7) 2011 PCV7 (Hib ,DPT ) 2010 2 7 PCV7 505 353 PCV7 152 PCV7 DPT(58%),Hib(23%), (7%) 25 13 DPT III Immunogenicity and Safety of a 13-Valent Pneumococcal Conjugate Vaccine Given with DTaP Vaccine in Healthy Infants in JapanPediatr Infect Dis J 1096-1104, 2015 PCV13 III PCV13+DPT(n=183) PCV7+DPT(n=184) DPT+catch-up PCV7(n=184))

9 3 PCV13 PCV7 7 IgG g/mL PCV13+DPT PCV7+DPT PCV13+DPT PCV13 6 IgG 3 DPT GMC FHA 3 PCV13+DPT PCV7+DPT DPT 13 26 Hib PCV7 Prospective safety monitoring of Hib and PCV7 in Kagoshima, JapanJpn J Infect Dis 235-237, 2013 Hib PCV7 2009 2 2011 1 29 Hib (76/11,197) PCV7 (28/3,049) Hib (31/5,662) versus (45/5,535) ;P= PCV7 (11/1,247) versus (17/1,802) ;P= Hib PCV7 27 IPV III Vol,67 2014 1685-1694 III 74 1 1~3 1 100 27 (DTP,PCV7,Hib) 27 7 3 28 RV5 DPT-sIPV Concomitant administration of diphtheria, tetanus, acellular pertussis and inactivated poliovirus vaccine derived from Sabin strains (DTaP-sIPV)

10 With pentavalent rotavirus vaccine in Japanese InfantsHuman Vaccines & ImmunotherapeuticsPublished online: 31 Jan 2017 6 11 192 1 1 96 96 RV5 DPT-sIPV 2 4 6 3 1 3 5 RV5 2 4 6 DPT-sIPV PT FHA 1 2 3 DTP-IPV 1-6 14 18/94 44/96 29 121-123, 2014 2010 12 2011 7 1219 1 147 ( ),2 853 ( ),3 203 ( ),4 (16 ) Hib PCV DPT Hib DPT Hib PCV DPT PCV 1 2 3 4 PCV 11 30 2016 C 6 DPT, , ,BCG, , DPT, , 2227 1160 2 6 14 PCV ,DPT ,Hib ,IPV 31 116 5 823-826 2012 2007 12 2011 2 104 170 13 3 ( 2 7 )