中国5个县（区）首剂麻疹减毒活疫苗免疫成功率监测分析

目的分析中国5个县（区）儿童接种首剂麻疹减毒活疫苗（First Dose Measles Attenuated Live Vaccine，MV1）后的免疫成功率及受免疫前抗体的影响，评价MV1的接种质量。方法2010年，在黑龙江省富锦县、河北省武安市、广东省广州市海珠区、江苏省响水县和上海市松江区，对290名适龄儿童在接种MV1前和接种后1个月，各采集1次血标本，进行血清抗体检测。结果5个县（区）儿童MV。免疫前麻疹免疫球蛋白（Immunoglobulin，Ig）G平均阳性率为13．28％，免疫后麻疹IgG阳性率为98．34％。8～17月龄儿童麻疹IgG阳性率的差异无统计学意义（x2=0．49，P〉0．05），仅7月龄组低于其他组；不同月龄组麻疹IgG几何平均浓度的差异有统计学意义（F=2．26，P〈0．05）。MV1免疫后免疫成功率为85．89％，MV1免疫前麻疹IgG阴性者免疫后免疫成功率为97．60％，MV1免疫前麻疹IgG阳性者免疫后免疫成功率为9．38％。MV1免疫前麻疹IgG不同水平的儿童，MV1免疫后麻疹IgG阳性率、阳性者麻疹IgGGMC差异均无统计学意义（X2=2．16，F=1．82；P均〉0．05），但MV。免疫后免疫成功率差异有统计学意义（x2=178．29，P〈0．05）。结论儿童接种MV1后可使麻疹IgG阳性率达到较高水平；MV1免疫成功率水平较高；5个县（区）儿童的MV1及时接种率有待提高。

Monitoring and Analysis of Vaccination Success Rate after the First Dose of Measles Attenuated Live Vaccine in 5 Counties of China

Objective To analyse the vaccination success rate after the first dose of measles attenuated live vaccine （MV1 ） in 5 counties of China and to provide a reference for developing the immunization strategy to eliminate measles..Methods In 2010, 290 children were selected from Fujin county of Heilongjiang province, Wu＇an county of Hebei Province, Haizhu district, Guangzhou city of Guangdong Province, Xiangshui county of Jiangsu Province and Songjiang district of Shanghai. Serum samples were collected before MV1 vaccination and a month after vaccination for antibody concentration detection. Results The average positive rate of measles antibody before MV1 vaccination was 13.28%. Measles antibody positive rate after MV1 vaccination was 98.34%, with no difference among 8-17 month children,except lower in 7-month children. However, difference exit in different month groups in terms of geometric mean concentration （ GMC ） of measles antibody. Vaccination success rate after MV1 was 85.89%. The level of antibody from mothers had no statistically significant influence to measles antibody GMC and positive rate after the first dose of measles vaccine but had significant effect on the vaccination success rate.Conclusions Measles antibody tositive rate after MV1 reached very high level. The vaccination success rate after MV1 is as high as ehpected. The coverage of timely MV1 need to be improved in 5 counties.