2015-2019年南通市通州区兴仁镇入托入学儿童预防接种证查验分析

目的 了解江苏省南通市通州区兴仁镇入托入学儿童预防接种证查验及疫苗接种和补种情况,为探讨有效的管理方法、提高儿童预防接种率提供科学依据.方法 收集2015-2019年通州区兴仁镇入托入学儿童预防接种证查验和补种资料,采用描述流行病学方法分析数据.结果 2015-2019年兴仁镇托幼机构和小学和查验对象查验率均为100％,入托和入学儿童预防接种证持证率97.44％和补证率100.00％;持证率托幼机构高于小学、流动儿童低于常住儿童;查验前漏种率托幼机构低于小学、四安片区低于兴仁片区、常住儿童低于流动儿童;漏种针次处于第一位的是流脑A+C疫苗,其次是“白破”疫苗和脊髓灰质炎疫苗;疫苗总体接种率呈上升趋势;疫苗补种率90.20％,补种率常住儿童高于流动儿童、四安片区高于兴仁片区.结论 兴仁镇入托入学预防接种证查验工作已常规开展并取得良好成效;仍需进一步加强卫生健康与教育部门协作,提高查验和补种工作成效,应重点关注大年龄组儿童并加强流动儿童接种管理,提高持证率、接种率和补种率.     

免疫规划疫苗未接种原因追查制度实施效果分析

目的分析广西藤县免疫规划疫苗未接种原因追查制度的实施效果,为修订和完善辖区免疫规划管理策略提供科学依据。方法分析2010—2013年藤县查漏补种及2013—2014年脊髓灰质炎强化免疫活动中未种原因追查制度落实情况。结果 2010—2013年查漏补种累计追查未种儿童12 090人,占前两位的原因为已外出3个月以上和居住地更换频繁,分别占未接种原因追查总数的84.37%和12.49%;2013—2014年脊髓灰质炎强化免疫追查未种原因9 080人,主要原因相同,分别占未接种原因追查总数的65.51%和22.76%;查清未种原因,除去有接种禁忌和已外出3个月以上的流动儿童,校正后补种率可提高9.93%-36.25%。结论建立并推行未接种原因追查制度,适合当前免疫规划管理工作需要,对巩固和提高免疫规划管理质量具有积极的促进作用,应坚持贯彻落实。     

2021年河南省驻马店市某镇1～79岁健康人群百日咳、白喉和破伤风抗体水平分析

目的 了解2021年河南省驻马店市某镇健康人群百日咳、白喉和破伤风的抗体水平，为优化免疫接种策略提供参考。方法 采用多阶段分层随机抽样法抽取健康人群，现场问卷调查，采用酶联免疫吸附试验(ELISA)检测健康人群血清百日咳、白喉和破伤风IgG抗体，分析抗体阳性率。结果 共调查550人，百日咳、白喉和破伤风血清IgG抗体阳性率分别为54.55%、44.36%和38.36%，男女性别比0.96∶1，百日咳抗体阳性率女性略高于男性(χ²=4.420,P<0.05)，破伤风抗体阳性率男性略高于女性(χ²=4.745,P<0.05)；白喉(趋势χ²=5.044)和破伤风(趋势χ²=187.071)抗体水平随人群年龄增长而降低(P<0.05)，不同年龄组百日咳(χ²=63.257)、白喉(χ²=55.962)和破伤风(χ²=202.922)抗体阳性率差异均有统计学意义(P<0.05)；“百白破”疫苗(DPT)末剂次接种后白喉...     

2003～2012年广西钦州市流行性乙型脑炎疫情分析

目的了解钦州市流行性乙型脑炎（简称乙脑）的流行情况,为有效预防控制乙脑提供科学依据。方法对钦州市2003-01~2012-12的乙脑疫情资料用描述流行病学方法进行整理分析。结果 2003~2012年该市共报告乙脑病例91例,年均发病率为0.29/10万;散居儿童发病69例,占75.82%;男性、女性分别占69.23%、30.77%;2~10岁儿童发病77例,占发病总数为84.62%;5~7月份发病90例,占病例总数的98.90%,呈明显的夏秋季发病高峰;病例主要集中在农村边远地区,共65例,占病例总数的71.43%。结论预防控制乙脑要重点抓好农村边远地区2~10岁散居儿童的乙脑疫苗常规接种和查漏补种工作,在乙脑高发的夏秋季节加强监测力度和宣传教育力度,落实防蚊措施,减少乙脑发病。     

兰州市七里河区入学儿童预防接种证查验及报告数据质量分析

目的评价甘肃省兰州市七里河区入学儿童预防接种证查验及疫苗补种工作效果与报告数据质量。方法采用分层整群随机抽样方法在七里河区东、中、西部各抽取1～2所小学,调查2018年秋季入学儿童接种证查验工作各项指标,并与报告数据比较。结果预防接种证查验前、后脊髓灰质炎4剂次(PV4,88.35%和95.39%,χ~2=12.247),A+C流脑疫苗2剂次(MPV-AC2,58.27%和87.80%,χ~2=81.635)和"百白"(DT,59.62%和91.33%,χ~2=100.206)接种率差异有统计学意义(P0.001);入学儿童接种证查验率(88.89%)明显低于报告接种证查验率(100.00%),差异有统计学意义(χ~2=43.412,P0.001);国家免疫规划(NIP)疫苗漏种率(56.37%)明显高于报告漏种率(41.46%),差异有统计学意义(χ~2=15.814,P0.001);NIP疫苗补种率(68.27%)明显低于报告补种率(92.81%),差异有统计学意义(χ~2=30.965,P0.001)。结论预防接种证查验可显著提高入学儿童NIP疫苗接种率,但目前七里河区接种证查验工作仍存在不足。     

甘肃省镇原县甲肝灭活疫苗群体性预防接种项目实施效果分析

目的评价甲肝灭活疫苗群体性预防接种效果,为有效预防和控制甲型肝炎提供科学依据。方法根据甘肃省疾病预防控制中心下发的《甲肝疫苗群体性预防接种项目实施方案》,在镇原县范围内对2～14岁儿童集中式接种一剂次甲肝灭活疫苗后,采用现场快速评价法进行调查评估。结果项目实施后,全县2～14岁儿童甲肝疫苗平均接种率96.32%,现场快速评价接种率98.00%。常住儿童接种率96.31%,流动儿童接种率98.31%,流动儿童高于常住儿童(P<0.01)。农村地区接种率96.31%,城区接种率96.51%,二者差异无统计学意义(P>0.01)。各乡镇接种率在85.09%～100%,孟坝、平泉等乡镇在90%以下;不同年龄组儿童接种率在87.89%～99.38%,2岁年龄组最低,为87.89%;不同乡镇、不同年龄组儿童接种率差异均有统计学意义(P<0.01)。15岁以下儿童甲肝发病率由项目实施前的10.51/10万下降为项目实施后的0.88/10万(P<0.01)。结论甲肝灭活疫苗接种率达96%以上,预防接种效果显著,15岁以下儿童甲肝发病率逐年下降。今后进一步开展甲肝疫苗群体性预防接种后的效果监测,在做好重点地区低年龄组人群查漏补种的同时,重点要加强15岁以上人群甲肝疫苗的免疫接种,逐步在各类人群中形成免疫屏障,有效控制甲肝疫情。     

查漏补种在提高免疫接种率中的作用

保持计划免疫接种率水平,是预防和控制乃至消灭相应传染病的必经途径,而查漏补种是巩固和提高接种率的重要手段。新疆焉耆县在实现计划免疫“3个85%”目标后,不断强化查漏补种工作管理,常规免疫接种率一直保持在95%以上。1查漏补种的必要性由于焉耆县城镇人口相对集中,人口流动     

2021年商丘市睢阳区健康人群8种疫苗针对疾病抗体水平监测分析

目的 对商丘市睢阳区8种疫苗针对疾病的抗体水平进行监测,评价预防接种效果,为完善和制定免疫策略提供依据。方法 2021年随机抽取商丘市睢阳区1～79岁健康人群,采集其静脉血,使用酶联免疫吸附试验测定麻疹、风疹、流行性腮腺炎、白喉、破伤风、百日咳、甲肝IgG抗体和乙肝表面抗体,运用SPSS 17.0软件进行分析,检验水准α=0.05。结果 共监测商丘市睢阳区550名健康人群,其麻疹、风疹、流行性腮腺炎、白喉、破伤风、百日咳、甲肝IgG抗体总阳性率分别为86.00%、99.27%、76.73%、43.82%、41.64%、65.45%和81.82%,乙肝表面抗体阳性率为84.00%。除风疹外,其余7种疫苗不同年龄组间抗体阳性率差异均有统计学意义（P均<0.05）。除破伤风外,其余7种疫苗不同性别间抗体阳性率差异均无统计学意义（P均>0.05）。结论 商丘市睢阳区健康人群麻疹和流行性腮腺炎IgG抗体阳性率呈现两头高中间低现象,建议在小学入学前开展儿童麻疹和流行性腮腺炎的加强免疫;健康人群若暴露于破伤风后仍需进行免疫阻断;甲肝疫苗IgG抗体阳转率较低,其原因有待进一步研究;乙肝疫苗...     

新疆麻疹流行特征及免疫策略概述

目的了解新疆麻疹流行特征及实施的免疫策略,为麻疹预防控制提供依据。方法查阅新疆麻疹相关文献及资料,整理疫苗接种前后麻疹发病特征及防控措施,分析新疆麻疹发病的规律及特点。结果 2004年以来新疆麻疹发病呈现2~3年的流行周期,发病地区主要分布在免疫薄弱和流动人口多的区域,冬、春季高发,人群分布以小年龄组模式为主;新疆主要采取常规免疫接种和后续的强化免疫、查漏补种、麻疹监测等免疫策略。结论新疆麻疹发病呈周期性波动,基础免疫有漏种人群,应针对15岁以下人群开展含麻类成分疫苗查漏补种为主的预防控制措施,并及时处理暴发疫情。     

武威市儿童免疫规划疫苗接种率调查

目的了解2016—2018年甘肃省武威市儿童免疫规划疫苗接种情况,评价免疫规划系统报告质量,分析影响因素,为提高接种率提供依据。方法采用WHO推荐的按容量比例概率抽样法选取武威市三县一区120个接种单位;抽取0～6岁7个年龄组儿童各1人调查疫苗接种率,资料来自中国免疫规划信息管理系统和入户调查数据。结果2016—2018年共调查武威市适龄儿童2 520人,建卡率为99.76%、建证率99.76%、卡证相符率95.71%;"五苗"基础免疫及全程、扩大国家免疫规划疫苗和加强免疫调查接种率均维持在较高水平;A+C群流脑疫苗第一(χ~2=25.944)、第二剂次(χ~2=7.356)、脊髓灰质炎疫苗加强(χ~2=55.238)和"白破"疫苗(χ~2=16.213)调查接种率年度间差异有统计学意义(P0.05),A+C群流脑第一(χ~2=1 127.679)、第二剂次(χ~2=1 303.147)和"白破"疫苗(χ~2=36.372)报告接种率年度差异有统计学意义(P0.05);A+C群流脑第二剂次(χ~2=47.213)、脊髓灰质炎疫苗加强(χ~2=414.578)和"白破"疫苗(χ~2=585.681)的调查接种率和报告接种率差异有统计学意义(P0.05)。结论武威市适龄儿童接种率始终保持较高水平,调查接种率和报告接种率呈逐年上升趋势,个别加强免疫疫苗接种率不高;应继续加强适龄儿童预防接种,加大预防接种人员的培训及群众的宣传工作,提高接种质量、有效减少传染病的发生。     

Thailand Expanded Program on Immunization: a ten-years review of coverage and impact on EPI target diseases

The national immunization coverage in Thailand for all types of vaccine has been steadily increasing since 1978, when the EPI was formally launched. The coverage in 1987 was 96% for BCG, 75% for DPT, 74% for OPV, and 60% for TT. Measles vaccine, which started only in late 1984, had the lowest coverage, 51%, in 1987. During the period 1982-1987, the drop-out rates between the first and third dose of DPT and OPV decreased dramatically from 69% to 13% and from 42% to 13% respectively. Sampling surveys of immunization coverage showed higher coverage for DPT and OPV than those from reporting in all regions, especially in the capital city which has a high concentration of the private health sector. Only the northeastern region had less coverage from surveys than from reporting. Following the launch of EPI, the disease incidence demonstrated a clearly downward trend for diphtheria, poliomyelitis, and measles, while in the case of pertussis and neonatal tetanus, slower of still fluctuating declines were observed. The reported age-specific incidences per 100,000 population in 1986 for children 0-4 years were as follows: 4 for diphtheria, 0.9 for poliomyelities, 180 for measles, 14 for pertussis, and 10 for tetanus.     

Serum antibodies to diphtheria-tetanus-pertussis vaccine components in Argentine children

Summary The Argentine vaccination schedule against diphtheria, tetanus and pertussis (DTP) recommends three doses of DTP vaccine at 2, 4 and 6 months of age, two boosters at 18 months and 6 years, a booster dose of tetanus vaccine every 10 years and two doses during pregnancy. To evaluate the effect of this schedule, antibodies against pertussis toxin (PT) and filamentous hemagglutinin (FHA) and against tetanus and diphtheria toxoids were determined by ELISA in serum samples from children (1 month to 6 years) who received different doses of DPT vaccine: 0 dose (n=50), 1 dose (n=25), 2 doses (n=25), 3 doses (n=55), first and second booster (n=25); 25 pregnant women and their offspring, and 45 adults. High antibody levels against PT (>140 EU/ml) and FHA (>80 EU/ml) were recorded in mothers and in the newborn. Antibody titers against PT increased with the number of doses given and decreased with time. Full protection against tetanus (titers >0.1 IU/ml) was observed in the group of adults (0.37 IU/ml), in mothers (4.4 IU/ml) and their newborn offspring (5.5 IU/ml), and in children after receiving the second dose of DTP vaccine (1.86 IU/ml). The immune status for diphtheria was far lower, as most of the groups lacked adequate protection. After the third dose of DTP vaccine, only 78% of the children had antibody titers above the protective level (0.1 IU/ml). Since antibody levels considered to provide full protection were only achieved after the first booster dose of DTP vaccine, the primary three-dose schedule seems to be insufficient to confer adequate immunity in all vaccinees. Because of the high proportion of non-protected adults, a booster dose of Td vaccine should be considered for this group.     

EPI vaccines-induced antibody prevalence in 8-9 year-olds in The Gambia

OBJECTIVES: We evaluated antibody prevalence to measles, polio 1 and 3, and tetanus toxoid antibodies in 8-9 year-old children in The Gambia within the framework of the Gambia Hepatitis Intervention Study (GHIS), a large vaccine trial aimed at evaluating vaccine efficacy against hepatitis B virus (HBV) infection, chronic carriage and primary liver cancer in a high risk population. The results of the present survey were compared with a previous survey performed with the same objectives and same methodology but in different children at 3-4 years of age. METHODS: Four clusters of 200 children each were sampled as representative of the whole country. Children would have received BCG, diphtheria-pertussis-tetanus vaccine (DPT), poliovirus vaccine (OPV), measles and yellow fever immunization. The measles haemoagglutination inhibition test (HAI) was used to detect measles antibody. Antibodies to polioviruses 1 and 3 were tested using the standard polio neutralization assay described in the EPI manual (WHO 1990). An enzyme-linked immuno-sorbent assay (ELISA) was used to measure tetanus toxoid antibodies. RESULTS: A high proportion of children were fully vaccinated in both age groups. Measles antibody concentrations were < or =1 : 8 in 8.2% of 8-9 year-old vaccinated children. In the previous survey of 3-4 year-old children this was 11.3%. In the present survey, GMC was lower than in the 3-4 year-old children; 88% of 3-4 year-olds and 89% of 8-9 year-olds had detectable antibody levels against poliovirus type 1. Fewer children at 8-9 years of age had antibodies against poliovirus type 3 than 3-4 year-olds (78%vs. 89% P < 0.001). A significant overall lower proportion of 8-9 year-old children had detectable tetanus toxoid antibodies compared to 3-4 year-old children (87%vs. 95% P < 0.001), as well as those who received four doses of DPT (90%vs. 97% P < 0.001). Conclusions High vaccine coverage is achieved in The Gambia with EPI. With time the number of vaccinated children who are not protected against measles, poliovirus 3 and tetanus increases. Besides the maintenance of high vaccine coverage in infants and young children, booster doses of some of the EPI vaccines in adolescents should be considered.     

Tetanus antitoxin levels in various Japanese age groups in 1989

The nationwide DPT vaccine program was started in 1969 for infants under 12 months of age. In order to estimate the tetanus immune status among the general population of various age groups, we measured the serum tetanus antibody level in randomly selected outpatients from Metropolitan Tokyo (n = 211, 6 months-60 years) and Hamamatsu, a city of 510 thousand population (n = 128, 3 years-80 years) between January 1987 and June 1989. Among the 211 subjects from Tokyo, the antibody value exceeding effective level of 0.01 HAU/ml was observed in 102 subjects (48.3%). The antibody positive rate was 90.8% in subjects of 3 to 21 years and was 27.7% in subjects of 22 years or older. The positive rate was significantly higher in subjects of 21 years or younger (p less than 0.005). Among 128 subjects from Hamamatsu, 60 (46.1%) had a positive antibody and the antibody positive rare was 96.9% in subjects of 3 to 21 years and was 29.5% in subjects of 21 years or younger (p less than 0.005). The above findings indicate that our DPT vaccination program has been functioning well for the last 20 years and that the immunized population is adequately protected against tetanus.     

Immunity and immunization of children against tetanus in sweden.

Tetanus antitoxin titres were determined in sera of 457 children, 6-, 10- and 16- year-old. Primary vaccination against tetanus had been given as 3 doses of DPT or DT vaccine at intervals of 4-6 weeks beginning in the 2nd or 3rd month of life. A booster dose is offered to schoolchildren at 8-10 years of age. As boosters, the children were given 0.1, 0.25 or 0.5 ml of diphtheria/tetanus toxoid (DT) containing 7.5 Lf/ml tetanus toxoid. The antitoxin titres against tetanus were much higher than those against diphtheria found in previous studies. Blood samples tested from 68 children, 5-year-old, who had been given basic immunization according to a spaced time schedule showed that 97% of the children had levels greater than 0.1 IU/ml. Prior to booster injection of the 6-year-old children, 1% lacked protective titre levels (greater than or equal to 0.01 IU/ml). 53% had antitoxin titre levels of greater than or equal to 0.01 - less than 0.1 IU/ml and 46% had levels of 0.1 IU/ml. The corresponding figures for the 10-year-old were 6, 65 and 29%, and for the 16-year-old 2, 7 and 91% respectively. After a booster injection high antitoxin levels were seen in all children. 95% had levels greater than 1 IU/ml irrespective of vaccine dose.     

The immunogenicity and safety of a new combined diphtheria, tetanus and poliomyelitis booster vaccine (Td-eIPV)

Summary In view of the continuing risk of contracting tetanus, diphtheria and poliomyelitis, and the well-documented decline in immunity with time, the need for booster vaccinations is substantial. The immunogenicity and safety of a new combined booster vaccine against tetanus, diphtheria and poliomyelitis (REVAXIS^™) developed by Pasteur Mérieux Connaught (Lyon, France) were evaluated in four clinical studies. This vaccine (Td-eIPV) combines an adsorbed tetanus toxoid and low-dose diphtheria toxoid vaccine (Td) with an enhanced, inactivated polio vaccine against poliovirus types 1, 2 and 3 (eIPV). In 256 healthy young adults, a single dose of Td-eIPV was shown to be immunogenic, eliciting antibody levels considered protective against disease for each vaccine component in ≥99.6% of the subjects. In 112 healthy older subjects (>40 years of age), two doses of Td-eIPV elicited seroprotective levels of antibodies in 94% of the subjects for diphtheria, and in all subjects for tetanus and poliovirus types 1, 2 and 3. Safety data from all 368 subjects, as well as 31 phase I volunteers and 1,742 subjects included in a safety study, reveal that the vaccine is safe. Most reactions were predictable, temporary and mild. There was no evidence that the vaccine was associated with any clinically serious event or modification of clinical laboratory parameters. The data reviewed here show that Td-eIPV is immunogenic and safe when administered as a booster vaccination in healthy adults of all ages.     

Diphtheria boosters for adults: balancing risks

Combined tetanus-diphtheria vaccines are now the only means of protecting adults from tetanus or diphtheria. When advising on the benefits and risk of vaccinating for one disease, clinicians now have to consider the other vaccine component, and questions have arisen about where the balance of risk lies for different patients. Five doses of diphtheria-toxoid containing vaccine are probably sufficient protection for individuals who remain in low-incidence countries such as those in most of Western Europe. Adults who remain in the UK are extremely unlikely to be exposed to diphtheria and this needs to be taken into account when assessing the balance of risk where individuals have received fewer than five doses of diphtheria toxoid but five or more doses of tetanus toxoid. In contrast to diphtheria, if someone has received fewer than five doses of tetanus toxoid but is up to date for diphtheria toxoid, the balance of lifelong risk is probably in favour of giving tetanus toxoid irrespective of the individual's diphtheria status. For travellers to diphtheria endemic countries boosters are recommended if more than 10 years has elapsed since the last dose. For individuals who have already received five or more doses of tetanus vaccine in the past, receiving further boosters of tetanus in combination with diphtheria toxoid is unlikely to cause any significant reactions. The only absolute contraindication to such boosters is a previously documented anaphylactic reaction to either diphtheria or tetanus toxoid. Individuals who have a history of such a reaction should be well advised regarding probable risk of infection, symptoms of the disease and the need to seek early treatment.     

Erythema multiforme minor following vaccination with paediatric vaccines

We present 2 cases of erythema multiforme following a combined tetanus and diphtheria revaccination and a combined diphtheria, tetanus, acellular pertussis inactivated polio and Haemophillus influenzae type B vaccine respectively, suggesting vaccines containing diphtheria and tetanus toxoids as a potential precipitating factor to erythema multiforme.     

An antibody induction method in mice for the potency assays of diphtheria and tetanus components in combined vaccines

Eleven batches of Adsorbed Diphtheria-Tetanus (DT) vaccines and thirteen batches of Adsorbed Diphtheria-Pertussis-Tetanus (DTP) vaccines were tested for the potency of diphtheria and tetanus components by an Antibody Induction Method (AIM) developed in mice. The potency results obtained were found comparable and did not show any statistically significant difference with those obtained by WHO recommended lethal challenge tests for diphtheria in guinea pigs and for tetanus in mice. AIM in mice is more economical as both diphtheria and tetanus components of combined vaccine can be tested in the same experiment and the procedure also eliminates the use of guinea pigs required in the lethal challenge/conventional tests. The data obtained while testing tetanus component by the conventional antibody induction (IP) method in guinea pigs suggests that minimum requirements laid down in i.p. is too low which may be fixed as at least 3 out of 9 guinea pig sera and should contain > or = 4 units of tetanus antitoxin per ml.     

Antibody levels for diphtheria, tetanus and pertussis in young adult females immunized with whole cell pertussis-diphtheria-tetanus toxoid vaccine in infancy

Antibody levels for diphtheria, tetanus and pertussis in 84 young adult females were measured. They had been immunized with whole cell pertussis-diphtheria-tetanus toxoid (DTwP) vaccine as a routine immunization in their infancy. Their history of DTwP vaccination were confirmed in their Maternal and Child Health Handbook, which includes their immunization record. Among the 84 cases, 4 cases (4.7%) had been immunized with the first dose of DTwP, 5 cases (6.0%) with the second dose, 23 cases (27.4%) with the third dose and 52 cases (61.9%) with the fourth dose. Of the 84 cases, 89.3% had received DTwP vaccine more than the third dose. In the 15-19 years after the last DTwP vaccination, the antibody positive rate for diphtheria and tetanus (> or = 0.01 IU/ml) were 86.9% and 94.0%, respectively. On the other hand, antibody positive rate for anti-pertussis toxin (anti-PT) and anti-filamentous hemaggulutinin (anti-FHA) (> or = 10 EU/ml) were 35.7% and 55.9%, respectively. The positive rate for pertussis compared with those for diphtheria and tetanus were lower. These findings suggested that DTwP vaccination in infancy does not provide sufficient immunity for young adults against pertussis, but DTwP vaccination provides adequate immunity against diphtheria and tetanus.