中山市某大学学生接种甲型H1N1流感疫苗安全性及免疫效果评价

目的分析中山市当前接种的甲型H1N1流感疫苗的安全性及免疫效果,为甲型H1N1流感疫苗的科学使用提供依据。方法采用多阶段随机抽样方法抽取一定数量对象作为接种组和对照组,运用流行病学实验研究的方法,观察接种组疑似预防接种异常反应发生情况,监测抗体阳转率,比较接种组和对照组甲型H1N1流感的发病率,并计算效果指数和疫苗保护率。结果本研究接种组和对照组均为464人,接种组接种甲型H1N1流感疫苗后均未出现疑似预防接种异常反应。在接种组抽取100名接种对象进行抗体检测,出现抗体阳转61例,抗体阳转率为61.00%。接种组与对照组的甲型H1N1流感发病率分别为4.74%(22/464)、10.34%(48/464),差异有统计学意义(P<0.01)。疫苗的效果指数为2.18、保护率为54.16%。结论中山市当前接种的甲型H1N1流感疫苗具有良好的安全性,但免疫效果偏低,是否有进一步提高的空间,有待进一步研究。     

2009年华容县健康人群甲型H1N1流感疫苗免疫效果分析

目的了解健康人群接种甲型H1N1流感疫苗后的免疫效果及抗体水平。方法观察接种甲型H1N1流感疫苗人群中不良反应的发生情况;按照不同的年龄组随机抽取350人,采用描叙性流行病学方法,对疫苗的安全性和有效性进行评价;微量血凝抑制试验检测接种者甲型H1N1流感病毒抗体,SPSS16.0统计学软件对接种30 d后甲型H1N1流感与普通流感的发病率、就诊率及HI抗体阳转率进行比较。结果接种组接种甲型H1N1流感疫苗30 d后甲型H1N1流感与普通流感的发病率与就诊率均低于对照组,差异有统计学意义（P〈0.05）;接种甲型H1N1流感疫苗人群中共出现不良反应1 891例,总不良反应率为4.35%;接种组总体HI抗体阳转率显著高于对照组（χ2=4.27,P〈0.05）,达到欧盟药品评价委员会的标准,各年龄组间HI抗体阳转率差异无统计学意义。结论国产甲型H1N1流感疫苗具有较高的安全性与较好的免疫原性,适合在健康人群中普遍接种。     

无锡市甲型H1N1流感及季节性流感疫苗接种效果分析

目的调查流感样病例(ILI)和无锡市一般人群中甲型H1N1流感疫苗及季节性流感疫苗的接种情况,评估疫苗接种后对人群的保护效果。方法以无锡市2家哨点医院为基础,采集流感样病例病毒核酸检测阳性的病例作为病例组,共1 529人,同时按照"病例"的电话信息,随机产生电话号码选择、年龄匹配的一般人群作为对照组,共380人。结果病例组甲型H1N1流感疫苗接种率为6.1%(94/1 529),对照组甲型H1N1流感疫苗接种率为12.1%(46/380),两组比较,差异有统计学意义(P0.01);甲型H1N1流感病例中接种甲型H1N1流感疫苗的比例为12.5%(3/24),门诊检测阴性的ILI病例接种甲型H1N1流感疫苗的比例为6.1%(78/1 273),"接种甲型H1N1流感疫苗"因素的OR值为0.457(P=0.201);以电话调查一般人群(330例)作为对照组,接种甲型H1N1流感疫苗的比例为13.3%(44/330),OR值为1.077(P=0.908)。结论该次调查说明接种甲型H1N1流感疫苗对预防流感样病例有一定效果,但由于样本量较少,24种方法病例对照分析均未得出差异有统计学意义。     

小学生接种国产甲型H1N1流感疫苗偶合发热反应分析

目的评价国产甲型H1N1流感疫苗安全性,探索学校群体性预防接种偶合症风险防范措施。方法采用描述流行病学方法,对咸宁市某小学753名学生接种国产甲型H1N1流感疫苗前后健康状况开展调查与随访观察。结果某小学生接种甲型H1N1流感疫苗后,发热反应发生率为1.33%。反应发生过程时间较短,各年级(学前班、一年级和二年级)之间发热反应发生率差异有统计学意义(P<0.05),其中学前班反应发生率较高。接种反应发生后,所有患儿均得到及时诊治,预后良好。结论开展甲型H1N1流感疫苗学校群体性预防接种活动时,有必要加强预防接种风险预警和管理。     

甲型H1N1流感疫苗预防接种效果观察

目的探讨接种甲型H1N1流感疫苗的有效性和安全性。方法选择120例18～60岁在我院接种甲型H1N1流感疫苗人员为接种组,同时按照年龄、性别、疾病匹配的情况选取未接种甲型H1N1流感疫苗者110例为对照组。调查分析甲型H1N1流感疫苗接种后90d内两组甲型H1N1流感发病率和其他流感样疾病发生情况。同时观察接种甲型H1N1流感疫苗后48h内不良反应发生情况。结果接种组甲型H1N1流感发病率和就诊率为0%,对照组甲型H1N1流感发病率和就诊率为7.3%,两组比较有显著统计学差异（P〈0.01）;接种组90d内甲型H1N1流感的保护率为100%,减少就诊率100%。接种组其他流感样疾病发生率（15.0%）和就诊率（8.3%）均明显低于对照组（22.7%和16.3%）,有统计学差异（P〈0.05）;接种组90d内其他流感样疾病的保护率为33.9%,减少就诊率49.4%;接种组共出现不良反应8例,总体不良反应率6.7%,给予适当的处理,症状很快消失。结论接种甲型H1N1流感疫苗是有效和安全的。     

南宁市甲型H1N1流感疫苗接种人群不良反应情况

目的分析接种甲型H1N1流感疫苗的情况,探讨预防甲型H1N1流感的对策。方法南宁市第七人民医院按照卫生部规定的方法和程序,于2009年10月12~21日对5家单位共302名人员进行了甲型H1N1流感疫苗预防接种,并对接种后不良反应进行分析。结果302名受种者中,男性190人（62.9%）,女性112人（27.1%）,年龄范围16~58岁。受种者中有7人发生了局部不良反应,局部不良反应率2.3%,男性局部不良反应率为2.1%,女性为2.7%,差异无统计学意义（P〈0.05）。无全身不良反应发生,远期不良反应有待进一步追踪报告。结论防控甲型甲型H1N1流感,应做好流感及疫苗的宣传工作,扩大疫苗的生产规模和接种范围。     

深圳市福田区2009—2010年甲型H1N1流感疫苗接种情况

目的为下阶段甲型H1N1流感疫苗接种提供经验,进一步做好甲型H1N1流感的防控工作。方法对深圳市福田区2009年11月5日—2010年2月12日春节前夕甲型H1N1流感疫苗接种人群及预防接种不良反应（AEFI）进行描述性及分析性流行病学分析。结果福田区甲型H1N1流感疫苗第1阶段共接种100 668人,上报预防接种不良反应55例,其中一般反应41例,异常反应7例,偶合症7例,反应发生率54.6/10万,年龄分布结果差异有统计学意义（χ2=15.0415,P=0.0046）。结论福田区的接种实践说明甲型H1N1流感疫苗是安全的,因媒体对疫苗接种疑似异常反应的过度报道及群众过度敏感等原因,部分重点人群接种率不高,后期须正确引导舆论导向,提高群众对甲型H1N1流感疫苗接种的科学认识。     

接种甲型H1N1流感疫苗后偶合死亡事件处理的思考

目的：了解松阳县接种甲型H1N1流感疫苗后偶合发病死亡纠纷事件的处理情况,为制定免疫规划相关策略提供依据。方法：对1例接种甲型H1N1流感疫苗后偶合发病死亡纠纷事件进行分析。结果：接种甲型H1N1流感没苗偶合发病死亡发生率5.83/10万,发病与接种甲型H1N1流感疫苗只是时间上的偶合,家属对预防接种异常反应诊断专家组鉴定结论有疑议,与接种方发生了激烈的纠纷。结论：预防接种偶合反应难免发生,必须加强预防接种队伍建设和进一步完善补偿机制、处理程序及相关法律法规。     

接种甲型H1N1流感疫苗后患甲型H1N1流感分析

目的 分析接种甲型H1N1流感疫苗后发生甲型H1N1流感感染的病例,探讨发病原因,为进一步提高疫苗预防效果提供参考依据.方法 对接种甲型H1N1流感疫苗后发生甲型H1N1流感感染148例,进行回顾性调查分析.结果 接种甲型H1N1流感疫苗11176例.发生甲型H1N1感染148例,感染率1.32%,其中1～14 d感染81例,感染率0.72%,＞15 d感染67例,感染率0.60%.结论 甲型H1N1流感病毒裂解疫苗是一种安全高效的疫苗,不足之处尚待进一步探讨、完善.     

初中生甲型H1N1流感疫苗接种效果分析及抗体水平监测

目的了解初中生接种甲型H1N1流感疫苗的流行病学效果及抗体水平。方法采用非随机对照临床试验方法,选择9 123名初中生,分甲型H1N1流感疫苗接种组(3 726人)和对照组(5 397人),随访观察一个流行周期(6个月),比较两组流感样病例、甲型H1N1流感病例、季节性流感病例的发生率及接种前后阳性率和阳转率。结果接种组与对照组除甲型H1N1流感发病密度(接种组:0/1 000人年,对照组:2.22/1 000人年)差异有统计学意义外(P=0.0121),其他流感相关疾病(流感样病例、乙型流感、流感病毒核酸阳性)发病密度差异无统计学意义(P>0.05);不管是接种组还是对照组,不同住宿情况(住校和走读)流感样病例发生差异均有统计学意义,接种组中,季节性流感接种对乙型流感和流感病毒核酸阳性差异均有统计学意义;对照组中,流感症状史对甲型H1N1、乙型流感和流感病毒核酸阳性差异均有统计学意义;疫苗接种前与接种后1个月比较,流感抗体几何平均滴度(GMT)与阳性率都增高(P<0.05)。结论初中生大规模接种甲型H1N1流感疫苗能有效预防甲型H1N1流感,其免疫及保护效果良好,住校生较走读生更易发生流感样病例,疫苗接种可能不存在交叉保护作用。     

2009年上海市甲型H1N1流感疫苗大规模人群接种免疫学效果评价

目的评价2009-2010年上海市甲型H1N1流行性感冒疫苗(甲流疫苗)的免疫学效果。方法以公安人员、中小学生、医务人员这三类重点人群作为免疫学评价的对象,采用分层抽样的方法在上海市4个区县抽取公安人员110人,中小学生146人,医务人员306人,于甲流疫苗接种前和接种后5~6周分别采集外周静脉血,检测甲型H1N1流感(甲流)抗体水平,进行甲流疫苗免疫学效果评价。结果总体上,甲流抗体阳性率由接种前34.9%提高到98.9%,抗体几何平均滴度(GMT)由接种前1∶17提高到1∶351,抗体≥4倍增长率为85.6%。结论 2009年上海市大规模人群接种的甲流疫苗具有良好的免疫学效果。     

甲型H1N1流感疫苗免疫效果及影响因素研究

目的了解学生大规模接种甲型H1N1流感疫苗的免疫效果及影响因素,为探索甲型H1N1流感免疫策略和防控措施提供科学依据。方法分别对344名中学生在甲型H1N1流感疫苗接种前及接种后1个月采集血清标本,进行抗体水平的检测。并收集中学生在接种疫苗前季节性流感疫苗接种史、流感样症状等有关流行病学信息,评价甲型H1N1流感疫苗的免疫效果及影响因素。结果 344名中学生在免前H1N1流感抗体几何平均滴度(GMT)为1∶16.97(95%CI:1∶14.49~1∶19.86),抗体阳性率为36.50%(95%CI:31.35%~41.89%);免后GMT为1∶167.41(95%CI:1∶145.08~1∶193.18),阳性率为89.91%(95%CI:86.19%~92.91%),阳转率为72.54%(95%CI:67.76%~77.32%),均明显高于免前。接种疫苗前3个月的季节性流感疫苗接种史、流感样症状史等因素分组后,各组间免疫学效果指标间差异无统计学意义(P>0.05)。结论接种甲型H1N1流感疫苗后免疫成功率70%以上,符合欧盟和美国FDA的有关规定,免疫效果良好。季节性流感疫苗接种史、流感症状史等对疫苗的免疫学保护效果无明显影响。     

Correlates of 2009 pandemic H1N1 influenza vaccine acceptance among middle and high school teachers in rural Georgia

BACKGROUND: Teachers play an essential role in the school community, and H1N1 vaccination of teachers is critical to protect not only themselves but also adolescents they come in contact within the classroom through herd immunity. School‐aged children have a greater risk of developing H1N1 disease than seasonal influenza. The goal of this study was to assess the relationship between attitudes toward H1N1 vaccination and vaccine acceptance among middle and high school teachers in rural Georgia. METHODS: Participants were recruited from 2 counties participating in a school‐based influenza vaccination intervention in rural Georgia. Data were collected from surveys distributed to middle and high school teachers in participating counties in September 2009 prior to implementing the interventions to increase vaccination against seasonal influenza. Multivariate logistic regression was used to assess the association between teachers' attitudes toward H1N1 vaccination and H1N1 vaccine acceptance, controlling for demographic variables. RESULTS: Among participants, 52.9% indicated that they would get the H1N1 vaccine. In multivariate analyses, H1N1 vaccine acceptance was associated with male gender (odds ratio[OR] = 3.67, p = .016), fear of contracting H1N1 (OR = 3.18, p = .025), and receipt of a seasonal influenza vaccine in the past year (OR = 3.07, p = .031). H1N1 vaccine acceptance was not significantly associated with age, race, perceived severity of H1N1, belief that the H1N1 vaccine would cause illness, or talking about H1N1 with friends. CONCLUSIONS: Teachers may play a pivotal role in school‐based H1N1 vaccinations. Understanding and addressing teachers' attitudes toward H1N1 vaccination may assist in future immunization efforts.     

接种甲型H1N1流感裂解疫苗偶合水痘1例报告

[目的]分析接种甲型H1N1流感裂解疫苗后疑似异常反应的原因,为诊断是否为异常反应提供科学依据。[方法]对1例患者的既往病史、疫苗及注射器的使用情况、接种单位及接种人员情况进行详细的流行病调查。[结果]排出接种事故及异常反应。该患者从发病时间和临床特征上均符合水痘病毒感染特点,为接种甲流疫苗后偶合水痘。[结论]应高度重视接种前告知和检诊工作,如医务人员在接种前进行认真的问诊和检诊,则可防止此偶合病例发生。     

上海市长宁区小学生甲型H1N1流行性感冒疫苗接种情况及影响因素分析

目的了解小学生甲型H1N1流行性感冒(甲流)疫苗接种的影响因素,为开展疫苗接种工作提供参考。方法在上海市长宁区采取分层、随机整群抽样的原则抽取1752名小学生家长进行甲流疫苗相关情况问卷调查。结果 1752名学生中,甲流疫苗接种率为42.18%,接种过季节性流行性感冒(季流)疫苗、未接种过季流疫苗、不清楚是否接种过季流疫苗的学生甲流疫苗接种率分别为48.89%、38.44%和45.11%(P<0.05)。甲流疫苗未种原因主要为家长不了解疫苗(43.04%)和认为孩子有禁忌证不能接种(32.97%)。多因素Logistic回归分析结果显示,小学生甲流疫苗接种与其年龄(OR=0.924)、健康状况(OR=2.350)、以前是否接种过季流疫苗(OR=1.446)、母亲文化程度(初中及以下OR=0.366,高中OR=0.694)和是否想了解更多的流感疫苗知识(OR=0.734)有关。结论在进行疫苗大规模人群接种前,应遵循"健康教育先行"的原则,充分利用主流媒体进行广泛而深入的宣传,增加大众对疫苗的认可程度,才能提高疫苗的接种率。     

Nurses' vaccination against pandemic H1N1 influenza and their knowledge and other factors

This study aimed to estimate the vaccination coverage against the pandemic H1N1 influenza in a group of nurses and determine the factors associated with their vaccination behaviours. An anonymous, self-administered questionnaire was distributed to a convenience sample of nurses who were enrolled on continuing professional education courses in a university in London. The survey response rate was 77.7% (n=522). A total of 172 (35.2%) nurses reported receiving the pandemic H1N1 vaccine in the 2009-2010 influenza season and only 22.3% of them had the intent to accept the vaccine in the next season. Compared to nurses with low knowledge scores, those with high knowledge scores were more likely to receive the pandemic H1N1 vaccine (p=0.017), recommend the vaccine to their patients (p=0.003), and have the willingness to recommend vaccination to patients in the future (p=0.009). There was a higher vaccination rate among nurses with higher risk perception scores than with lower scores (p=0.001). A small, positive correlation between H1N1 knowledge and risk perception scores was identified (p<0.001) indicating that a high knowledge level was associated with high levels of risk perception. More male nurses received the H1N1 vaccine than females (p<0.001) and there were a significant differences in the uptake among nurses from different clinical specialty groups (p<0.001). About half of the vaccinated nurses reported the intent to be vaccinated again but only 8.1% of the unvaccinated nurses had the intent to receive the vaccine in the next season (p<0.001). The pandemic H1N1 2009 influenza vaccination coverage among this nurse sample was sub-optional. Lack of knowledge and risk perception were predictors associated with the nurses' vaccination behaviours. The identified knowledge items should be addressed in future vaccination campaigns. The hindrances associated with continuing vaccination decision-making and factors contributing to the different vaccination coverage among clinical specialty groups require further exploration.     

接种甲型H1N1流感疫苗1年后免疫持久性评价

目的 评价成都市甲型H1N1流感疫苗接种1年后疫苗免疫持久性.方法 以2010年免后1个月HI抗体≥1∶40的398人作为观察对象,用微量血凝抑制试验方法测定抗体,计算人群抗体几何平均滴度(GMT)和疫苗保护率.结果 免疫后1年人群GMT下降62.03％,抗体保护率达92.71％,老年组保护率为83.12％;免后1个月低抗体水平个体(1∶40、1∶80),1年后有40.21％的人抗体滴度上升.结论 甲流疫苗具有一定的免疫持久性,老人免疫持久性相对较差.     

Correlates of 2009 H1N1 influenza vaccination among day care-aged children, Miami-Dade County

Background

The aim of this study was to assess factors influencing 2009 H1N1 influenza vaccination among a demographically diverse group of day care-aged children. Day care children were chosen because they were an initial target group for vaccination and are at higher risk of influenza infection than children cared for at home.

Methods

A cross-sectional study was conducted from March to May 2010 among parents of day care aged children in 13 day care facilities in Miami-Dade County. Data was collected by an anonymous self-administered two-page 20 question survey which consisted of demographic variables and information regarding 2009 H1N1 influenza vaccine knowledge, attitude and acceptance. Data was analyzed using SAS to conduct both bivariate and multivariate analyses.

Results

There were 773 participants in the study. The response rate ranged from 42% to 72.2% among day care centers. A total of 172 parents (22.3%) and 225 (29.1%) children had received the 2009 H1N1 influenza vaccine. Non-Hispanic White and Black parents were more likely to vaccinate their children than Hispanic and Haitian parents. Primary reasons for non-vaccination included vaccine safety (36.7%) and side effects (27.1%). Among parents who spoke with a health care professional, 274 (61.4%) stated the health care professional recommended the vaccine.

Conclusion

Misperceptions about influenza vaccination among parents created a barrier to 2009 H1N1 influenza vaccination. Parents who got the vaccine, who believed the vaccine was safe and whose children had a chronic condition were more likely to immunize their children. Clear, reliable and consistent vaccine information to the public and health care providers and initiatives targeting minority groups may increase vaccination coverage among this population.     

甲型H1N1流行性感冒病毒裂解疫苗的安全性研究

目的评价甲型H1N1流行性感冒裂解疫苗(简称甲流疫苗)的安全性。方法设立主动监测点,通过全国疑似预防接种异常反应信息管理系统,收集全市接种甲流疫苗和主动监测点接种季节性流感疫苗后的AEFI个案信息,采用描述性方法对相关指标进行流行病学分析。结果邯郸市常规报告接种甲流疫苗后AEFI发生率14.64/10万,以一般反应为主,占88.57%,症状主要为38.5℃以下的低热,无严重不良反应和接种事故发生。主动监测点接种甲流疫苗后AEFI发生率752.63/10万,全部为一般反应,以发热为主。主动监测点接种季节性流感疫苗后AEFI发生率203.14/10万,全部为一般反应,均为发热。结论甲流疫苗接种后AEFI发生率高于季节性流感疫苗,但低于欧盟流感疫苗评价指标。甲流疫苗接种后AEFI反应类型以一般反应为主,且多为低热。甲流疫苗是安全的。