深圳市宝安区西乡社区儿童水痘疫苗接种率及影响因素分析

[目的]了解社区儿童水痘疫苗接种情况及其影响因素,探讨社区儿童水痘疫苗接种效果,提高疫苗接种率。[方法]2009年9-10月,对深圳市宝安区西乡预防保健所辖区街道1-10岁儿童进行调查。[结果]调查490名儿童,水痘疫苗接种率为47.55%。接种水痘疫苗后1个月至10年间,接种组水痘及轻型皮疹、重型皮疹、发热发生率分别为13.30%、10.30%、3.00%、11.59%,未接种组分别为37.96%、26.45%、10.51%、30.74%,接种组均低于未接种组（P〈0.01）。多因素非条件Logistic回归分析结果显示,本地户籍、家庭月人均收入≥3 000元、医院分娩的儿童水痘疫苗接种率较高（OR=2.34,1.68,3.42,P〈0.01）。[结论]社区儿童的水痘疫苗接种率较低,应加大水痘疫苗知识的宣传,提高各人群对水痘疫苗的认识,提高接种率,有效预防水痘疾病的发生。     

越城区水痘疫苗免疫接种效果情况调查分析

目的掌握浙江省绍兴市越城区水痘疫情特征,评价疫苗免疫效果,为有效控制水痘疫情提供依据。方法对2010年和2011年发病资料进行描述分析,同时对越城区属的水痘病例中1～11岁的859例病例进行疫苗接种史回顾性调查。结果水痘平均发病率172.05/10万,0～9岁组占72.92%。发病前有无免疫史的差异有统计学意义(χ2=454.67,P<0.001),疫苗的总体保护率为75.37%;接种国产疫苗和进口疫苗的发病率差异有统计学意义(χ2=5.62,P=0.018),国产疫苗相对于进口疫苗保护效果的OR值为1.53(95%CI:1.07～2.18)。结论提高接种率是控制水痘发病的有效手段,且进口疫苗免疫效果优于国产疫苗,当前应扩大疫苗接种年龄范围。     

水痘疫苗保护效果的病例对照研究

目的 分析儿童接种水痘疫苗后的保护效果,探讨接种1剂次水痘疫苗的保护效果随时间推移而改变的规律,根据研究结果对无锡地区水痘疫苗免疫策略制定提出建议。方法 对病例与对照开展流行病学调查,收集调查对象人口学、水痘疫苗接种史等信息,比较两组水痘疫苗接种情况,探讨接种后的保护效果及其效果随时间推移而发生衰减的规律。结果 共纳入研究对象942例,其中病例组324例,对照组618例。水痘疫苗总体保护率为55%（95%CI:42%~65%）,1剂次水痘疫苗的保护率为26.6%（95%CI:3.3%-44.3%）,2剂次水痘疫苗的保护率为67.8%（95%CI:21.3%~86.9%）。接种后＜1年、1~年、2~年、3~年、4~年水痘疫苗保护率分别为79.3%、52.7%、33.0%、26.9%、13.6%（x2=8.258,P＜0.05）。结论 仅接种1剂次水痘疫苗预防疾病的效果较差,提倡免疫程序更改为2剂次,可显著提升水痘疫苗保护效果。1剂次水痘疫苗保护率不持久,接种后疫苗保护效果逐年递减,建议在接种3年后加强接种1剂次水痘疫苗。     

水痘疫苗预防2~5岁儿童患水痘的免疫效果观察

目的观察水痘疫苗预防2~5岁儿童患水痘的免疫效果。方法选择东莞市企石镇社区卫生服务中心2014年1-12月接种水痘疫苗的960例2~5岁儿童为观察组,另选择同期未接种过水痘疫苗的900例同龄儿童为对照组,比较两组儿童水痘发生率,记录观察组儿童疫苗接种后不良反应发生情况。结果观察组儿童水痘发生率为0.21%,低于对照组的1.89%,差异有统计学意义(P0.05);观察组疫苗保护率为88.89%;观察组儿童接种疫苗后,有5例出现局部发红、疼痛和一过性皮疹,均自行消退。两组间皮疹症状、皮疹密度和并发症发生率比较,差异无统计学意义(P0.05)。结论水痘疫苗保护率较高,可有效降低2~5岁儿童的水痘患病率。     

上海市闸北区2005～2006年水痘流行病学分析

[目的]了解闸北区水痘的发病状况。[方法]对水痘报告和监测资料进行描述性分析。[结果]2005和2006年闸北区本市人口水痘发病率为58.62/10万和37.33/10万,外来人口发病率为32.20/10万和35.09/10万。4~6、7~9和10~143个年龄组的病例数最多,分别占2005年和2006年病例数的83.04%和71.95%,≥20岁的病例分别占5.58%和8.58%。2005年本市人口各年龄组发病率最高的是7~9岁组,2006年是4~6岁组。水痘比例男女性别比为1.3︰1。水痘发病的季节高峰为冬季和春夏季。水痘病例在各街道间的分布不平衡。水痘暴发均发生在中小学校,暴发平均持续时间为26d。暴发病例中既往接种过水痘疫苗占8.72%。有一半以上的暴发病例未通过国家疾病报告管理系统报告。[结论]学龄前儿童和中小学生是水痘的高发人群,应该采用学龄前儿童常规接种和在学生中补种相结合的策略开展水痘疫苗的群体水平免疫;水痘监测和报告网络有待完善。     

国产腮腺炎单价疫苗的免疫原性和保护效果的系统评价

目的比较国产腮腺炎单价疫苗与进口含腮腺炎成分的联合疫苗(MMR)在免疫原性的差异,并系统分析国产腮腺炎单价疫苗保护效果,为免疫规划工作提供科学依据。方法检索中国生物医学文献光盘数据库、中国期刊全文数据库、维普中文科技期刊、万方数字化期刊、Pubmed、EMbase、Web of Science等数据库,筛选符合研究目的的文献,对符合纳入标准的文章采用Stata10.0进行Meta分析。结果提取8篇关于含腮腺炎疫苗成分的国产单价疫苗与进口联合疫苗接种后抗体阳转情况比较的文献资料,分析结果显示:国产单价疫苗和进口MMR组接种后腮腺炎抗体阳性率差异无统计学意义[RR=1.01,95%CI(0.95,1.07),P=0.780];入选的8篇文章均比较了国产单价疫苗的接种组和未接种组的保护效果的研究,合并后接种组腮腺炎发病率和未接种组腮腺炎发病率差异有统计学意义[OR=0.16,95%CI(0.06,0.45),P0.001],接种国产单苗发病率显著低于未接种组,其疫苗保护率为84%。结论国产单价疫苗在免疫原性方面和进口MMR无统计学差异,国产单价腮腺炎疫苗对预防儿童腮腺炎有保护作用。     

一起小学水痘暴发疫情的疫苗保护效果研究

目的分析水痘疫苗对控制水痘暴发疫情的保护效果。方法选取发生水痘疫情的某小学的学生作为研究对象,采用回顾性队列研究方法分析接种疫苗与水痘发病的关系,计算疫苗保护率。结果对能明确接种史并且未患过水痘的1 216名学生进行回顾性队列研究,结果显示,水痘疫苗接种组与未接种组罹患率差异有统计学意义(P0.01),疫苗总体保护率为58%,接种2剂次疫苗保护率为100%;接种水痘疫苗后3年内保护率为100%,第4年开始下降。结论接种水痘疫苗是控制水痘暴发疫情的有效策略,尤其要提高2剂次水痘疫苗的接种率。     

北京市小学生水痘疫苗应急接种效果及影响因素评价

目的 评价北京市小学生水痘疫苗应急接种效果及其影响因素.方法 对2007年5-7月北京市4个区(县)49起小学水痘疫情应急接种进行前瞻性观察.将应急接种前发生水痘病例的班级和同楼层或同排平房无病例班级的全体7882名学生作为观察对象;收集水痘病史、疫苗接种史、病例个案等资料,采用描述流行病学方法评价水痘疫苗应急接种保护效果.结果 水痘疫苗应急接种总体保护率为85.26%.首例水痘病例既往有疫苗接种史、疫情发现及时、病例数少、距首例病例发病时间短的水痘疫苗应急接种保护效果较好;分别对水痘疫苗应急接种前已发生病例班级和同楼层或同排平房无病例班级的应急接种效果进行分析,疫苗保护率分别为84.26%和87.06%.首例病例既往有水痘疫苗接种史的应急接种保护率分别为92.09%和93.06%,均高于首例病例既往无疫苗接种史的学校.应急接种前仅发生1例病例的疫曲接种保护率分别为83.09%和93.02%,均高于应急接种前已发生2～3例病例的学校.首例病例发病后<5 d完成消毒、隔离和应急接种等综合措施的疫苗保护率分别为86.60%和92.73%,均高于首例病例发病后<5 d完成消毒、隔离、但≥5 d完成应急接种的学校.此外,学校教室为平房、无校车或食堂、无住宿、学生间无搭伴包车或就餐的学校应急接种后疫苗保护率较高.结论 北京市小学生水痘疫苗应急接种具有较高的保护率,有利于控制水痘疫情.     

浙江省宁波市某区2010--2012年水痘突发疫情中疫苗保护效果分析

目的了解水痘疫苗接种在水痘突发疫情中的保护效果。方法收集宁波市某区2010--2012年水痘疫情报告信息,计算接种疫苗与否水痘发病率的比值比（OR）,疫苗保护率及疫苗的效果指数。随机抽取未出现疫情的小学生109名,使用ELISA法进行水痘IgG抗体检测,评价疫苗接种的效果。结果该区2010—2012年共发生3起一般水痘突发事件,共报告病例40例（无死亡病例）,均为幼托儿童和小学生。疫情发生所在班级学生161人,接种疫苗和未接种疫苗者发病率比较差异有统计学意义（19．42％：59．09％,X2=16．01,P〈0．01）,DR值为0．17（95％CI：0．07~0．43）。疫苗总体保护率为67．13％,疫苗效果指数为3．05。未出现疫情的109名学生中,有77人接种过疫苗,但水痘IgG抗体检测显示,仅40．26％（31／77）抗体阳性。结论幼托儿童、小学生接种水痘疫苗可有效降低水痘的发病率,水痘疫苗的质量及实际保护效果需进一步评估。     

集居人群流感疫苗不同接种覆盖率的保护效果评价

目的研究集体居住生活人群季节性流感疫苗的保护效果。方法按流感疫苗接种覆盖率将7家企业集体居住人群划分为A、B和C组,比较3组的流感发病率及组内接种与未接种人群的发病率,并计算各组疫苗保护率。结果 A、B和C组企业职工流感疫苗接种覆盖率分别为30.60%、64.69%和80.64%,疫苗接种后1年内甲型流感发病率分别为57.28‰、25.37‰和8.60‰,均低于接种前2年发病率;3组免后1年内发病率进行两两比较,差异均有统计学意义(P0.01),甲型流感年发病率随接种覆盖率增高而降低(P0.05)。A、B、C组职工免后1年内的疫苗保护率及95%可信区间分别为61.93%(46.63%~72.85%)、86.51%(78.57%~91.50%)和86.22%(79.18%~90.88%);B组和C组的疫苗保护率均高于A组。结论接种季节性流感疫苗对预防流感效果明显;在集体居住生活人群中,提高疫苗接种覆盖率可提高疫苗保护率。     

北京市安定镇15岁以下人群水痘疫苗接种情况

目的了解北京市安定镇15岁以下人群水痘疫苗接种情况,为提高水痘疫苗接种率和控制水痘疫情提供依据。方法对北京市安定镇全部15岁以下人群通过免疫规划信息系统和查阅应急接种表,对水痘疫苗接种史进行描述性分析。结果共调查3 461人,水痘疫苗接种率66.57%(76.62～34.39%),1～7岁组接种率维持在较高水平(71.64%～76.62%),年龄组接种率差异有统计学意义(P0.01)。该地人群与外地人群接种率分别为60.78%、67.56%,差异有统计学意义(P0.01)。进口水痘疫苗接种率随年龄下降而增加;托幼机构和小学、中学水痘疫苗接种率分别为78.72%、63.84%、41.40%,差异有统计学意义(P0.01)。应急接种占总接种数的42.52%;小、中学生应急接种分别占该年龄组接种总数的52.67%、94.76%。结论该镇要加强15岁以下人群水痘疫苗接种宣传,提高接种率,控制托幼机构和学校水痘疫情。     

Study of incidence of measles and vaccination coverage in Ahmedabad urban slums

Measles incidence and vaccination coverage survey was carried out in Ahmedabad urban slums in February 2000. A total of 3073 children between 9 to 59 months were studied. The incidence rate of measles was 11.2% (95% C.I-10.04-12.36). Measles vaccination coverage was only 59.88%. There was no gender difference in vaccine coverage or measles incidence rate. Diarrhoea was the most common complication observed among both vaccinated and unvaccinated children and it was significantly more among unvaccinated children. Among 1840 vaccinated children only 529 (28.75%) children received vitamin A along with measles vaccination.     

Reduced efficiency of influenza vaccine in prevention of influenza-like illness in working adults: a 7 month prospective survey in EDF Gaz de France employees,in Rhône-Alpes, 1996-1997

The efficiency of influenza vaccine was evaluated in the working population by comparing the percentage of people presenting with an influenza-like illness (ILI) according to their influenza immunization status, drug expenses and workdays lost. A self-completed questionnaire about the vaccination was sent to 5785 people randomly chosen among 18 249 workers. When any sick leave was incurred amongst the respondents (63.3%), of whom 301 were vaccinated and 3362 unvaccinated, a clinical form was completed by the private physician and the medical adviser of the firm (Electricité de France and Gaz de France). A final self-completed questionnaire was sent to people whose sick leave was not documented by a physician's reported diagnosis. In total, we obtained complete data for 90.9% of the sampling. The vaccine coverage rate of 8.2% [95% confidence interval (95% CI) = 7.4-9.0%] was higher in men than in women, increasing with age and professional category. Among the 775 subjects with a medical diagnosis, the vaccine effectiveness was not significant: 27.3% (95% CI = -13.8 to 53.5%). In the unvaccinated group, 9.6% had days absent from work, versus 7.0% in the vaccinated group; the two populations were comparable in terms of clinical symptoms, smoking habits, exposure to respiratory risk factors and chronic pathology. The average duration of sick leave for ILI was not significantly different between vaccinated (0.5 days) and unvaccinated workers (0.6 days). Despite the large size of the population and the occurrence of an epidemic due to a virus closely related to the vaccine strain (A/Wuhan/359/95), the vaccine did not effectively protect the small vaccine group nor result in an economic benefit, whatever the professional group.     

国产和进口水痘疫苗免疫效果对比研究

[目的 ]　比较国产和进口水痘疫苗免疫效果 ,了解宝山区儿童水痘—带状疱疹病毒 (VZV)自然感染情况。　[方法 ]　随机选择 2 6 5名无水痘病史的 0～ 7岁儿童调查血清抗VZV -IgG阳性率 ;选择 84名 1～ 2岁VZV易感儿童随机分成两组 ,分别接种国产和进口水痘疫苗 ,免疫后 6周采血 ,用酶联免疫吸附试验检测抗VZV -IgG。　 [结果 ]　 1～ 7岁儿童抗VZV -IgG阳性率分别为 2 .0 0 %、11.11%、2 0 .0 0 %、17.6 5 %、30 .77%、40 .0 0 %、32 .14 % ;免前抗VZV -IgG阴性儿童 ,分别接种国产和进口水痘疫苗后 ,抗体阳转率分别为 90 .70 % ( 39/43)和 95 .12 % ( 39/41) ,两者差别无显著性 ;两种疫苗的抗VZV-IgG几何平均滴度倒数 (GMRT)分别为 2 0 4.848( 95 %CI190 .73～ 2 6 0 4.79)和 482 .6 9( 95 %CI93.30～ 2 497.5 ) ,进口疫苗GMRT略高于国产疫苗。　 [结论 ]　宝山区婴幼儿 6个月内部分存在VZV -IgG母体免疫 ,7个月后母体免疫消失 ;国产水痘疫苗免疫效果良好 ,本区 1～ 7岁儿童是易感人群 ,尤其是 1～ 4岁易感儿童适宜接种     

Impact of a mass vaccination campaign against Serogroup B meningococcal disease in the Saguenay-Lac-Saint-Jean region of Quebec four years after its launch

In the Saguenay-Lac-Saint-Jean region of Quebec, 83% of the population ≤20 years (n ≅ 59,500) was immunized in 2014 with the four-component Serogroup B meningococcal vaccine to control a long-lasting outbreak caused by a virulent ST-269 Serogroup B Neisseria meningitidis clone. Following the campaign, invasive meningococcal B disease (B-IMD) incidence fell sharply in the target population from 11.4/100,000 in 2006–2014 to 0.4/100,000 in 2014–2018 (p < 0.0001). Five B-IMD cases occurred in the region from July 2014 to June 2018, including one vaccinated child, one unvaccinated young adult and 3 unvaccinated elderly adults. Estimate of direct vaccine protection was 79% [95%CI:−231%;99%]. The overall campaign impact in the region taking into account the decrease in B-IMD incidence at provincial level was a 86% [95%CI:−2%;98%] decrease in B-IMD risk. The campaign impact was mostly seen in the target age-group suggesting no herd effect among unvaccinated older adults.     

2007—2009年北京市俸伯地区水痘疫情分析

目的了解北京市俸伯地区水痘发病情况,为完善水痘防控措施提供科学依据。方法采用描述性统计方法分析水痘发病的流行病学特征。结果 2009年发病率是2007年的1.65倍,2009年病例占3年总病例数的43.22%,明显高于2007、2008各年的病例数。水痘发病以学生为主,学生病例占发病总数的77.97%。发病有季节性。发病患者中有接种史的明显低于无接种史的。结论该地区水痘发病呈逐年上升趋势,已经成为儿童特别是在校儿童的高发病,应适当调整水痘苗免疫程序,以降低水痘在儿童中的发病。     

水痘疫苗接种对学校暴发疫情的保护效果及影响因素分析

目的 评价学校水痘暴发疫情中,水痘疫苗免疫史对发病以及疾病严重程度的影响,并探索其影响因素,为制定相应预防控制措施提供参考。方法 选择广东省2021年发生水痘疫情的2所中小学校中既往没有水痘患病史的3 888名学生。采用回顾性队列研究方法进行问卷调查,计算相对危险度(RR)和保护效果(VE),并分析水痘疫苗保护效果的影响因素。结果 研究对象中水痘确诊病例138例。不同性别学生的疫苗接种率差异无统计学意义(χ²=1.36,P=0.51),不同年龄组学生的疫苗接种率差异有统计学意义(χ²=555.82,P<0.01)。水痘疫苗总体保护效果为66.94%(95%CI=56.17%～77.71%),2剂次疫苗保护效果(VE=90.02%,95%CI=83.13%～96.90%)高于1剂次(VE=49.40%,95%CI=32.36%～66.44%),差异有统计学意义(χ²=24.93,P<0.01)。疫苗接种组与未接种组高热率分别为7.69%和25.81%,中重度皮损率分别为20.00%和50.00%,差异均有统计学...     

Spatial and environmental connectivity analysis in a cholera vaccine trial

This paper develops theory and methods for vaccine trials that utilize spatial and environmental information. Satellite imagery is used to identify whether households are connected to one another via water bodies in a study area in rural Bangladesh. Then relationships between neighborhood-level cholera vaccine coverage and placebo incidence and neighborhood-level spatial variables are measured. The study hypothesis is that unvaccinated people who are environmentally connected to people who have been vaccinated will be at lower risk compared to unvaccinated people who are environmentally connected to people who have not been vaccinated. We use four datasets including: a cholera vaccine trial database, a longitudinal demographic database of the rural population from which the vaccine trial participants were selected, a household-level geographic information system (GIS) database of the same study area, and high resolution Quickbird satellite imagery. An environmental connectivity metric was constructed by integrating the satellite imagery with the vaccine and demographic databases linked with GIS. The results show that there is a relationship between neighborhood rates of cholera vaccination and placebo incidence. Thus, people are indirectly protected when more people in their environmentally connected neighborhood are vaccinated. This result is similar to our previous work that used a simpler Euclidean distance neighborhood to measure neighborhood vaccine coverage [Ali, M., Emch, M., von Seidlein, L., Yunus, M., Sack, D. A., Holmgren, J., et al. (2005). Herd immunity conferred by killed oral cholera vaccines in Bangladesh. Lancet, 366(9479), 44–49]. Our new method of measuring environmental connectivity is more precise since it takes into account the transmission mode of cholera and therefore this study validates our assertion that the oral cholera vaccine provides indirect protection in addition to direct protection.