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。     

北京市宣武区流行性感冒疫苗保护效果和成本效益分析

目的分析和评估北京市宣武区居民应用流感疫苗后的保护效果和成本效益。方法通过抽样调查的方法,选取宣武区居民1000人作为研究对象,其中接种流感疫苗组501人,对照组499人,两组间年龄、性别、健康状况基本匹配,在基线调查的基础上,分别在接种流感疫苗后的第1、3和6个月对其进行随访调查。结果接种流感疫苗后第1、3和6个月内对ILI(流感样疾病)保护率分别为64.6%、43.2%和43.2%,因接种流感疫苗,ILI和普通感冒就诊率分别减少了61.7%、68.1%和68.1%;接种流感疫苗无不良接种反应发生;接种效益和效益成本比随着接种时间的延长而增加,接种后1、3、6个月疫苗的接种效益分别为-6.29、334.89、336.21,效益成本比分别为-0.09、4.97和4.98。结论流感疫苗接种是安全有效的,具有良好的保护作用和接种效益,应当加大推广接种。     

椒江区老年人接种流感疫苗的保护效果

目的评价台州市椒江区≥60岁老年人接种流感疫苗的保护效果,为推进老年人流感疫苗免费接种项目和提高流感疫苗接种率提供依据。方法在椒江区随机选取500名于2017年9—10月免费接种流感疫苗的≥60岁老年人为接种组,在相同社区选择性别、年龄和健康状况等因素1∶1匹配的从未接种过流感疫苗500名老年人为对照组,在疫苗接种(或基线调查)后12个月内随访调查流感样疾病(ILI)及并发症发生情况等,并评价流感疫苗的保护效果。结果496名接种组和479名对照组完成了全程随访调查。接种组老年人12个月内ILI发病率为8.06%,低于对照组的19.42%(P0.05),流感疫苗对ILI的保护率为58.46%。疫苗接种后3个月,接种组老年人因呼吸系统疾病门诊就诊率和住院率分别为5.44%和4.44%,均低于对照组的20.67%和8.35%(P0.05);两组接种后6个月和12个月的门诊就诊率和住院率差异均无统计学意义(P0.05)。结论老年人接种流感疫苗能有效预防ILI,降低因呼吸系统疾病的门诊就诊率和住院率。     

北京市丰台区老年人免费流感疫苗接种效果评价

目的 评价北京市丰台区老年人接种免费流感疫苗的效果。方法 随机抽取丰台区2019年10—11月434名接种免费流感疫苗的60周岁以上的老年人作为接种组,选取2019年未接种流感疫苗的60周岁以上的434名老年人作为对照组。采用统一设计的调查问卷,收集调查对象的基本情况、接种疫苗后一年内流感样病例、呼吸系统疾病和心脑血管疾病的发生及就诊情况。结果 接种免费流感疫苗3个月内,接种组流感样病例的发病率(1.61%)低于对照组的发病率(5.07%),差异有统计学意义(χ²=8.027,P=0.005)。接种免费流感疫苗3个月内、4～6个月、7～12个月流感样病例的保护率分别为68.24%、16.67%、25.00%,流感样病例就医行为的保护率分别为40.00%、25.00%、50.00%;呼吸系统疾病的保护率分别为25.45%、-29.93%、-67.03%,呼吸系统疾病就医行为的保护率分别为19.97%、-8.70%、-57.14%;心脑血管系统疾病的保护率分别为40.00%、16.67%、-25.00%,心脑血管系统疾病就医行为的保护率分别为60.00%、75.00%...     

243名军队离退休人员流感疫苗预防接种效果观察

目的调查军队离退休人员接种流感疫苗预防流感的效果。方法选取驻京某军队医院2005年10~12月接种过流感疫苗的243名军队离退休人员为接种组,同时按照年龄、性别、疾病匹配的情况选取未接种流感疫苗的220名地方人员为对照组。调查分析流感疫苗接种后1年内两组流感样疾病,心血管、呼吸、内分泌系统疾病发生情况。结果接种组流感样疾病发生率(22.2%)和就诊率(18.1%)均明显低于对照组〔(33.2%)和(31.8%)〕(P<0.05,P<0.01)。接种组心脑血管、呼吸、内分泌系统疾病发生率与对照组比较差异无统计学意义,就诊率(71.2%)明显低于对照组(93.6%,P<0.01)。接种组1年内流感样疾病保护率为33.1%,减少就诊率43.1%;心脑血管、呼吸、内分泌系统疾病减少就诊率23.9%。结论接种流感疫苗既减少了老年人流感样疾病的发生率,还降低了心脑血管、呼吸、内分泌等系统疾病的就诊率。     

慢性病患者接种流感疫苗的效果与效益评价

目的评价常州市武进区慢性病患者接种流感疫苗的效果和效益。方法采用流行病学类试验研究,招募慢性病患者441名作为接种组,接种三价流感病毒裂解疫苗;并选取与接种组年龄、性别、健康状况相匹配的慢性病患者467人作为对照组,进行基线调查和为期1年的随访调查。结果观察1年后,接种组和对照组分别有431和460人完成了基线和4次随访调查。接种组和对照组流感样疾病发病率为分别为7.42%(32/431)和14.13%(65/460),差异有统计学意义(χ^2=9.634,P=0.002),保护率为47.46%,效果指数1.90;普通感冒发病率分别为16.94%(73/431)和25.43%(117/460),差异有统计学意义(χ^2=9.077,P=0.003),保护率为33.41%,效果指数1.50;慢性病发作发病率分别为5.57%(24/431)和9.35%(43/460),差异有统计学意义(χ^2=4.043,P=0.044),保护率为40.43%,效果指数1.68。人均接种效益为675.86元,效益-成本比为10.09∶1。结论慢性病患者接种流感疫苗能有效预防流感样疾病的发生,降低相关慢性病的发作,具有较好的成本效益。     

某部新兵流感疫苗接种效果及效益分析

目的评价某部新兵接种流感疫苗的效果和效益,为部队制订流感疫苗接种策略提供依据。方法于2014年10月选取某部292名新兵接种流感疫苗,作为接种组,同时在该战区选择条件相近的1472名新兵作为对照组,于疫苗接种后70 d的新训期进行随访调查。结果流感疫苗接种组流感样发热疾病的发病率与对照组间差异有显著性意义,流感疫苗对流感样发热疾病的保护率为89.10%。新兵接种流感疫苗后70 d新训期的效益-成本比为5.44∶1。结论对刚到部队的新兵及时接种流感疫苗,可以有效减少流感样发热病例,以及因感染流感病毒造成的经济损失。     

季节性流感疫苗接种效果观察

目的评价不同人群接种流感疫苗的效果。方法采取面访与自填式相结合的问卷调查方法,了解接种组和未接种组在2002-2003年度内流感样症状的发病情况,用Epi2002软件进行统计分析。结果共调查2238人,接种组1202人,未接种组1036人;接种组流感样症状发病率为2.91%,未接种组发病率为11.00%;全人群流感疫苗保护率为72.21%,其中18岁以下儿童组、18～60岁工龄组、60以上老年组的保护率分别为79.22%、55.89%、91.28%。结论应将老人和儿童作为流感疫苗重点推广的目标人群。     

老年人接种流感疫苗的效果评价

目的评价老年人接种流感疫苗的效果。方法选取670名离退休教职工为接种组,675名未接种离退休人员为对照组,在接种流感疫苗后的第3个月采取问卷调查。分析两组流感样疾病的发生及治疗情况。结果接种疫苗后3个月,接种组和对照组流感样疾病的发病率分别为11.2%和23.7%,差异有统计学意义(P0.01)。流感疫苗的保护率为52.7%。对照组和接种组患者服用1种药物的比率分别是66.7%和25.0%,服用2种及多种药物的比率为33.3%和75.0%,差异均有统计学意义(P0.01)。结论接种流感疫苗对老年人具有一定的保护作用。     

老年人接种流感疫苗的效果评价

目的评价老年人接种流感疫苗的效果。方法选取670名离退休教职工为接种组,675名未接种离退休人员为对照组,在接种流感疫苗后的第3个月采取问卷调查。分析两组流感样疾病的发生及治疗情况。结果接种疫苗后3个月,接种组和对照组流感样疾病的发病率分别为11.2%和23.7%,差异有统计学意义(P<0.01)。流感疫苗的保护率为52.7%。对照组和接种组患者服用1种药物的比率分别是66.7%和25.0%,服用2种及多种药物的比率为33.3%和75.0%,差异均有统计学意义(P<0.01)。结论接种流感疫苗对老年人具有一定的保护作用。     

西安市社会医疗保险参保人群接种流感疫苗的成本效益分析

目的评价西安市参保职工接种流感疫苗的成本效益。方法选择西安东方集团有限公司为研究现场，对该集团公司全部12109名参保职工，用随机整群抽样方法，抽取2949人，进行问卷调查。样本人群中，接种流感疫苗1900人、未接种流感疫苗1049人。采用历史性队列研究方法，对接种组和对照组同时进行回顾性调查。重点调查流感疫苗接种后12个月内，两组人群呼吸系统、心脑血管疾病及其他慢性病患病情况及医疗服务利用情况。结果接种组呼吸系统疾病和心脑血管疾病粗住院率分别为0．51％和1．64％，较对照组降低了68．90％和56．05％。疫苗接种后第3、4个月接种组和对照组粗住院率分别为0．62％、0.80％和0．28％、1．00％。65岁及以上年龄接种组粗住院率较对照组低53．59％。2005年度西安市参保人群接种流感疫苗降低住院率产生的效益成本比标化后为6．48。结论西安市参保职工接种流感疫苗具有较高的成本效益，产生良好成本效益的原因是，明显降低了接种组参保中老年职工呼吸系统和心脑血管疾病住院率。     

深圳市社区居民流感疫苗免疫效果分析

目的通过对社区居民流感疫苗接种免疫效果的分析,为评价流感疫苗接种效益提供依据。方法采用血清学流行病学方法 ,在深圳市龙岗区通过对研究对象进行流感疫苗免疫前、后流感抗体检测及是否接种后的流感样病例的发生情况。结果接种疫苗1个月后H1Nl、H3N2、B（Brisbane）3个血清型流感病毒HI抗体均有不同程度的增长,阳性率分别达到86.7%、84.0%和90.7%,几何平均滴度分别为1：53.13、1：51.10和1：78.91,3种亚型流感病毒株免疫成功率分别为73.3%、78.0%和85.3%。接种后1个月、3个月和6个月后接种组比对照组流感样疾病的发生明显较少（P〈0.05）,3个时段流感疫苗保护率分别为55.6%、51.8%、51.5%。结论流感疫茼免疫效果好,接种后能有效减少人群种流感样疾病的发生。     

Long time trends in influenza-like illness and associated determinants in The Netherlands

We analysed long-term epidemiological trends in influenza-like illness (ILI) in The Netherlands and used an ecological analysis to estimate its relationship with age, influenza vaccination, and virological aspects. This study used data from weekly ILI consultation reports from sentinel general practitioners (1986/1987 to 2006/2007), virological data from sentinel ILI patients (1992/1993 to 2006/2007), and data for influenza vaccine uptake (1991-2005). The incidence of ILI consultations, although varying during the study period, was estimated to decrease in the total population by 12.2/10 000 persons each season (95% CI 8.6-15.9). Uptake of influenza vaccination in people aged > or = 65 years (elderly) increased from 28% in 1991 to >70% since 1997. ILI incidence in the elderly declined by 1.7/10 000 persons (P=0.05) per percentage vaccine uptake per season. The decline in ILI incidence over the last 20 years could be related to the increased vaccine uptake. However, insufficient data were present to assess the impact of other potential contributing factors, such as diminished fitness of influenza viruses and changes in consulting behaviour.     

苏州地区2011—2012年儿童流感疫苗保护效果的初步观察

目的了解2011-2012年苏州地区5岁以下儿童流感样病例（ILI）的发生情况,初步观察流感疫苗对6～59月龄儿童ILI发生的保护效果。方法以苏州地区5岁以下常住儿童为研究对象,分别于2012年1月和2012年10月采用分层随机抽样方法,通过电话调查的方式获取调查对象前一个月内ILI的发生情况;通过计划免疫信息系统将调查对象分为流感疫苗接种组和对照组,比较两组的ILI发生率。结果两次调查共抽取7524名5岁以下儿童,3493名儿童接受并完成了调查。两次调查前一个月ILI发生率分别为7．2％和6．7％。2011—2012年度流感疫苗接种率分别为11．3％和6．2％。流感疫苗接种组的ILI发生率低于对照组,且接种疫苗对6～23月龄儿童有保护效果（P〈0．05）。结论接种流感疫苗儿童的ILI发生率相对较低,且流感疫苗对6～23月龄儿童的ILI发生有较好的保护效果。     

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。     

Vaccine effectiveness in preventing influenza hospitalizations in Navarre, Spain, 2010-2011: cohort and case-control study

We evaluated the 2010-2011 seasonal influenza vaccine effectiveness in preventing hospitalizations. Using healthcare databases we defined the target population for vaccination in Navarre, Spain, consisting of 217,320 people with major chronic conditions or aged 60 years and older. All hospitalized patients with influenza-like illness (ILI) were swabbed for influenza testing. A total of 269 patients with ILI were hospitalized and 61 of them were found positive for influenza virus: 58 for A(H1N1)2009 and 3 for B virus. The incidence rates of hospitalization with laboratory-confirmed influenza were compared by vaccination status. In the Cox regression model adjusted for sex, age, children in the household, urban/rural residence, comorbidity, pandemic vaccination, pneumococcal vaccination, outpatient visits and hospitalization in the previous year, the seasonal vaccine effectiveness was 58% (95% CI: 16-79%). The nested test-negative case-control analysis gave an adjusted estimate of 59% (95% CI: 4-83%). These results suggest a moderate effect of the 2010-2011 seasonal influenza vaccine in preventing hospitalization in a risk population. The close estimates obtained in the cohort and the test-negative case-control analyses suggest good control of biases.     

Relation of chronic disease and immune response to influenza vaccine in the elderly

The ability of elderly patients to mount an adequate immune response to influenza vaccine has been debated. We studied the serum haemagglutination inhibition (HI) antibody response in elderly persons to determine whether different degrees of chronic illness were a critical factor in immune response. In autumn 1986, trivalent split virus vaccine was used to immunize 87 healthy ambulatory elderly adults and 53 institutionalized elderly adults. The pre-vaccination health status of the healthy elderly group was significantly better as measured by the incidence of chronic disorders and drug use (p less than 0.02) and by the Chronic Health Evaluation component of the APACHE severity of disease classification (p less than 0.001). No group differences were observed in serum HI antibody after immunization with the trivalent influenza vaccine. However, in 28 patients from each group who received the monovalent A/Taiwan/86(H1N1) vaccine 1 month after the trivalent vaccine, the percentage with a postvaccination HI titre greater than or equal to 40 was 57% (16 of 28) for the healthy elderly vs 7% (2 of 28) for the institutionalized elderly (p = less than 0.001). Geometric mean postvaccination HI titres were 31 and 13, respectively (p = 0.004). We concluded that the institutionalized elderly in our study mounted an inferior immune response against the new heterotypic influenza A/Taiwan strain when compared to healthy elderly adults. The Chronic Health Evaluation score may be an effective predictor of a poor immune response to new influenza vaccine strains in the elderly. Increasing age per se and lack of a history of prior influenza immunization did not adversely affect the development of protective levels of serum antibody.(ABSTRACT TRUNCATED AT 250 WORDS)     

Pandemic and seasonal vaccine coverage and effectiveness during the 2009–2010 pandemic influenza in an Italian adult population

Objectives

To evaluate the response to pandemic vaccination and seasonal and pandemic vaccine effectiveness (VE) in an Italian adult population, during the 2009?C2010 influenza season.

Methods

Data were recorded by interviewing 19,275 subjects (??35?years), randomly recruited from the general population of the Moli-sani project. Events [influenza-like illness (ILI), hospitalization and death], which had occurred between 1 November 2009 and 31 January 2010 were considered. VE was analyzed by multivariable Poisson regression analysis.

Results

Pandemic vaccine coverage was very low (2.4%) in subjects at high-flu risk, aged 35?C65?years (N?=?8,048); there was no significant preventive effect of vaccine against ILI. Seasonal vaccine coverage was 26.6% in the whole population (63% in elderly and 21.9% in middle-aged subjects at high-flu risk). There was a higher risk to develop ILI in middle-age [VE: ?17% (95% CI: ?35,?1)] or at high flu-risk [VE: ?17% (95% CI: ?39, 2)] vaccinated groups.

Conclusions

Coverage of pandemic vaccine was very low in a Southern Italy population, with no protective effect against ILI.     

Seasonal influenza vaccine effectiveness against medically attended influenza illness among children aged 6–59 months,October 2011–September 2012: A matched test-negative case–control study in Suzhou,China

BackgroundSeasonal influenza infections among young children in China lead to substantial numbers of hospitalizations and financial burden. This study assessed the seasonal influenza vaccine effectiveness (VE) against laboratory confirmed medically attended influenza illness among children in Suzhou, China, from October 2011–September 2012.MethodsWe conducted a test-negative case–control study among children aged 6–59 months who sought care at Soochow University Affiliated Children's Hospital (SCH) from October 2011–September 2012. A case was defined as a child with influenza-like illness (ILI) or severe acute respiratory infection (SARI) with an influenza-positive nasopharyngeal swab by rRT-PCR. Controls were selected from children presenting with ILI or SARI without laboratory confirmed influenza. We conducted 1:1 matching by age and admission date. Vaccination status was verified from the citywide immunization system database. VE was calculated with conditional logistic regression: (1 − OR) × 100%.ResultDuring the study period, 2634 children aged 6–59 months presented to SCH with ILI (1975) or SARI (659) and were tested for influenza. The vaccination records were available for 69% (1829; ILI: 1354, SARI: 475). Among those, 23% (427) tested positive for influenza, and were included as cases. Among influenza positive cases, the vaccination rates were 3.2% for SARI and 4.5% for ILI. Among controls, the vaccination rates were 13% for SARI, and 11% for ILI. The overall VE against lab-confirmed medically attended influenza virus infection was 67% (95% CI: 41–82). The VE for SARI was 75% (95% CI: 11–93) and for ILI was 64% (95% CI: 31–82).ConclusionsThe seasonal influenza vaccine was effective against medically attended lab-confirmed influenza infection in children aged 6–59 months in Suzhou, China in the 2011–12 influenza season. Increasing seasonal influenza vaccination among young children in Suzhou may decrease medically attended influenza-associated ILI and SARI cases in this population.     

Effectiveness of influenza vaccination in preventing influenza-like illness among community-dwelling elderly: population-based cohort study in Japan

A population-based cohort study was conducted during the 2003-2004 season to examine the effectiveness of influenza vaccine among community-dwelling elderly. The subjects consisted of 4787 elderly, ranging from 65 to 79 years. We either interviewed the elderly directly or their families regarding acute febrile illness, hospital visits, hospitalization and death by telephone every month. The vaccination status and physician-diagnosed clinical influenza (hereinafter referred as clinical influenza) were determined based on data obtained from the city office and hospitals, respectively. Influenza-like illness (ILI) was defined as an acute febrile illness (> or = 38.5 degrees C) during the epidemic period. After adjusting for confounders, vaccination decreased ILI significantly (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.17-0.85), but not clinical influenza (OR, 0.76; 95% CI, 0.28-2.06). The results were inconclusive for preventing hospitalization for influenza or pneumonia (OR, 0.37; 95% CI, 0.09-1.47) and death (OR, 3.68; 95% CI, 0.75-18.12), due to the inadequate sample size. In conclusion, the influenza vaccination was thus found to be associated with a decreased ILI during the epidemic period in community-dwelling elderly.