上海市青浦区社区预防接种门诊冷链容积评估

目的对上海市青浦区社区预防接种门诊冷链容积进行评估,为冷链合理配置提供参考。方法通过上海市疾病预防控制中心开发的免疫规划制品数据库(immunization products database,IPD)、青浦区2013年接种率监测数据库和社区预防接种门诊冷链设备数据库获得基础数据,计算各接种门诊冷链实际配备与需要量比值。结果青浦区各社区预防接种门诊冷链容积需要量以徐泾接种门诊最大(2 246.26 L),金泽分门诊最小(135.8 L)。实际容积配备量最大的为盈浦接种门诊(3 936 L)、最小为西岑接种门诊(1 102L)。配备容积相对充足的金泽(11.12)、商榻(7.80)、西岑(6.56),相对紧张的是徐泾(1.15)、白鹤(1.26)、赵巷(1.57)。青浦区各社区接种门诊2013年共使用47种疫苗,其中一类疫苗14种,二类疫苗33种;使用的14个一类疫苗产品中仅有3个产品每剂次体积100 cm3,而33个二类疫苗产品中有17个产品每剂次体积100 cm3;2013年青浦区一类疫苗、二类疫苗接种39余万剂次,一类疫苗和二类疫苗接种剂次比为1.54:1。结论青浦区社区预防接种门诊冷链容积总体容量是充足的,但在各社区接种门诊间应进行相应的优化配置,满足合理需要同时,杜绝资源浪费。     

南通市两类预防接种门诊冷链设备配置现状分析

目的了解南通市两类预防接种门诊的冷链设备配置现状,探讨冷链建设中存在的问题,为冷链设备的合理配置提供依据。方法采用调查表,收集两类预防接种门诊冷链设备类型、容积、使用年限、疫苗接种剂次以及各种疫苗体积等信息,进行比较分析。结果现有冷链设备以家用冰箱为主,使用年限≥10年的冷链设备占18.9%,数字化接种门诊的冷链设备配备要高于规范化门诊,有8.2%的冷链设备未安装自动温度监测仪。冷藏容积总体充足,部分接种单位存在不足,冷冻容积均有富余。结论部分老化设备需要更新,两类预防接种门诊冷链建设需同等对待。需建立切实可行的冷链容积评估方法,来配置冷链设备。     

2014年天津市预防接种门诊疫苗冷链事故调查分析

摘要:目的　了解天津市预防接种门诊疫苗冷链事故发生情况,分析存在问题并提出解决对策。方法　收集整理2014年天津市预防接种门诊冷链设备档案资料以及冷链事故发生情况,利用描述性流行病学分析方法进行统计分析。结果　全市预防接种门诊冷链冰箱使用年限在6～10年的占31.80%,≥11年的占12.55%。全年共发生疫苗冷链事故15次,涉及冰箱22台,造成疫苗损失8166支（粒）,其中第一类疫苗7295支（粒）,占89.33%;第二类自费疫苗871支,占10.67%。事故发生时间主要在5-10月份,占86.67%。事故原因中冰箱机械故障、电源断电、温度超标、雷击发生率分别为2.13%、1.77%、1.06%、0.12%。结论　我市预防接种门诊冷链运转情况整体良好,但仍存在部分设备老旧、运行稳定性不足、缺失有效管理措施等问题,未来应重视冷链设备的更新维护以及配套管理机制的制定与落实,并可逐步利用信息化技术手段,提升冷链监测管理水平。     

中国2022年疾病预防控制机构和预防接种单位疫苗冷链设备现况

目的 评估中国疾病预防控制机构(Center for disease control and prevention, CDC)和预防接种单位疫苗冷链设备现况。方法 基于省级免疫规划信息系统收集截至2022年12月31日各级CDC和接种单位冷链设备信息,进行描述性分析。结果 2022年中国各级CDC和接种单位现有冷链设备共359 696个,平均每万人口拥有2.55个,平均每个机构拥有4.60个,平均使用年限(中位数)为3.08年;冷库、医用冰箱、非医用冰箱、冷藏车、疫苗运输车、冷藏箱/包和发电机组的每万人口拥有数量分别为0.09座、1.27台、0.62台、0.04辆、0.01辆、0.46个和0.06个;平均使用年限(中位数)分别为2.29年、2.61年、4.58年、2.22年、3.73年、2.17年和2.16年。结论 中国2022年CDC和接种单位疫苗冷链系统建设得到进一步发展,新型冠状病毒疫苗大规模接种工作促进了疫苗冷链设备更新补充。     

一种基于疫苗体积和接种数的冷链容积评价方法

目的介绍一种基于疫苗体积和接种数的冷链容积评价方法。方法将疫苗单剂次体积乘以其接种剂次数,再考虑库存系数和空间系数,得到储存这些疫苗的冷链容积需要量（Vaccine-cold-chain Capacity Needs,VCN）。当前实际的冷链设备容积除以VCN得到评价指标——冷链容积匹配度（Matching for Vaccine-cold-chain Capacity,MVC）,用于评价当前冷链容积是否满足疫苗储存所需。MVC的数值转化为等级评价,共有过剩、充足、合适、略低、较低和过低六种结论。结果利用前述方法对上海市2010年预防接种门诊（门诊,下同）的MVC进行测算和评价,按开展常规免疫接种储存1个月和2个月疫苗量测算,平均MVC分别为7.30/门诊和3.65/门诊,两种情况下各有98.1%和86.5%的门诊处于冷链容积过剩/充足/合适状态。按含麻疹成分疫苗补充免疫活动当月使用的疫苗量测算,平均MVC为1.22/门诊,总体仍处于充足状态,但有50.0%门诊的MVC处于略低/较低/过低状态。结论此冷链容积评价方法可以计算VCN,并评价其与实有量之间是否匹配,为冷链设备配置提供参考。     

预防接种门诊冷链自动监测系统应用效果评价

目的了解预防接种门诊冷链运转情况,评价冷链自动监测系统使用效果。方法在市区、郊区、郊县分别选取1个区(县)记录使用自动监测系统前后的手工和自动模式下的监测数据,比较二者差异。结果 3个区(县)冷链冰箱5年内购置比例为60.14%,手工与自动监测模式下,冰箱机械故障、电源断电、停机维护、温度超标这4种异常事件发生率分别为2.90%、2.17%、19.57%、5.80%和8.70%、17.39%、16.67%、23.19%。采用自动监测系统后机械故障、电源断电、温度超标的报告数量较手工方式分别提高了2倍、7倍、3倍,郊县提升幅度最为明显。结论相对手工管理模式,冷链自动监测系统在完整性、准确性、及时性、敏感性等方面具有明显优势,对于保障预防接种门诊冷链安全具有重要作用,应进一步推广使用。     

呼和浩特市2008年冷链设备容积调查

目的了解目前呼和浩特市、旗县区、乡镇各级疾病预防控制机构冷链设备容积现状,给今后装备冷链设备提供科学依据。方法随机抽查一个县的一个乡,调查其实际冷链设备情况,同时根据报表资料及领苗情况记录,查看运转一次的疫苗数量,从而进一步计算各级疾控机构冷链设备所需的容积。结果各旗县区冷链设备的容积普遍不能满足工作需要,仅仅武川县由于接种二类疫苗少,尚能够满足需要。结论基层冷链设备容积普遍不足,需要进一步地完善。     

2010年与2017年郑州市预防接种门诊建设比较

目的了解郑州市基层预防接种单位建设发展情况。方法采用t检验、χ~2检验等方法比较2010年和2017年郑州市预防接种门诊的数量、级别、主要冷链设备、信息化建设。结果 2010年和2017年示范预防接种门诊比例差异有统计学意义(χ~2=40.433,P=0.001)。2017年城区与非城区低温冰箱的数量差异有统计学意义(t=2.250,P=0.042),平均每个预防接种门诊接种台小冰箱从0增加到1.93台。2017年城区和非城区平均每个预防接种门诊疫苗电子订单系统的配备有统计学意义(t=22.500,P=0.013)。结论郑州市预防接种门诊综合服务能力提升,疫苗全程冷链得到实现,信息化建设取得长足进步。     

北京市大规模群体性预防接种冷链容积需求增加的应对模式探索

北京市自2007年起每年10-11月份为户籍60岁及以上老年人和中小学生免费接种流感疫苗.2019年的接种数据显示,10月份北京市疫苗接种量为183.39万剂,是其余常规接种月平均接种量的2.59倍.接种量的增多,使疫苗储存运输的冷链容积需求也相应增多.本研究通过对预防接种门诊的实地调查,与北京市区级疾病预防控制中心冷...     

上海市闵行区预防接种门诊冷链配置现状评价

随着扩大免疫规划的全面实施,国家免疫规划疫苗从6种增加到14种,社区预防接种门诊的服务剂次量显著增加。同时,由于闵行区是上海市主要的人口导入区,人口的不断导入也带来了社区预防接种量的逐年上升。     

合肥市冷链建设和疫苗管理工作现状调查分析

目的了解合肥市级、县（区）级疾病预防控制中心（CDC）和预防接种门诊点的冷链配置及使用、疫苗管理情况,为规范全市冷链建设和疫苗管理工作提供依据。方法采用横断面调查方法,通过现场访谈和实地实物查看,了解全市各级CDC和预防接种门诊冷链和疫苗管理现状。结果共调查216家单位,冷链储存容积较为紧张,基层仍然需要更新和优化冷链设备。其中5个县区CDC需要冷藏车,26个预防接种门诊点需要立式冷藏柜。有30.20%～32.70%的单位没有冷链管理制度和疫苗管理制度;有39.70%的单位建立了冷链和疫苗管理的应急预案;有33.80%的单位药房的疫苗储存温度记录不健全;26.10%的单位周末或假日不记录冰箱温度;大部分县区CDC和预防接种门诊点未实施冷库和冰箱温度短信报警工作。46.80%的单位对于过期或者破损疫苗履行报废手续,并送至定点单位进行报废处理。结论合肥市目前冷链配备尚不能完全满足工作需求,冷链和疫苗信息化管理程度不高。     

常州市2008年报告预防接种副反应特征分析

目的了解常州市报告预防接种副反应(AEFI)分布特征,为制定AEFI策略提供科学依据。方法对儿童预防接种管理信息系统上的统计数据及查阅计划免疫报表进行分析。结果该市2008年报告AEFI共126例,发生率达0.37/10万,发生AEFI的主要疫苗有流脑、百白破等,一般反应为主,占84.92%,异常反应占12.70%,偶合症占2.38%。≤1岁的儿童占69.05%,预防接种后≤1日发生率占90.48%,临床分型以发热为主,其次为过敏性皮疹、卡介苗淋巴结炎。因疫苗生产企业无法录入致个案完整率99.21%。结论预防AEFI需加强对工作的督导,强化预防接种告知制度和接种前的健康检查;儿童预防接种信息管理系统需逐步完善。     

Thermotolerance of an inactivated rabies vaccine for dogs

This study provides the first robust data that the antibody response of dogs vaccinated with Nobivac® Rabies vaccine stored for several months at high temperatures (up to 30 °C) is not inferior to that of dogs vaccinated with vaccine stored under recommended cold-chain conditions (2–8 °C). A controlled and randomized non-inferiority study was carried out comparing the four-week post vaccination serological responses of Tanzanian village dogs inoculated with vaccine which had been stored at elevated temperatures for different periods of time with those of dogs vaccinated with the same product stored according to label recommendations. Specifically, the neutralizing antibody response following the use of vaccine which had been stored for up to six months at 25 °C or for three months at 30 °C was not inferior to that following the use of cold-chain stored vaccine. These findings provide reassurance that the vaccine is likely to remain efficacious even if exposed to elevated temperatures for limited periods of time and, under these circumstances, it can safely be used and not necessarily destroyed or discarded. The availability of thermotolerant vaccines has been an important factor in the success of several disease control and elimination programs and could greatly increase the capacity of rabies vaccination campaigns to access hard to reach communities in Africa and Asia. We have not confirmed a 3-year duration of immunity for the high temperature stored vaccine, however because annual re-vaccination is usually practiced for dogs presented for vaccination during campaigns in Africa and Asia this should not be a cause for concern. These findings will provide confidence that, for rabies control and elimination programs using this vaccine in low-income settings, more flexible delivery models could be explored, including those that involve limited periods of transportation and storage at temperatures higher than that currently recommended.     

中国流感疫苗预防接种技术指南(2018-2019)

接种流感疫苗是预防流感病毒感染及其并发症的最有效手段。目前,我国国内批准上市的灭活流感疫苗为三价（ⅡV3）和四价（ⅡV4）疫苗,包括裂解疫苗和亚单位疫苗。流感疫苗在我国大多数地区属于第二类疫苗,实行自愿、自费接种。为指导我国流感预防控制和疫苗应用工作,中国CDC国家免疫规划技术工作组流感疫苗工作组综合国内外最新研究进展,对2014年版指南进行了更新和修订,形成了《中国流感疫苗预防接种技术指南（2018－2019）》。本指南主要更新了以下内容：流感的流行病学和疾病负担,流感疫苗的种类、2018－2019年度流感疫苗抗原组份、ⅡV3和ⅡV4疫苗的免疫反应、免疫持久性、免疫原性、效力、效果、安全性、成本效果和成本效益等;并基于现有的科学证据,提出了2018－2019年度流感疫苗预防接种的建议。本指南建议：原则上,接种服务单位应为≥6月龄所有愿意接种流感疫苗且无禁忌证的人提供接种服务。对可接种不同类型、厂家疫苗产品的人群,可由受种者自愿选择接种任一种流感疫苗,无优先推荐。为降低高危人群罹患流感及感染后发生严重临床结局的风险,指南推荐6月龄至5岁儿童、≥60岁老年人、慢性病患者、医务人员、<6月龄婴儿的家庭成员和看护人员以及孕妇或准备在流感季节怀孕的女性为优先接种对象;首次接种流感疫苗的6月龄至8岁儿童应接种2剂次,间隔≥4周;2017－2018年度或以前接种过≥1剂次流感疫苗的儿童,建议接种1剂次;≥9岁儿童和成年人仅需接种1剂次。建议各地防疫部门在疫苗供应到位后尽快安排接种工作,最好在10月底前完成免疫接种;对10月底前未接种的对象,整个流行季节都可以提供接种服务;孕妇在孕期的任一阶段均可接种流感疫苗。本指南适用于从事流感防控相关的各级CDC工作人员,预防接种点的接种人员,各级医疗机构儿科、内科、感染科等医务人员,以及各级妇幼保健机构的专业人员。     

Impact of seasonal influenza vaccination in the presence of vaccine interference

BackgroundAnnual influenza vaccination is a key to preventing widespread influenza infections. Recent reports of influenza vaccine effectiveness (VE) indicate that vaccination in prior years may reduce VE in the current season, suggesting vaccine interference. The purpose of this study is to evaluate the potential effect of repeat influenza vaccinations in the presence of vaccine interference.MethodsUsing literature-based parameters, an age-structured influenza equation-based transmission model was used to determine the optimal vaccination strategy, while considering the effect of varying levels of interference.ResultsThe model shows that, even in the presence of vaccine interference, revaccination reduces the influenza attack rate and provides individual benefits. Specifically, annual vaccination is a favored strategy over vaccination in alternate years, as long as the level of residual protection is less than 58% or vaccine interference effect is minimal. Furthermore, the negative impact of vaccine interference may be offset by increased vaccine coverage levels.ConclusionsEven in the presence of potential vaccine interference, our work provides a population-level perspective on the potential merits of repeated influenza vaccination. This is because repeat vaccination groups had lower attack rates than groups that omitted the second vaccination unless vaccine interference was at very high, perhaps implausible, levels.     

The contribution of vaccine manufacturers to the establishment of vaccination policies

Aim  This paper seeks to analyse the contribution of vaccine manufacturers to the establishment of immunisation policies. Subjects and methods  The recent evolution of the role of industry from product development to post-licensure studies is reviewed in detail. Results  The primary responsibility of vaccine manufacturers has always been to develop vaccines and demonstrate their safety and efficacy. However, with the development of new vaccines it appears that vaccine manufacturers are expected to go beyond this role and to provide policy-makers with additional information required to support the establishment of optimal vaccination policies. This includes conducting extensive post-licensure risk management plans as part of follow-up measures to the initial marketing authorisation. Manufacturers are also requested to generate information on the epidemiology of the disease to be prevented as well as health-economics data and to assess the expected impact of the vaccine in the population. This requires additional in-house skills, external collaborations, not to mention considerable financial investment. Conclusion  Over the recent decades new functions and departments have been created to address all the technical aspects leading to the introduction and adoption of new vaccines, such as risk management, epidemiology, policy affairs, and outcome research. Nevertheless such activities cannot be properly conducted or managed without an active partnership between the private sector and national or international public heath or academic institutions.     

台州市2018/2019年度社区老年人接种流感疫苗的保护效果

目的评估台州市2018/2019年度社区老年人接种三价灭活流感疫苗(TIV)的保护效果(VE)。方法运用前瞻性队列研究设计,招募接种和未接种TIV的≥60岁社区老年人随访6个月,观察流感样疾病(ILI)、因ILI就诊、因ILI或肺炎住院、因呼吸或循环系统疾病住院4种临床结局,计算TIV的VE。结果 TIV接种组、未接种组分别纳入研究对象1 048名、1 025名。接种TIV后1-3月预防4种临床结局的VE(95%CI)分别为-25.1(-80.4-13.2)%、-33.1(-99.2-11.1)%、35.8(-124.9-81.7)%和-12.6(-229.2-61.5)%;接种TIV后4-6月分别为25.5(-7.5-48.4)%、35.1(3.0-56.5)%、1.4(-249.1-72.1)%和-11.5(-240.9-63.5)%;接种TIV后1-6月分别为5.9(-24.2-28.7)%、11.6(-18.9-34.3)%、21.7(-99.2-69.2)%和-13.9(-155.5-49.2)%。结论台州市2018/2019年度社区老年人接种TIV对预防ILI病例发病、就诊和相关住院具有一定的保护效果。     

Improving knowledge on vaccine storage management in general practices: Learning effectiveness of an online-based program

BackgroundAdequate vaccine storage is a prerequisite for assuring effective vaccinations yet storage conditions in practices are frequently inadequate. The online learning program Keep Cool aims at improving knowledge on international best practices. This study evaluates the program’s learning effectiveness focusing on key indicators for knowledge on vaccine storage, such as temperature target range (2 to 8 °C) and documentation requirements.MethodsParticipants were recruited from within a university teaching practice network. Knowledge was measured with an online-based questionnaire (11 correct items = optimal vaccine storage knowledge) which was completed before and after the online program.Results60 physicians and practice assistants from 25 practices participated. The mean knowledge score was 5.6 correct answers (standard deviation [SD] 1.9), which increased to 9.8 (SD 1.2) after program participation (p < 0.001). The item with the highest net change addressed the need for twice-daily documentation of temperatures (+76.7%). Knowledge of the lower and upper temperature targets improved from 58% respectively 63% to 100% each. Optimal vaccine storage knowledge after participation (38% of participants) was associated neither with age, gender, occupational group nor practice type.ConclusionThe new online education program showed a high learning effectiveness regarding key indicators for the quality of vaccine storage management.Clinical Trial Registry Number: DRKS00006561.     

UAE efforts in promoting COVID-19 vaccination and building vaccine confidence

The United Arab Emirates (UAE) is leading globally in many indicators for tackling the COVID-19 pandemic. This ranges from taking adequate preventive measures to the free vaccination drive and viable public health strategy. As of 18 August 2021, the UAE has significantly reduced the number of cases and successfully administered 17,454,250 doses. Furthermore, efforts and plans are underway to provide the third dose to high-risk people three months after completing the second dose and six months later to others. The UAE is considered one of the leaders globally for vaccinating “medically eligible” residents against COVID-19, with over 70% of the population currently fully vaccinated in the drive towards achieving herd immunity. The UAE's vaccination program is on track, covering a significant part of the population. The massive efforts of the National Vaccination Program's roll-out made by the UAE government and the various health authorities and stakeholders were vital for the general public's active participation in its success.