2017—2018年北京市丰台区小学生流感疫苗接种及保护效果评价

目的 了解2017—2018年北京市丰台区小学生流感疫苗接种情况,分析流感疫苗接种在发生流感聚集性疫情时的保护作用。方法 选取2017年北京市丰台区小学集中接种免费流感疫苗资料和2017—2018年流感流行季发生的流感聚集性疫情调查资料,进行疫苗接种率和流感疫苗保护效果分析。 结果 2017年北京市丰台区107所小学及其分校集中接种免费流感疫苗,在册学生共71 103人,接种人数35 721人,疫苗接种率为50.24%。2017—2018年流感流行季期间,全区共23所小学上报经实验室检测确认的流感聚集性疫情39起,共报告408例病例,发生流感聚集性疫情数量越多、规模越大、疫情发生后产生续发病例的学校,疫苗接种率越低。接种组小学生在流感聚集疫情发生时发病率为22.70%,未接种组发病率为30.30%,疫苗保护率为25.11%,效果指数为1.34。 结论 接种流感疫苗可减少流感聚集性疫情的发生和扩散,在流感聚集性疫情发生时对学生有一定的保护作用,应加强健康教育和公众交流,进一步提高流感疫苗的接种率。     

东丽区65岁以上老人流感疫苗接种效果评估

目的评价东丽区65岁以上户籍老年人免费接种流感疫苗的效果。方法选取东丽区2 0 1 4年免费接种过流感疫苗的51 2人65岁以上老年人为接种组,同时选取与接种组性别、年龄、身体状况等相匹配未接种过流感疫苗的3 60名65岁以上老年人为对照组,在流感疫苗接种后半年开展问卷调查,分析两组流感样症状及并发症的发病情况。结果接种流感疫苗对流感样症状的保护率为83.4 7%;对感冒后合并心肺并发症的保护率为81.73%;对普通感冒样症状的保护率为2 8.4 6%;接种流感疫苗发生接种反应的发生率为4.4 9%,均为一般反应。结论老年人接种流感疫苗安全有效。     

医务人员流感疫苗免费接种措施实施效果评价及改进建议

目的 了解医务人员流感疫苗免费接种措施实施效果,探讨影响其是否接受免费接种的主要因素并提出改进建议。 方法 将成都市妇女儿童中心医院儿童门急诊全部医务人员作为调查对象,按自我意愿分为接种组与对照组。分析措施实施前后医务人员流感疫苗接种意愿、接种行为的改变及其影响因素,并对接种组与对照组流感发病率进行比较。 结果 实施流感疫苗免费接种措施后医务人员接种意愿由实施前的56.40%提高至87.20%,接种率由23.93%提高至66.58%,增幅明显;接种疫苗组发病率为5.34%,未接种疫苗组发病率为11.35%,差异有统计学意义(χ²=4.982,P＜0.05)。 结论 流感疫苗免费接种措施能有效提高医务人员接种意愿和促进接种行为,降低医务人员流感发病率,今后可通过提前宣传培训、灵活接种方式、实施配套鼓励等措施,进一步提高医务人员接种率。     

干休所75岁以上老年人接种流感疫苗效果观察

目的评价居住在干休所中75岁以上老年人流感疫苗接种的预防效果。方法 2007年9～11月选取干休所接种流感疫苗的162例75岁以上老年人为接种组;同时按照年龄、性别、合并慢性疾病情况匹配,选取未接种流感疫苗的157例75岁以上老年人为对照组。调查分析流感疫苗接种后1年内两组老年人流感样疾病发病及就诊情况,以及慢性心脑血管疾病、慢性呼吸系统疾病、糖尿病等发病(复发)及就诊情况。结果接种组流感样疾病患病率22.22%,就诊率19.75%,均明显低于对照组患病率33.12%,就诊率31.21%,(P<0.05)。接种组心脑血管疾病、呼吸系统疾病、糖尿病(复发)患病率与对照组比较差异无统计学意义,就诊率62.96%明显低于对照组78.98%(P<0.01)。接种组接种疫苗后26例(16.05%)出现局部或全身反应,经对症处理后均恢复正常。结论接种流感疫苗可有效减少75岁以上老年人流感样疾病的发生,并能减少心脑血管疾病、呼吸系统疾病、糖尿病等疾病的就诊率。     

公众流感疫苗认知、接种现状及影响因素分析

目的 了解公众流感疫苗认知、接种现状及影响因素,为提高流感疫苗接种率提供科学依据。 方法 2020年1月15日—4月30日期间,使用12320公益电话平台,对广州、廊坊、南京、苏州、太原和重庆等6地区公众流感疫苗认知和2019—2020年流感季流感疫苗接种现状开展电话调查,采用多因素logistic回归模型分析影响不同年龄段公众流感疫苗接种率的相关因素。 结果 有效应答共计12 263人。2019—2020年流感季,16.34%(1 959/11 989)受访者曾咨询过流感疫苗接种事宜,流感疫苗接种比例为12.95%(1 529/11 810),其中6月龄~5岁儿童接种比例为26.84%(877/3 267),6~17岁学生为14.78%(245/1 658),18~59岁成年人为3.99%(199/4 989),≥60岁老年人为10.97%(208/1 896)。仅5.22%(202/3 866)受访者认为流感疫苗不安全,74.85%(3 785/5 057)认为流感疫苗具有中等和较好的保护效果。多因素logistic回归分析显示,免费接种、咨询流感疫苗接种、认为流感疫苗保护效果好、接种方便可促进流感疫苗的接种。 结论 公众对流感疫苗安全性和保护效果认可度较高,作为流感重症高危人群的5岁以下儿童和老年人需要进一步提升流感疫苗接种覆盖率。加大对流感疫苗相关知识宣传力度,提供便捷的咨询和接种服务可提高公众流感疫苗接种率。     

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。     

广州市越秀区托幼机构流感样病例暴发疫情经济负担评估和流感疫苗卫生经济学评价

目的 对广州市越秀区学龄前儿童的流感经济负担进行评估,并针对流感疫苗开展卫生经济学评价,为制定免疫规划策略提供依据。方法 以广州市越秀区托幼机构2019年1—6月发生的9起流感样病例暴发疫情的患病儿童为研究对象,采用问卷调查的方式开展经济负担评估,并以其中1起暴发疫情为基础建立SEIAR动力学模型,模拟不同接种策略下的疫情趋势,评价其经济学效益。结果 患病儿童总经济负担人均1 293.56（95% UI:1 096.23~1 592.84）元,其中直接医疗费用人均422.56（95% UI:320.71~555.29）元,直接非医疗费用人均125.95（95% UI:82.41~188.80）元,间接经济损失人均797.03（95% UI:661.50~938.76）元。在流行季前接种1剂次三价流感疫苗,每投入226.19元,可减少1例流感病例,每投入1元,可获得5.72元效益;接种2剂次三价流感疫苗,每投入178.77元,可减少1例流感病例,每投入1元,可获得7.24元效益;接种四价流感疫苗,每投入315.83元,可减少1例流感病例,每投入1元,可获得4.10元效益。结论 广州市越秀区托幼机构流感样病例暴发疫情经济负担较高,如在流行季前接种2剂次三价流感疫苗,可以获得正效益和最好的效益成本比。     

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。     

北京市老年人群流行性感冒疫苗免疫效果及成本效益评价

目的评价老年人群接种流行性感冒(流感)疫苗的效果和效益。方法选取北京市朝阳区和宣武区590名接种过流感疫苗,且年龄>60岁的老年人群为接种组,在社区中随机选择与接种组年龄、性别、健康状况等相匹配的602名未接种流感疫苗者为对照组。采用流行病学试验方法,在基线调查的基础上,分别于流感疫苗接种(基线调查)后的第1、3和6个月对试验组和对照组进行随访调查。结果接种组流感样疾病的发病率和就诊率均低于对照组,接种后第1、3和6个月内流感疫苗对流感样疾病的保护率分别为52.38%、36.84%和37.89%;接种流感疫苗减少流感样疾病就诊率分别为45.16%、50.54%和50.54%。接种组患感冒、其他呼吸系统疾病和慢性病的发病率和就诊率低于对照组,接种流感疫苗对感冒、其他呼吸道疾病和其他慢性疾病的保护率分别为49.54%、64.54%和38.82%。老年人群接种流感疫苗后第3和6个月内所获得的效益成本比为4.97∶1和4.98∶1。结论老年人群接种流感疫苗能有效地预防流感样疾病的发生,降低流感相关慢性疾病的发病率和复发率,且能够获得较高的成本效益。     

海宁市老年人流感疫苗接种效果评价

目的评价海宁市老年人流感疫苗接种效果,为提高流感疫苗接种率提供依据。方法于2018年11月选取海宁市17家卫生院免费接种过流感疫苗的≥60岁老年人为接种组,以同期来卫生院进行基本公共卫生体检而未接种流感疫苗的≥60岁老年人为对照组。采用自行设计的调查问卷收集人口学信息及流感、普通感冒、流感样病例(ILI)、门诊就医和住院治疗发生情况,采用多水平Logistic回归模型分析流感疫苗接种效果。结果接种组349人,对照组346人,两组年龄、性别、居住地、文化程度、职业、年收入和自评健康状况差异均无统计学意义(P0.05)。对照组流感、普通感冒、ILI、门诊就医与住院治疗的发生率分别为2.30%、21.40%、2.99%、16.00%和1.61%;接种组分别为1.00%、18.44%、1.73%、12.17%和0.91%。多水平Logistic回归模型分析结果显示,接种流感疫苗可降低流感发生风险(OR=0.312,95%CI:0.108～0.897),减少门诊就医行为(OR=0.732,95%CI:0.567～0.944)。结论老年人接种流感疫苗可有效减少流感发生和门诊就医行为。     

Evolution of influenza vaccination coverage in France from 2001 to 2006

INTRODUCTION: The increased risk of a new influenza pandemic has raised awareness of the need for high influenza vaccination rates. OBJECTIVES: This study aims at assessing trends in influenza vaccination coverage from 2001 to 2006 in France, at understanding the drivers and barriers, and to identify vaccination intentions for 2006/2007. METHODS: We conducted a mail-based household survey on 9,835 persons representative of the population from age 15. Essentially, the same questionnaire was used in all seasons. RESULTS: The influenza vaccination coverage rate slightly increased, reaching 24.2% in 2005/2006 (70.1% in patients over 65). In the last two seasons the fact that the vaccination was provided for free was the most frequent reason for getting vaccinated. Older age, considering influenza as a serious disease and recommendations from the family doctor or nurse were also important drivers for vaccination. Only 2% of those vaccinated in 2005/2006 indicated the threat of avian influenza as a reason. The reasons for non-vaccination among persons never vaccinated before were feeling too young for vaccination, never having considered vaccination before and absence of recommendation by the family doctor. Among those who were previously vaccinated but not in the current season, the reasons for not being vaccinated were not finding vaccination necessary, forgetfulness and having influenza-like illness despite vaccination. CONCLUSION: Stable vaccination rates were observed from 2001 to 2006. France is well on its way to reach the international vaccination goal set by the WHO (75% in the elderly population), but continuously effort is needed for others.     

Rapid assessment of influenza vaccine effectiveness: analysis of an internet-based cohort

The effectiveness of influenza vaccination programmes is seldom known during an epidemic. We developed an internet-based system to record influenza-like symptoms and response to infection in a participating cohort. Using self-reports of influenza-like symptoms and of influenza vaccine history and uptake, we estimated vaccine effectiveness (VE) without the need for individuals to seek healthcare. We found that vaccination with the 2010 seasonal influenza vaccine was significantly protective against influenza-like illness (ILI) during the 2010-2011 influenza season (VE 52%, 95% CI 27-68). VE for individuals who received both the 2010 seasonal and 2009 pandemic influenza vaccines was 59% (95% CI 27-77), slightly higher than VE for those vaccinated in 2010 alone (VE 46%, 95% CI 9-68). Vaccinated individuals with ILI reported taking less time off work than unvaccinated individuals with ILI (3.4 days vs. 5.3 days, P<0.001).     

Assessment of efficacy and economic impact of an influenza vaccination campaign in the personnel of a health care setting

INTRODUCTION: Although vaccination against influenza is a well-established practice among the elderly in rest homes, in community-dwelling elderly people and in persons with underlying medical conditions associated with a high risk of complications, vaccination of workers is not always considered cost-effective, even though influenza is high on the list of diseases of public health importance. The aim of this study was to evaluate the efficacy and the cost-benefit ratio of an influenza vaccination campaign in health care workers (HCW) of a teaching hospital. METHODS: A group of 423 HCW vaccinated against influenza during the 2002-2003 winter season was compared with a group of subjects not vaccinated, matched for sex and working area. The following outcomes were considered: (i) prevalence of influenza-like illness (ILI); (ii) days of absence from work due to ILL The cost-benefit ratio was calculated with a model using the following indices. indirect benefits (IB), indirect non medical costs (IC) and direct costs (DC). RESULTS: The prevalence of ILI in the non vaccinated group (102 cases out of 423 subjects, 24%) was significantly increased (p < 0.001) compared with vaccinated subjects (64 cases out of 423, 15%). Working days lost for ILI were 516 in the non-vaccinated group versus 315 reported in the vaccinated group. Economic impact evaluation showed a cost of Euro 35,786.88 in vaccinees and of Euro 57,759.52 in the non-vaccinees. The resulting IB was Euro 21,078.64. The DC and IC for vaccination were Euro 2,463.29 and Euro 2,172.53 respectively. The overall cost-benefit ratio (IB/DC+IC) was 4.5. DISCUSSION: The study shows that the influenza vaccination campaign was effective in preventing the influenza syndrome in HCW The economic impact assessment shows a cost-saving with an important cost-benefit ratio. This study suggests that a continuous effort should be recommended to increase the compliance of HCW with vaccination practice both to reduce their chance of becoming infected and for the economic benefits for healthy working adults.     

Influenza vaccination rates and motivators among healthcare worker groups.

BACKGROUND: The rate of influenza vaccination among healthcare workers (HCWs) is approximately 40%. Differences in vaccination rates among HCW groups and reasons for accepting or rejecting vaccination are poorly understood. OBJECTIVES: To determine vaccination rates and motivators among different HCW groups during the 2004-2005 influenza season. DESIGN: Cross-sectional survey conducted between July 10 and September 30, 2005. SETTING: Two tertiary care teaching hospitals in an urban center. PARTICIPANTS: Physicians, nurses, nursing aides, and other staff. Surveys were collected from 1,042 HCWs (response rate, 42%). RESULTS: Sixty-nine percent of physicians (n=282) and 63% of medical students (n=145) were vaccinated, compared with 46% of nurses (n=336), 42% of nursing aides (n=135), and 29% of administrative personnel (n=144). Physicians and medical students were significantly more likely to be vaccinated than all other groups (P<.0001). Pediatricians (84%) were more likely than internists (69%) and surgeons (43%) to be vaccinated (P<.0001). Among the HCWs who were vaccinated, 33.4% received the live attenuated influenza vaccine (LAIV) and 66.6% received trivalent inactivated influenza vaccine (TIV). Vaccinated HCWs were less likely than unvaccinated HCWs to report an influenza-like illness (P=.03). Vaccination with LAIV resulted in fewer episodes of influenza-like illness than did receiving no vaccine (P=.03). The most common reason for rejecting vaccination was a concern about availability. Understanding that HCWs may transmit the virus to patients correlated with vaccine acceptance (P=.0004). CONCLUSIONS: Significant differences in vaccination exist among physician specialties and employee groups, and there are inadequate vaccination rates among those with the greatest amount of patient contact, potentially providing a basis for group-specific interventions.     

Influenza outbreaks in nursing homes: how effective is influenza vaccine in the institutionalized elderly?

During the 1984-1985 influenza season, outbreaks of influenza A (H3N2) occurred in three Connecticut nursing homes. Influenza vaccination rates were 67% (96 out of 144), 35% (30 out of 85) and 69% (332 out of 483), respectively. The relative risk of illness for vaccinated compared to unvaccinated residents was 1.8 (95% confidence interval, 0.6, 5.9), 1.6 (95% confidence interval, 0.8, 3.0) and 1.1 (95% confidence interval, 0.8, 1.7) for each of the three nursing homes, respectively. In the third outbreak, 22 vaccinated residents without clinical illness had a geometric mean titer of hemagglutination-inhibition (HI) antibody of 20. Although low, this titer was significantly higher than that of nine unvaccinated residents without clinical illness (12, p less than .05); only three (14%) vaccinated residents had HI titers of greater than or equal to 40. These results suggest that levels of HI antibody in vaccinated residents were not protective at the time of the third outbreak, four to five months after vaccination. In general, the study of vaccine effectiveness in nursing homes is limited by sample size and statistical power. Despite these limits, the retrospective investigation of influenza outbreaks in nursing homes is often the only practical way to evaluate influenza vaccine effectiveness in the elderly on a yearly basis.     

2020—2021年度温州市鹿城区儿童流感疫苗应用现状及安全性和保护效果研究

目的 评价2020—2021年度温州市鹿城区儿童流感疫苗的接种现状、安全性以及保护效果。方法 以温州市人民医院2020年9—12月儿童保健科门诊接诊儿童为调查对象，对7 053例6月龄～14周岁受调查儿童流感疫苗接种情况进行统计，并选取500例接种儿童作为观察组，同期500例未接种儿童作为对照组，观察疫苗接种不良反应情况以及疫苗的保护效果。结果 7 053例受调查儿童中，疫苗接种率为7.60%(536例),其中完全接种者占54.10%(290/536)。接种流感疫苗的500例观察组儿童不良反应发生率为3.4%,以发热、接种部位疼痛和红肿为主。随访1年，观察组患病风险是对照组的0.43倍，疫苗保护效果达62.8%(95%CI:46.2%～74.2%)。6～35 m组部分接种、完全接种疫苗保护效果分别为22.2%(95%CI:0.0%～73.9%)、59.4%(95%CI:6.3%～82.4%);36～59 m组部分接种疫苗、完全接种疫苗保护效果分别为48.7%(95%CI:5.2%～72.2%)、79.2%(95%CI:29.9%～93.8%);5～14岁组部分接种、完全接种疫苗保护效果...     

The effect of mass influenza immunization in children on the morbidity of the unvaccinated elderly

The objectives of these studies were to analyse the effect of mass influenza immunization in children on the morbidity of unvaccinated non-institutionalized elderly during an influenza epidemic. A mass vaccination campaign with vaccine was conducted in children aged 3-6 years attending kindergartens (57.4% of 6374) and aged 7-17 years attending schools (72% of 34237) in two communities of the Moscow region. The clinical effectiveness of vaccination was 60.9% for kindergartens and 68.8% for schools. There were 3.4 times fewer episodes of influenza-like illnesses and 1.7-2.6 fewer episodes in all seven diseases which are possible complications of influenza out of the 10 evaluated diseases in 158451 unvaccinated non-institutionalized elderly people during the influenza epidemic compared with the control communities. The differences were found to be statistically significant. Mass vaccination of children attending child institutions brought about a significant reduction of both influenza-like illnesses in children and influenza-associated illnesses in unvaccinated non-institutionalized elderly persons living in the home setting.     

Influenza vaccine effectiveness among elderly persons living in the community during the 2003--2004 season

To examine the effectiveness of influenza vaccine among community-dwelling elderly (65-79 years old), we conducted a population-based cohort study during the 2003--2004 influenza season. A total of 4787 elderly individuals were interviewed 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. After adjusting for confounders, the odds ratio (OR) of vaccination for influenza-like illness (ILI) with high-fever, which was defined as an acute febrile illness (> or =38.5 degrees C) during the epidemic period, was 0.38 (95% confidence interval [CI], 0.17-0.85) and the OR for clinical influenza was 0.76 (95%CI, 0.28-2.06). Due to the inadequate sample size, ORs 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) were not conclusive. These results suggested that vaccination was therefore effective for elderly persons living in the community.