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...     

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。     

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。     

湖南省5个地区6月龄-5岁儿童流感疫苗接种率和影响因素北大核心

目的探讨湖南省6月龄-5岁儿童流感疫苗接种率和影响因素。方法采用分层整群抽样法选取湖南省5个市州15个社区或幼儿园的6月龄-5岁儿童,对儿童家长进行问卷调查,分析2019年度儿童流感疫苗接种率及其影响因素。结果调查地区6月龄-5岁儿童2019年度流感疫苗接种率为37.4%(453/1212)。Logistic回归分析显示,过去1年儿童就医次数、儿童体质、可接受的疫苗价格、家长流感相关知识、接种医务人员流感疫苗介绍是影响儿童流感疫苗接种的显著性因素。结论湖南省6月龄-5岁儿童流感疫苗接种率低;建议加强儿童流感疫苗接种宣传,推行儿童免费接种流感疫苗。     

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。     

湖州市5岁及以下儿童家长流感疫苗接种知识认知调查及接种率的影响因素分析

目的调查湖州市5岁及以下儿童家长流感疫苗接种知识认知情况及接种现状,并分析接种率的影响因素。方法选择2016年7月—2020年4月在湖州市第一人民医院就诊的儿童为研究对象。采用分层抽样的方法,按照儿童的年龄(1岁以下、1岁~、2岁~、3岁~、4岁~、5岁~)抽取6个年龄组,每组随机抽取83名,总计498名。对抽中的儿童家长进行问卷调查。调查湖州市5岁及以下儿童家长流感疫苗接种知识认知情况及接种现状,接种率的影响因素予以单因素及多因素logistic回归分析。结果共发放498份问卷,回收有效问卷480份,回收率为96.39%。在480名被调查对象中,47.50%的家长是通过接种医生推荐了解到流感疫苗相关知识,65.83%的家长知道流感疫苗需要每年接种,72.08%的家长知道流感疫苗不可以完全预防流感,93.33%的家长希望流感疫苗能够免费接种。在480名被调查对象中,约有86名家长给儿童接种流感疫苗(占比17.92%),剩余394名家长未给儿童接种流感疫苗(占比82.08%)。单因素分析结果显示,湖州市5岁及以下儿童接种率与家长的年龄、性别无关(P>0.05),而与家长的文化程度、户籍、职业、家庭人均月收入、医疗费用来源有关(P<0.05)。经多因素logistic回归分析发现:家长的文化程度、职业、家庭人均月收入是湖州市5岁及以下儿童接种率的影响因素(均P<0.05)。结论湖州市5岁及以下儿童接种率较低,家长流感疫苗接种知识仍需加强,家长的文化程度、职业、家庭人均月收入是影响5岁及以下儿童接种率的主要影响因素,应多层次开展有关流感及其疫苗接种知识的宣教。     

2017－2018年流感流行季儿童接种流感疫苗效果社区队列研究

目的 评价6~72月龄儿童接种流感疫苗效果。方法 采用社区队列研究设计,2017年10-12月,从浙江省永康和义乌两市10家儿童接种门诊招募了1 752名6~72月龄儿童。每名儿童入队列后,完成知情同意和问卷调查,并随访至2018年4月30日,观察记录流感样病例（ILI）发病、门诊就诊和自行服药及流感疫苗接种情况。以ILI、门诊就诊和自行服药的发生次数为因变量,采用广义线性模型（GLM）拟合,估算流感疫苗效果（VE）值。结果 1 752名儿童中,男童925名（52.80%）,月龄M=30.00月,累计随访观察308 166人天,平均每天有5.27‰发生ILI、3.41‰因ILI去医院门诊就诊、1.45‰因ILI自行服药治疗;共有643名儿童接种了流感疫苗,与未接种儿童相比,流感疫苗对ILI、门诊就诊和自行服药的VE值分别为23.5%（95% CI：15.1%~31.1%）、19.3%（95% CI：8.2%~29.1%）和25.8%（95% CI：9.3%~39.3%）。643名接种儿童,接种后与接种前比,流感疫苗针对36~72月龄儿童ILI、门诊就诊和自行服药的VE值分别为31.9%（95% CI：12.7%~46.9%）、32.6%（95% CI：8.6%~50.3%）和44.3%（95% CI：11.9%~64.8%）,而对6~35月龄儿童,VE值均无统计学意义。2016-2018年流感疫苗不同接种暴露VE值评估,两个流感流行季均有接种史的,仅2017-2018年流感流行季有接种史的,流感疫苗VE值,均有统计学意义;仅2016-2017年流感流行季有接种史的,VE值均无统计学意义。结论 流感流行季接种流感疫苗一定程度可预防ILI发病、门诊就诊和自行服药,且对36~72月龄儿童保护效果优于6~35月龄儿童。     

楚雄州流行性感冒流行特征及病原学分析

[目的]对楚雄州流感流行特征及流感病毒毒株型别进行分析，探讨科学有效的流感防控措施。[方法]收集2006～2010年楚雄州流感监测系统流感样病例（ILI）监测资料，对病毒分离与鉴定结果以及暴发痰晴信息进行描述流行病学分析。[结果]2006—2010年间，哨点监测医院共报告ILI10139例，0～15岁组报告了7364例，占72．63％，ILI占门诊量百分比和流感病毒检出阳性高峰均出现在1～4月和9～11月：共检测ILI咽拭子标本2942份，检出流感病毒阳性255份，季H1型、季H3型和B型流感病毒检出阳性率最高的均是5～14岁年龄组，甲型H1N1流感病毒检出阳性率最高的是15～24岁年龄组（x2=81．37，P=O．001）；共报告流感暴发痰晴13起，发生在3月（8起）和9～10月（5起），分布在7个县（市）9个乡镇的中小学校。[结论]流感样病例（ILI）存在春季和秋季2个流行高峰，15岁以下儿童是流感防控的重点人群，加强中小学校流感防控工作、增加流感疫苗接种时间、不同人群有选捍性地接种相应组份的流感疫苗是楚雄州预防和控制流感发病的重要措施。     

2013-2014年度季节性流行性感冒疫苗对儿童保护效果的病例对照研究

目的 评价2013-2014年度季节性流行性感冒疫苗（流感疫苗）对6~59月龄儿童的保护效果。方法 选择2013-2014年度6~59月龄的实验室诊断流感病例为病例组,在广州市免疫规划系统中随机选择健康儿童为对照组,进行成组病例对照研究,采用非条件Logistic回归计算保护效果。结果 本研究共纳入2 690名研究对象。2013-2014年度,流感疫苗对6~59月龄儿童的保护效果为42.3%（95% CI:27.8%~53.8%）,对36~59月龄儿童的保护效果高于6~35月龄儿童,完全免疫的保护效果高于部分免疫,性别间保护效果无统计学差异。结论 流感疫苗对6~59月龄儿童具有中等保护效果,建议6~59月龄儿童每年接种流感疫苗。     

The effectiveness of influenza vaccination among nursery school children in China during the 2016/17 influenza season

BackgroundThe effectiveness of influenza vaccine among nursery school children has not been systematically studied. We conducted a cohort study of children from 13 nursery schools in Suzhou, China, to estimate the effectiveness of influenza vaccine against laboratory-confirmed influenza during 2016–17.MethodsChildren aged 36–72 months were chosen from 13 nursery schools from 3 District in Suzhou. The surveillance started 2 weeks after vaccination during October 2016–February 2017. Class teachers reported the names of students with ILI (influenza-like illness) to study clinicians on each school day. Further, local physicians collected the student’s nasopharyngeal swab or throat swab, either at a study clinic or at the child’s home. The swabs were sent to the National Influenza Network Laboratory in Suzhou Center for Disease Control and Prevention for influenza testing by RT-PCR.ResultA total of 4614 children were enrolled, of which 15 children (vaccinated: 2; unvaccinated: 13) were lost to follow-up. Of the remaining 4599 children, 558 swabs were collected. Among these swabs, 70 samples tested positive for influenza virus; 17 in the vaccinated group (B Victoria: 2; H3N2: 15) and 53 in the unvaccinated group (B Victoria: 14; A(H1N1)pdm09: 1; H3N2: 38). The overall influenza vaccine effectiveness (VE) during the influenza season of 2016–2017 was 20.6%. The incidence of developing ILI symptoms and healthcare seeking behavior through clinical visits was significantly lower in vaccinated children than in the unvaccinated group.ConclusionInfluenza vaccine protection in vaccinated and unvaccinated children showed no statistical difference and the VE percentage varied for different virus subtypes. However, the incidence rate of developing ILI and healthcare seeking behavior was significant lower in the vaccinated group than in the unvaccinated children. Larger studies are required to estimate the VE according to the influenza type, subtype, and lineage during influenza seasons in China in the future.     

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.     

A prospective, Internet-based study of the effectiveness and safety of influenza vaccination in the 2001-2002 influenza season

The effectiveness of the influenza vaccine used in the 2001-2002 influenza season in Japan was investigated in a large-scale, geographically widely distributed, Internet-based study. Data were collected from 8841 of 9902 subjects registered by 38 clinics prior to the start of influenza season. Subjects were categorized into three groups by vaccination regimen: unvaccinated, vaccinated once, and vaccinated twice. Efficacy was also analyzed for three age groups: 0-15, 16-64, and 65-104 years. Influenza-like illness (ILI) was diagnosed according to Ministry of Health (MWH, Labor and Welfare in Japan) criteria. Laboratory-confirmed influenza cases were analyzed separately. The respective vaccine efficacy in the 0-15 years group for the one- and two-dose regimens was 67.6 and 84.5% for ILI and 54.0 and 79.8% for laboratory-confirmed influenza. Influenza vaccination was also shown to be effective in subjects 16-64 years. Vaccine effectiveness was not able to be determined for the over 65 years group, probably due to an insufficient number of infected patients. These results suggest that influenza vaccination is effective for children and adults and that a two-dose regimen is superior to a single dose in children 0-15 years.     

2011-2017年苏州市区5岁以下儿童流感相关门诊就诊率的估计

  目的  估计2011-2017年苏州市区5岁以下儿童流感相关流感样病例（influenza-like illness，ILI）就诊率。  方法  2011年10月~2017年3月，在苏州大学附属儿童医院门急诊室开展对5岁以下儿童ILI病例的监测。收集咽拭子标本并采用实时定量逆转录-聚合酶链反应进行流感病毒检测。同时基于卫生服务利用数据及人口学数据，估计苏州市区5岁以下儿童流感相关ILI就诊数和就诊率。  结果  2011-2017年苏州市区约有45 930例次5岁以下流感相关ILI病例，其中因流感病毒A/H1N1感染就诊的ILI病例7 490例，A/H3N2就诊数为17 843例，B就诊数为20 597例。研究期间，苏州市区5岁以下儿童流感相关ILI病例的就诊率为6.4/100人年，其中2011-2012年流感相关ILI就诊率最高，达20.5/100人年，2012-2013年最低，为2.4/100人年。  结论  苏州市区5岁以下的儿童流感相关ILI就诊数和就诊率较高，疾病负担较大。     

Effectiveness of repeated influenza vaccination among the elderly population with high annual vaccine uptake rates during the three consecutive A/H3N2 epidemics

BackgroundAnnually, about 80% of the Korean elderly aged ≥65 years receive influenza vaccination. Repeated annual vaccination has been suggested as an important factor of poor influenza vaccine effectiveness (VE), though reported conflicting results.MethodsDuring the consecutive A/H3N2-dominant influenza seasons between 2012 and 2015, we comparatively evaluated the VE (repeated vs. current season only) against laboratory-confirmed influenza, pneumonia and hospitalization in the elderly aged ≥65 years with influenza-like illness (ILI). Clinical and demographic data were collected prospectively, and vaccination status of prior and current seasons was verified using the immunization registry data of Korean Centers for Disease Control and Prevention.ResultsDuring the first A/H3N2-dominant season in 2012–2013, influenza vaccine showed statistically significant effectiveness against influenza A infection only and when vaccinated in the current season only (VE 53%, 95% CI 15–77). In the latter two seasons (2013–2015 years), the adjusted VE for influenza A was indistinguishable between repeated vaccination and vaccination in the current season only.ConclusionDuring consecutive influenza A/H3N2 epidemics, poor influenza vaccine effectiveness may be more pronounced among the elderly population with a high annual vaccine uptake rate.     

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).     

Influenza vaccination coverage among pregnant women --- United States, 2010-11 influenza season

Women are at increased risk for morbidity and mortality from influenza during pregnancy. Vaccinating pregnant women for influenza can protect both the women and their infants, especially infants aged <6 months who are not old enough to receive influenza vaccination. Since 2004, the Advisory Committee on Immunization Practices and the American College of Obstetricians and Gynecologists have recommended inactivated influenza vaccine for all women who are pregnant during influenza season, regardless of trimester. Before 2009, estimated influenza vaccination coverage among pregnant women had been consistently low (approximately 15%). However, vaccination levels increased substantially in response to the 2009 influenza A (H1N1) pandemic to nearly 50%. To estimate influenza vaccination coverage among pregnant women for the 2010-11 season, CDC analyzed data from an Internet panel survey conducted in April 2011 among women who were pregnant any time during October 2010-January 2011. Among 1,457 survey respondents, 49% reported that they had received influenza vaccination: 12% were vaccinated before pregnancy, 32% during pregnancy, and 5% after pregnancy. Women offered influenza vaccination by a health-care provider (62%) were more likely to be vaccinated (71%) than other women (14%) and were more likely to have positive attitudes about vaccine effectiveness and safety. These results indicate that the higher vaccination level achieved the previous season (2009-10) was sustained and emphasize the critical role of health-care providers in promoting influenza vaccination. Continued efforts are needed to encourage health-care providers to strongly recommend and offer influenza vaccination to pregnant patients to protect both the mothers and their infants.     

Influenza vaccination coverage among children aged 6-59 months--six immunization information system sentinel sites, United States, 2006-07 influenza season

In June 2006, the Advisory Committee on Immunization Practices (ACIP) expanded its 2004 recommendation for routine influenza vaccination of children aged 6-23 months to include children aged 24-59 months. The 2006 ACIP recommendations also reemphasized that previously unvaccinated children aged <9 years should receive 2 doses of influenza vaccine administered at least 1 month apart to be fully vaccinated. In 2007, using data from six immunization information system (IIS) sentinel sites, CDC conducted the first assessment of influenza vaccination coverage among children aged 6-59 months during the 2006-07 influenza season. The findings demonstrated that, at all six sites, <30% of children aged 6-23 months and <20% of children aged 24-59 months were fully vaccinated. Vaccination coverage data from national and state surveys for an influenza season generally are not available until the next influenza season. Rapid assessment of influenza vaccination coverage can help direct activities of state and local public health agencies aimed at increasing the number of children fully vaccinated against influenza.     

Incidence of medically attended influenza infection and cases averted by vaccination, 2011/2012 and 2012/2013 influenza seasons

BackgroundWe estimated the burden of outpatient influenza and cases prevented by vaccination during the 2011/2012 and 2012/2013 influenza seasons using data from the United States Influenza Vaccine Effectiveness (US Flu VE) Network.MethodsWe defined source populations of persons who could seek care for acute respiratory illness (ARI) at each of the five US Flu VE Network sites. We identified all members of the source population who were tested for influenza during US Flu VE influenza surveillance. Each influenza-positive subject received a sampling weight based on the proportion of source population members who were tested for influenza, stratified by site, age, and other factors. We used the sampling weights to estimate the cumulative incidence of medically attended influenza in the source populations. We estimated cases averted by vaccination using estimates of cumulative incidence, vaccine coverage, and vaccine effectiveness.ResultsCumulative incidence of medically attended influenza ranged from 0.8% to 2.8% across sites during 2011/2012 and from 2.6% to 6.5% during the 2012/2013 season. Stratified by age, incidence ranged from 1.2% among adults 50 years of age and older in 2011/2012 to 10.9% among children 6 months to 8 years of age in 2012/2013. Cases averted by vaccination ranged from 4 to 41 per 1000 vaccinees, depending on the study site and year.ConclusionsThe incidence of medically attended influenza varies greatly by year and even by geographic region within the same year. The number of cases averted by vaccination varies greatly based on overall incidence and on vaccine coverage.