疫情防控常态化背景下疫苗集中接种点医务人员职业倦怠现况调查

目的 本研究调查新冠疫苗全面接种时期相关医务人员的职业倦怠状况,探讨个体因素以及社会支持对倦怠水平的影响。方法 在南京市12个行政区中随机抽取4个辖区的新冠疫苗集中接种点,将全部医务人员共428名作为研究对象进行问卷调查,问卷包括人口学特征、中文版职业倦怠量表和社会支持量表。结果 医务人员情感耗竭、人格解体、个人成就感降低维度得分分别为(17.99±7.89)、(7.20±3.52)和(12.07±5.30)分。多元线性回归分析结果显示,上司支持(β=-0.180, P< 0.05)、同事支持(β=-0.180, P< 0.05)为情感耗竭的保护因素,已婚、问诊岗位为情感耗竭的危险因素(β=0.161、β=0.095,P值均< 0.05),女性是人格解体的保护因素(β=-0.096,P< 0.05),亲友支持(β=-0.235, P< 0.05)是人格解体的保护因素,已婚是人格解体的危险因素(β=0.142,P< 0.05),同事支持(β=-0.168, P< 0.05)、亲友支持(β=-0.210, P< 0.05)、工龄(β=-0.154, P< 0.05)为个人成就感降低的保护因素,硕士学历是个人成就感降低的危险因素(β=0.126,P < 0.05)。结论 重视提高全方面社会支持,重点关注已婚、男性、硕士学历以及较短工龄医务人员的心理健康。     

2015—2018年西安市百日咳流行特征分析

目的 分析西安市2015—2018年百日咳流行病学特征,为预防和控制百日咳传播提供参考。方法 采用描述流行病学方法,对中国疾病预防控制信息系统中2015—2018年期间西安市百日咳报告病例和此期间西安市百日咳哨点监测病例的数据进行统计学分析。结果 西安市2015—2018年共报告百日咳确诊病例1 635例,发病率分别为3.97/10万、4.11/10万、4.85/10万和5.28/10万,发病有逐年上升趋势（χ2趋势 = 21.719,P＜0.001）;高发季为3—8月（2015—2018年分别占该年度总发病数的75.73%、66.76%、78.97%和80.27%）;以3～6月龄发病比例最高（2015—2018年分别占该年度总发病数的50.58%、48.60%、48.36%和41.22%）;未全程接种疫苗患儿所占比例最大（2015—2018年分别为36.26%、23.74%、42.76%和33.73%）,未到接种年龄就发病所占比例有逐年升高趋势（χ2趋势 = 10.302,P = 0.001）,无免疫史患儿比例呈逐年降低趋势（χ2趋势 = 36.088,P＜0.001）;3种实验室检测方法中荧光PCR的检出率最高（40.12%）;传播模式除了散发病例,出现了家庭聚集现象,且所有流行病学相关病例均被漏诊或误诊。结论 西安市近年来百日咳发病率有明显上升趋势,＜6月龄婴儿为主要发病人群,百日咳的日常监测仍有待加强,且其家庭聚集式传播现象值得关注。     

2008—2012年武鸣县疑似预防接种异常反应监测分析

目的了解武鸣县疑似预防接种异常反应（AEFI）的发生特征,评价疫苗的安全性,改善预防接种服务质量。方法采用描述性分析方法对武鸣县发生的AEFI进行流行病学分析。结果武呜县在2008—2012年共报告AEFI病例76例,累计发生率为6．61／10万,男性多于女性,〈1岁儿童占47．36％。AEFI报告发生率居前3位的疫苗是两个不同公司生产的23价肺炎球菌多糖疫苗和卡介苗,其中一般反应占38．16％、异常反应占47．37％、心因性反应占3．95％。治愈病例占90．79％,好转病例占9．21％。AEFI监测系统及时报告率97．37％,个案报告完整率100．00％。结论疫苗自身安全性良好,全县AEFI疫情上报及时、完整,监测体系走上正轨,今后应继续加强预防接种人员在发生AEFI后合理解释、规范处置等方面的培训,提高预防接种服务质量。     

2000～2012年急性播散性脑脊髓炎与预防接种关系分析

目的了解急性播散性脑脊髓炎（Acute Disseminated Encephalomyelitis,ADEM）流行病学特点、临床特征,病因的特点,为预防接种后ADEM的调查诊断和处置提供参考。方法从中国医院知识数据库（2000～2012年）收集ADEM病例个案资料,采用描述性分析方法分析所有个案的性别、年龄、病因、潜伏期和转归等特征。结果1155例个案中男性占57.92%。61.56%为感染后脑脊髓炎（postinfectious encephalomyelitis,PIE）,14.29%为疫苗接种后脑脊髓炎（postvaccinal encephalomyelitis,PVE）、其中狂犬病疫苗排第一位。PIE和PVE在性别和病例转归上差异无统计学意义,在潜伏期和年龄上差异有统计学显著性意义。结论 ADEM主要是由感染和疫苗接种引起。PIE和PVE在潜伏期和发病年龄上差异有统计学显著性意义。应加强进一步研究ADEM与预防接种的因果关系,研究制订ADEM与预防接种因果关系的调查诊断和鉴定技术标准,减低误判的几率,减少相关纠纷的产生。     

HEPATITIS B VACCINATION COVERAGE AND POSTVACCINATION SEROLOGIC TESTING AMONG MEDICAL STUDENTS AT A PUBLIC UNIVERSITY IN BRAZIL

The aim of this cross-sectional study was to determine the hepatitis B vaccination coverage among medical students at a public university in Rio de Janeiro, Brazil, and their compliance with the postvaccination serologic testing recommendations. Of the total of 858 students, 675 (78.7%) participated in the study. Among the participants, 48.9% (95% CI: 45.1% to 52.7%) were vaccinated against hepatitis B (received ≥ 3 doses of the vaccine), 31.6% were not (received 0, 1 or 2 doses), and 19.6% did not know their vaccination status. Hepatitis B vaccination coverage increased from 26.0% among first-year students to 70.6% among sixth-year students while the prevalence of unknown vaccination status decreased from 39.7% among first-year students to 2.4% among sixth-year students. The frequency of unvaccinated students ranged from 23.7% among fifth-year students to 34.4% among first-year students. Only 34.8% of the vaccinated students performed the anti-HBs testing after vaccination. Among these medical students, we found a low adherence to the hepatitis B vaccination and to the postvaccination serologic testing. A comprehensive hepatitis B immunization program should be offered to students at this medical school.     

Influenzaimpfung – für Risikogruppen besonders wichtig

Every year influenza infections leads to hospitalizations, deaths and days missed from work and school. However, influenza is a vaccine-preventable disease. Measures to improve vaccination rates among risk groups and healthcare personnel ought to be an important public health goal.     

Issues and considerations in the use of serologic biomarkers for classifying vaccination history in household surveys

Accurate estimates of vaccination coverage are crucial for assessing routine immunization program performance. Community based household surveys are frequently used to assess coverage within a country. In household surveys to assess routine immunization coverage, a child's vaccination history is classified on the basis of observation of the immunization card, parental recall of receipt of vaccination, or both; each of these methods has been shown to commonly be inaccurate. The use of serologic data as a biomarker of vaccination history is a potential additional approach to improve accuracy in classifying vaccination history. However, potential challenges, including the accuracy of serologic methods in classifying vaccination history, varying vaccine types and dosing schedules, and logistical and financial implications must be considered. We provide historic and scientific context for the potential use of serologic data to assess vaccination history and discuss in detail key areas of importance for consideration in the context of using serologic data for classifying vaccination history in household surveys. Further studies are needed to directly evaluate the performance of serologic data compared with use of immunization cards or parental recall for classification of vaccination history in household surveys, as well assess the impact of age at the time of sample collection on serologic titers, the predictive value of serology to identify a fully vaccinated child for multi-dose vaccines, and the cost impact and logistical issues on outcomes associated with different types of biological samples for serologic testing.     

Update on immunizations for healthcare personnel in the United States

Healthcare personnel (HCP) play a pivotal role in the transmission of contagious pathogens in the healthcare setting, and HCP are themselves at risk for infection with such pathogens due to the nature of their occupation. Many practices are important in order to reduce infection transmission, including HCP immunization. Unfortunately, HCP immunization rates in the United States (U.S.) have not reached recommended levels, so new strategies are being used to improve HCP coverage, including mandatory immunization and the use of immunization rates as measures of quality and safety. This article will review current practices, policies, and issues surrounding HCP immunization in the U.S.     

Successful reproduction of adenoviral gizzard erosion in 20-week-old SPF layer-type chickens and efficacious prophylaxis due to live vaccination with an apathogenic fowl adenovirus serotype 1 strain (CELO)

Recently, outbreaks of adenoviral gizzard erosion (AGE) have been documented in pullets and layers housed free range and in enriched cage systems characterized by increased mortality and a negative impact on egg production. In the present study the pathogenicity of a fowl adenovirus serotype 1 (FAdV-1) field strain as well as the aetiological role of a FAdV-8a strain, both isolated from AGE affected pullets, were investigated in vivo in 20-week-old specific-pathogen-free (SPF) layer-type chickens. Furthermore, the efficacy of a single (week 17) and double (week 14 and 17) application of a live vaccine consisting of an apathogenic FAdV-1 (CELO strain) against challenge with virulent FAdV-1 was investigated.For the first time, AGE was successfully reproduced in adult birds after oral infection of 20-week-old SPF birds with a virulent FAdV-1 field isolate, characterized by pathological changes of the gizzard from 7 days post challenge onwards. In addition, a negative impact of the FAdV-1 infection on the development of the reproductive tract was observed. Thus, confirming the pathogenicity and aetiological role of FAdV-1 in the development of AGE and economic losses due to AGE in layers. In contrast, no pathological changes were observed in birds infected with FAdV-8a.Independent of a single or double application of the live FAdV-1 vaccine strain CELO, no gross pathological changes were observed in gizzards post challenge with the virulent FAdV-1, indicating that complete protection of layers against horizontal induction of AGE was achieved. Nonetheless, virulent FAdV-1 was detected in cloacal swabs and gizzards in both vaccinated groups post challenge determined by the application of an amplification refractory mutation system quantitative PCR used to differentiate between vaccine and challenge strains.     

A prospective,double-blind,randomized, placebo-controlled study on the efficacy and safety of influenza vaccination in myasthenia gravis

Objective

To investigate the efficacy and safety of an influenza vaccination in patients with myasthenia gravis with acetylcholine receptor antibodies (AChR MG).