成都市EV71疫苗接种对手足口病的防控效果分析

目的探索接种EV71疫苗对成都市手足口病的预防控制效果。方法选择2016-08-20/2017-08-20期间接种过EV71疫苗的6月龄~5岁儿童为接种组;同期未接种过EV71疫苗的儿童为对照组。比较接种EV71疫苗组与未接种组手足口病发病、住院、重症、EV71肠道病毒感染的差异,使用SAS 8.1软件、SPSS 13.0软件分析数据、采用生存分析K-M法分析接种与未接种组重症病例发生时间差别。结果较低接种率下,手足口病防控效果不明显,仅在12~23月龄手足口病住院发生率接种组(0.04%)低于对照组(0.25%)(χ~2=77.29,P<0.01)。接种不同剂次EV71疫苗分类分析提示:2剂次接种后手足口病住院发生率(0.07%)低于1剂次接种住院发生率(0.13%)(χ~2=9.73,P<0.01),K-M分层分析提示2剂次接种组重症发生所需要时间长于1剂次接种的时间,长于未接种组的时间(χ~2=7.31,P<0.01)。结论本次研究观察时间仅1年,接种率低,显示防控效果不明显,仅在12~23月龄住院发生率接种组低于对照组,2剂次接种效果好于1剂次,EV71疫苗接种可延长手足口病重症发生的时间。应持续推广EV71疫苗接种,提高接种率,减轻疾病负担,降低因手足口病住院或重症的发生风险。

Analysis of Prevention and Control Effect of EV71 Vaccine Against HFMD in Chengdu City

Objective To explore the prevention and control effect of EV71 vaccine against hand-footmouth diseases(HFMD). Methods The children aged 6-60 months who had received EV71 vaccine during August 20, 2016 and August 20, 2017 were selected as the inoculation group. The control group included the children who had not received EV71 vaccine during the same period.The differences of HFMD incidence, hospitalization, severe disease and EV71 enterovirus infection between EV71 vaccine group and non-vaccine group were compared. The SAS 8.1 and SPSS 13.0 software were used to analyze the data. Survival analysis was used to analyze the time difference of severe cases in the inoculated and uninoculated groups by using K-M method. Results At a lower vaccination rate, the prevention and control effect of HFMD is not obvious. As for the age group of 12-23 months,the incidence of HFMD hospitalization in the inoculation group (0.04%) was lower than that in the control group (χ~2=77.29,P<0.01). In the inoculation group,the hospitalization rate of children inoculation with two doses was lower than that of the children inoculation with one dose (χ~2=9.73, P<0.01). The results of K-M stratified analysis indicated that the incidence time of severe disease after two doses of inoculation was longer than that of one dose of inoculation, and longer than that of the control group without inoculation (χ~2=7.31,P<0.01). Conclusion In this study, the observation time of vaccination was short, the vaccination rate was low. There was no significant difference in the effect between the two groups. As for the age group of 12-23 months, the incidence of hospitalization in the inoculation group was lower than that in the control group. Two doses of vaccination can reduce the incidence of hospitalization.EV71 vaccination can prolong the incidence time of severe HFMD. EV71 vaccination should be promoted continuously to improve the vaccination rate, reduce the burden of disease, and reduce the risk of hospitalization or severe illness caused by HFMD.