上海市金山区农村老年人肺炎疫苗免费接种知识、态度和行为调查

目的评价60岁以上老年人接种23价肺炎球菌多糖疫苗(PPV23)的效果。方法在上海市宝山区17个社区中抽取6个社区的13个村/里委，共抽取2014年4—6月的接种对象950名及未接种对象1 000名。通过队列研究，调查接种PPV23后1年中肺炎、其他呼吸道感染的患病及抗生素使用情况。结果利用倾向评分匹配法将调查对象进行匹配，最终保留接种组和未接种组各875例。随访满1年，两组人群肺炎患病率分别为0.91%和3.43%，差异有统计学意义(χ²=13.020，P＜0.01)，接种疫苗对人群患肺炎的保护率为73.47%；两组人群支气管炎患病率分别为2.40%和7.89%，差异有统计学意义(χ²=26.988，P＜0.01)，疫苗的保护率为69.71%；慢性支气管炎急性发作的患病率分别为0.11%和1.60%，差异有统计学意义(χ²=11.364，P＜0.01)，疫苗的保护率为93.13%；上呼吸道感染患病率分别为18.63%和27.43%，差异有统计学意义(χ²=19.114，P＜0.01)。两组人群抗生素使用率分别为4.46%和10.29%, 差异有统计学意义(χ²=21.767，P＜0.01)。结论老年人接种PPV23后可以降低发生呼吸道感染和患肺炎的风险，并减少抗生素的使用。

23-valent pneumococcal polysaccharide vaccine. WHO position paper

ObjectiveTo evaluate the effectiveness of 23-valent pneumococcal polysaccharide vaccine(PPV23) inoculated among people over 60 years old.MethodsFrom 13 villages/committees of 6 among 17 communities in Baoshan District of Shanghai were drawn 950 vaccinated and 1 000 unvaccinated objects in April -June 2014. Through cohort study were investigated the situation of the use of antibiotics and the incidence of pneumonia and other respiratory disease during one year after inoculation of PPV23.ResultsBy tendencies score matching method were matched the objects. Finally, there were 875 cases in both vaccinated and unvaccinated groups. After one year of follow-up, the pneumonia incidence in vaccination and unvaccinated groups were 0.91% and 3.43%, and the difference between the two groups was statistically significant(χ²=13.020, P < 0.01). The vaccine efficacy of PPV23 was 73.47%. The acute bronchitis incidences of the two groups were 2.40% and 7.89% respectively, whose difference was of statistical significance(χ²=26.988, P < 0.01), with the vaccine efficacy being 69.71%. And the acute exacerbation rate of chronic bronchitis were 0.11% and 1.60%, whose difference was statistically significant(χ²=11.364, P < 0.01), with vaccine efficacy being 93.13%. The incidences of upper respiratory tract infection were 18.63% and 27.43% respectively, the difference being statistically significant (χ²=19.114, P < 0.01). The usage rates of antibiotics in the two groups were 4.46% and 19.29%, the difference being statistically significant(χ²=21.767, P < 0.01).ConclusionPPV23 vaccination can reduce risks of pneumonia and other respiratory tract infection for elderly people, and reduce usage rate of antibiotics.