福建省乙肝疫苗纳入儿童免疫规划效果血清学评价

目的评价福建省乙肝疫苗纳入儿童免疫规划实施效果。方法采用多阶段分层整群抽样法,随机抽取福建省疾病监测点1～14岁居民1643人为研究对象。采用酶联免疫（ELISA）法检测乙肝血清标志物。结果 1～岁、5～岁、10～岁人群乙肝疫苗全程接种率分别为98.11%、95.69%、54.31%,乙肝疫苗首针及时接种率分别为75.76%、47.71%、27.81%;农村10～岁儿童乙肝疫苗接种率（49.06%）低于城市（60.44%）;1～14岁儿童接种疫苗的保护率为75.64%（95%CI：73.43%～77.84%）。乙肝表面抗原携带率随年龄增长呈上升趋势,1～岁年龄组明显较低为0.71%,5～岁为2.25%,10～岁为5.37%;年龄越大抗-HBs阳性率越低、抗-HBc阳性率越高、HBV阳性率上升。结论福建省新生儿乙肝疫苗接种纳入儿童免疫规划以来,乙肝疫苗全程接种率和首针及时接种率都有很大的提高,农村提高更快,城乡乙肝疫苗接种均等化基本得到实现。纳入儿童免疫规划以来,儿童乙肝表面抗原携带率大幅下降,实现了5岁以下儿童乙肝表面抗原携带率〈1%的控制目标。福建省HBV流行模式发生改变,目前该省乙肝感染以水平传播为主形成的儿童峰已经不复存在,通过免疫规划1～14岁儿童乙肝表面抗原携带者减少了约101.58万人。

Serological evaluation on HepB vaccination integrated into immunization program in Fujian Province

Objective To evaluate the effect of hepatitis B vaccine （HepB） vaccination integrated into immunization program in Fujian province. Methods With multiple stratified cluster random sampling method,we selected 1 643 residents aged under 15 years old,which were from National Disease Surveillance Point in Fujian. We tested serological situation of hepatitis B by ELISA. Results The coverage of series HepB in group aged 1～years old,5～,10～ was 98.11%,95.69%,54.31% respectively,and the coverage of first dose HepB vaccinated within 24hr was 75.76%,47.71% and 27.81% respectively. The coverage of series HepB aged 10～ children in rural area （49.06%） was lower than urban area （60.44%）. The protective rate of HepB in population aged under 15 years old was 75.64% （95% CI：73.43%～77.84%）. The positive rate of HBsAg increased with age. The positive rate of HBsAg aged 1～ years old was 0.71%,and 5～years old 2.25%,and 10～years old 5.37%. The positive rate of HBsAb decreased with age,and the positive rate of HBcAb and HBV increased with age. Conclusions Since HepB integrated into Expanded program on immunization in Fujian,the coverage of series HepB and first dose HepB vaccinated within 24hr have significantly increased,and the positive rate of HBsAg have substantially decreased. The coverage of HepB in rural area increase more quickly than in urban area. Now the target of equalization in HepB coverage between urban and rural have basically achieved,and the HBsAg positive rate of children under 5 years has already met the hepatitis B controlling target （1% HBsAg positive rate）. The epidemiologic model of hepatitis B virus has changed,and the peak caused by horizontal transmission of hepatitis B virus in the children have already disappeared. We estimate that the HBsAg positive population of 1～14 children have decreased about 1 015 800 person by immunization program.