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目的分析浙江省衢州市适龄儿童接种1剂水痘减毒活疫苗(VarV)的免疫效果,为制定水痘防控策略提供依据。方法收集疾病监测信息报告管理系统中报告的2005~2012年出生儿童的水痘病例,运用浙江省免疫规划信息系统查找VarV接种信息,计算VarV保护效果(VE)。结果衢州市2005~2012年出生儿童报告水痘病例1 226例,其中突破病例323例,突破病例的平均发病年龄晚于无VarV免疫史的病例,幼托儿童和学生是水痘突破病例的高发人群。衢州市VarV接种率呈逐年上升趋势,VarV接种率与水痘发病率之间呈负相关。2005年出生儿童在1~2岁接种1剂VarV的估算总VE为69.5%(95%CI:61.2%~76.0%),接种后≤3年、4~5年和≥6年的VE分别为96.5%(95%CI:93.4%~98.1%)、87.7%(95%CI:82.4%~91.4%)、84.1%(95%CI:78.1%~88.5%)。结论接种1剂VarV不能有效避免突破病例,且VE随时间而下降;建议实施2剂次VarV免疫程序。
Objective To analyze the immunogenicity of Varicella vaccine (VarV) in children of school age in Quzhou City, Zhejiang Province, and to provide basis for the prevention and control of Varicella. Methods The varicella cases reported in the Disease Surveillance Information Reporting Management System from 2005 to 2012 were collected. The VarV vaccination information was searched using the immunization planning information system of Zhejiang Province to calculate the VarV protective effect (VE). Results A total of 1 226 cases of chickenpox were reported in Quzhou from 2005 to 2012, of which 323 cases were breakthrough. The average age of breakthrough was later than that without VarV. The children and students were the high incidence of chickenpox breakthrough. The vaccination rate of VarV in Quzhou showed a year-by-year upward trend. There was a negative correlation between the vaccination rate of VarV and the incidence of chickenpox. The estimated VE for children born with a single dose of VarV at 1-12 years of age in 2005 was 69.5% (95% CI: 61.2% -76.0%), and the VE at ≤3 years, 4-5 years, and ≥6 years after vaccination was 96.5% (95% CI: 93.4% -98.1%), 87.7% (95% CI: 82.4% -91.4%), 84.1% (95% CI: 78.1% -88.5%). Conclusion Inoculation of 1 dose of VarV can not effectively avoid breakthrough cases, and VE decreases with time; it is recommended to administer 2 doses of VarV immunization program.