含腮腺炎成分疫苗在1起学校流行性腮腺炎暴发疫情中的保护效果
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摘要
目的了解含腮腺炎成分疫苗(Mumps containing vaccine, MuCV)在2017年四川省1起学校流行性腮腺炎(流腮)暴发疫情中的保护效果(Vaccine effectiveness,VE)。方法选取四川省发生流腮暴发疫情的1所学校的学生为研究对象,采用回顾性队列研究收集流腮发病和MuCV接种情况,评估VE。结果共537名学生纳入研究,流腮总罹患率为13.41%(72/537),MuCV接种组、未接种组罹患率分别为9.67%(41/424)、27.43%(31/113)(χ~2=24.25,P<0.05)。接种MuCV的总VE为65.75%(95%CI:46.47%-76.79%);接种1剂次、2剂次的VE分别为62.61%(95%CI:40.68%-76.44%)、68.62%(95%CI:42.82%-82.78%);接种后≤3年、4-5年、≥6年的VE分别为79.75%(95%CI:0.00%-97.06%)、64.72%(95%CI:29.70%-82.30%)、59.50%(95%CI:31.27%-76.13%)。结论 MuCV的VE随接种后时间增加而下降。
Objective To determine the vaccine effectiveness(VE) of mumps containing vaccine(MuCV) in a mumps outbreak in a school in Sichuan province in 2017. Methods We selected students during a mumps outbreak and conducted a retrospective cohort study to determine mumps incidence, MuCV vaccination status, and MuCV effectiveness. Results Among the 537 enrolled students, the mumps attack rate was 13.41%(72/537). The attack rate was 9.67%(41/424) among students who had received MuCV and was 27.43%(31/113) among students who had not received MuCV(χ~2=24.25, P<0.05). The overall MuCV effectiveness was 65.75%(95%CI: 46.47%-76.79%). VE was 62.61%(95%CI: 40.68%-76.44%) among students who had received one dose of MuCV, and was 68.62%(95%CI: 42.82%-82.78%) among those who received two doses. VE estimates for ≤3, 4-5, and ≥6 years since MuCV vaccination were 79.75%(95%CI: 0.00%-97.06%), 64.72%(95%CI: 29.70%-82.30%), and 59.50%(95%CI: 31.27%-76.13%), respectively. ConclusionsMuCV effectiveness decreased with increasing time since vaccination.
Objective To determine the vaccine effectiveness(VE) of mumps containing vaccine(MuCV) in a mumps outbreak in a school in Sichuan province in 2017. Methods We selected students during a mumps outbreak and conducted a retrospective cohort study to determine mumps incidence, MuCV vaccination status, and MuCV effectiveness. Results Among the 537 enrolled students, the mumps attack rate was 13.41%(72/537). The attack rate was 9.67%(41/424) among students who had received MuCV and was 27.43%(31/113) among students who had not received MuCV(χ~2=24.25, P<0.05). The overall MuCV effectiveness was 65.75%(95%CI: 46.47%-76.79%). VE was 62.61%(95%CI: 40.68%-76.44%) among students who had received one dose of MuCV, and was 68.62%(95%CI: 42.82%-82.78%) among those who received two doses. VE estimates for ≤3, 4-5, and ≥6 years since MuCV vaccination were 79.75%(95%CI: 0.00%-97.06%), 64.72%(95%CI: 29.70%-82.30%), and 59.50%(95%CI: 31.27%-76.13%), respectively. ConclusionsMuCV effectiveness decreased with increasing time since vaccination.
引文
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[5] 汉京华, 苗伟, 卜洁琼, 等. 日照市3所学校流行性腮腺炎暴发疫情流行病学调查[J]. 中国学校卫生, 2011, 32(6): 753-754.HAN Jinghua, MIAO Wei, BU Jieqiong, et al. Epidemiological survey of mumps outbreaks in 3 schools in Rizhao city [J]. Chinese Journal of School Health, 2011, 32 (6): 753-754.
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[8] 杜飞, 李银乔, 刘家洁, 等. 2004-2014年四川省流行性腮腺炎流行病学特征分析[J]. 预防医学情报杂志, 2016, 32(5): 445-450.DU Fei, LI Yinqiao, LIU Jiajie, et al. Analysis on epidemiological characteristics of mumps in Sichuan, 2004-2014 [J]. Journal of Preventive Medicine Information, 2016, 32(5): 445-450.
[9] ANDERSON RM, MAY RM. Immunisation and herd immunity [J]. Lancet, 1990, 335: 641-645.
[10] 马超, 贾海梅, 王雷, 等. 一起学校流行性腮腺炎爆发疫情调查与分析[J]. 中国疫苗和免疫, 2016, 22(2): 153-158.MA Chao, JIA Haimei, WANG Lei, et al. Field investigation of a mumps outbreak in a primary school [J]. Chinese Journal of Vaccines and Immunization, 2016, 22(2): 153-158.
[11] 傅传喜, 梁建华, 王大虎, 等. 疫苗对流行性腮腺炎保护效果的配对病例对照研究[J]. 中国疫苗和免疫, 2008, 14(5): 448-451.FU Chuanxi, LIANG Jianhua, WANG Dahu, et al. A case-control study on the protective effects of vaccine to mumps [J]. Chinese Journal of Vaccines and Immunization, 2008, 14(5): 448-451.
[12] 孟丽, 张天东, 张彦玲, 等. 流行性腮腺炎的免疫策略[J]. 中国社区医师(医学专业半月刊), 2008, 10(10): 136.MENG Li, ZHANG Tiandong, ZHANG Yanling, et al. Immunization strategy for mumps [J]. Chinese Community Doctors, 2008, 10(10): 136.
[13] 刘旭祥, 王蓓, 王晓萍, 等. 合肥市3～8岁儿童麻疹风疹流行性腮腺炎抗体水平调查[J]. 中国学校卫生, 2014, 35(10): 1528-1530.LIU Xuxiang, WANG Bei, WANG Xiaoping, et al. Antibodies against measles rubella and mumps among preschool children in Hefei [J]. Chinese Journal of School Health, 2014, 35(10): 1528-1530.
[14] 刘隽, 苏琪茹, 马超, 等. 不同免疫策略下流行性腮腺炎发病特征的初步比较分析[J]. 中国疫苗和免疫, 2014, 20(6): 519-522, 546.LIU Jun, SU Qiru, MA Chao, et al. Preliminary comparative analysis of epidemic characteristics of mumps with different vaccination strategies in China [J]. Chinese Journal of Vaccines and Immunization, 2014, 20(6): 519-522, 546.
[15] 马超, 郝利新, 苏琪茹, 等. 世界卫生组织194个成员国麻疹、流行性腮腺炎、风疹减毒活疫苗常规免疫程序、报告接种率与发病水平现状分析[J]. 中国疫苗和免疫, 2015, 21(3): 241-247, 254.MA Chao, HAO Lixin, SU Qiru, et al. Vaccination schedules, reported vaccination coverage rates, and incidences of measles, mumps and rubella of the 194 member states of the World Health Organization [J]. Chinese Journal of Vaccines and Immunization, 2015, 21(3): 251-247, 254.
[16] 于新蕊, 刘景东, 张仲钦. 流行性腮腺炎疫苗的全球应用[J]. 国外医学(社会医学分册), 2000, 17(2): 81-84.YU Xinrui, LIU Jingdong, ZHANG Zhongqin. The use of mumps vaccine worldwide [J]. Foreign Medical Sciences (Social Medicine Section), 2000, 17(2): 81-84.
[17] WHO. WHO position paper-mumps virus vaccines [J]. WER, 2007, 82(7): 51-60.
[18] 徐维祯, 张国民, 梁爽, 等. 流行性腮腺炎减毒活疫苗免疫学效果和保护效果的系统评价[J]. 中国疫苗和免疫, 2011, 17(5): 426-430, 450.XU Weizhen, ZHANG Guomin, LIANG Shuang, et al. Systematic review on immunology effect and protective efficacy of mumps attenuated live vaccine [J]. Chinese Journal of Vaccines and Immunization, 2011, 17(5): 426-430, 450.
[2] 管兆军, 耿晓萃, 骆艳玲. 一起学校流行性腮腺炎暴发疫情调查[J]. 中国学校卫生, 2014, 35(2): 288-289.GUAN Zhaojun, GENG Xiaocui, LUO Yanling. A school outbreak of mumps [J]. Chinese Journal of School Health, 2014, 35 (2): 288-289.
[3] 吕锐利, 聂轶飞, 尧怀志, 等. 一起学校流行性腮腺炎暴发调查[J]. 中国学校卫生, 2012, 33(12): 1534-1535.LV Ruili, NIE Yifei, YAO Huaizhi, et al. A survey of mumps outbreak in schools [J]. Chinese Journal of School Health, 2012, 33 (12): 1534-1535.
[4] 王俊武. 一起中小学流行性腮腺炎暴发疫情分析[J]. 中国学校卫生, 2014, 35(5): 776-778.WANG Junwu. Analysis of an outbreak of mumps in primary and secondary schools [J]. Chinese Journal of School Health, 2014, 35 (5): 776-778.
[5] 汉京华, 苗伟, 卜洁琼, 等. 日照市3所学校流行性腮腺炎暴发疫情流行病学调查[J]. 中国学校卫生, 2011, 32(6): 753-754.HAN Jinghua, MIAO Wei, BU Jieqiong, et al. Epidemiological survey of mumps outbreaks in 3 schools in Rizhao city [J]. Chinese Journal of School Health, 2011, 32 (6): 753-754.
[6] 吕海英, 王翠玲. 流行性腮腺炎疫苗在学校暴发疫情中的保护效果[J]. 中国学校卫生, 2015, 36(12): 1845-1847.LV Haiying, WANG Cuiling. Protection effectiveness of mumps attenuated live vaccine against mump outbreak in schools [J]. Chinese Journal of School Health, 2015, 36 (12): 1845-1847.
[7] 中华人民共和国卫生部. WS 270-2007流行性腮腺炎诊断标准[S]. 北京:中国标准出版社, 2007.Ministry of Health of the People's Republic of China. WS 270-2007 Diagnostic criteria of mumps [S]. Beijing: China Standard Press, 2007.
[8] 杜飞, 李银乔, 刘家洁, 等. 2004-2014年四川省流行性腮腺炎流行病学特征分析[J]. 预防医学情报杂志, 2016, 32(5): 445-450.DU Fei, LI Yinqiao, LIU Jiajie, et al. Analysis on epidemiological characteristics of mumps in Sichuan, 2004-2014 [J]. Journal of Preventive Medicine Information, 2016, 32(5): 445-450.
[9] ANDERSON RM, MAY RM. Immunisation and herd immunity [J]. Lancet, 1990, 335: 641-645.
[10] 马超, 贾海梅, 王雷, 等. 一起学校流行性腮腺炎爆发疫情调查与分析[J]. 中国疫苗和免疫, 2016, 22(2): 153-158.MA Chao, JIA Haimei, WANG Lei, et al. Field investigation of a mumps outbreak in a primary school [J]. Chinese Journal of Vaccines and Immunization, 2016, 22(2): 153-158.
[11] 傅传喜, 梁建华, 王大虎, 等. 疫苗对流行性腮腺炎保护效果的配对病例对照研究[J]. 中国疫苗和免疫, 2008, 14(5): 448-451.FU Chuanxi, LIANG Jianhua, WANG Dahu, et al. A case-control study on the protective effects of vaccine to mumps [J]. Chinese Journal of Vaccines and Immunization, 2008, 14(5): 448-451.
[12] 孟丽, 张天东, 张彦玲, 等. 流行性腮腺炎的免疫策略[J]. 中国社区医师(医学专业半月刊), 2008, 10(10): 136.MENG Li, ZHANG Tiandong, ZHANG Yanling, et al. Immunization strategy for mumps [J]. Chinese Community Doctors, 2008, 10(10): 136.
[13] 刘旭祥, 王蓓, 王晓萍, 等. 合肥市3～8岁儿童麻疹风疹流行性腮腺炎抗体水平调查[J]. 中国学校卫生, 2014, 35(10): 1528-1530.LIU Xuxiang, WANG Bei, WANG Xiaoping, et al. Antibodies against measles rubella and mumps among preschool children in Hefei [J]. Chinese Journal of School Health, 2014, 35(10): 1528-1530.
[14] 刘隽, 苏琪茹, 马超, 等. 不同免疫策略下流行性腮腺炎发病特征的初步比较分析[J]. 中国疫苗和免疫, 2014, 20(6): 519-522, 546.LIU Jun, SU Qiru, MA Chao, et al. Preliminary comparative analysis of epidemic characteristics of mumps with different vaccination strategies in China [J]. Chinese Journal of Vaccines and Immunization, 2014, 20(6): 519-522, 546.
[15] 马超, 郝利新, 苏琪茹, 等. 世界卫生组织194个成员国麻疹、流行性腮腺炎、风疹减毒活疫苗常规免疫程序、报告接种率与发病水平现状分析[J]. 中国疫苗和免疫, 2015, 21(3): 241-247, 254.MA Chao, HAO Lixin, SU Qiru, et al. Vaccination schedules, reported vaccination coverage rates, and incidences of measles, mumps and rubella of the 194 member states of the World Health Organization [J]. Chinese Journal of Vaccines and Immunization, 2015, 21(3): 251-247, 254.
[16] 于新蕊, 刘景东, 张仲钦. 流行性腮腺炎疫苗的全球应用[J]. 国外医学(社会医学分册), 2000, 17(2): 81-84.YU Xinrui, LIU Jingdong, ZHANG Zhongqin. The use of mumps vaccine worldwide [J]. Foreign Medical Sciences (Social Medicine Section), 2000, 17(2): 81-84.
[17] WHO. WHO position paper-mumps virus vaccines [J]. WER, 2007, 82(7): 51-60.
[18] 徐维祯, 张国民, 梁爽, 等. 流行性腮腺炎减毒活疫苗免疫学效果和保护效果的系统评价[J]. 中国疫苗和免疫, 2011, 17(5): 426-430, 450.XU Weizhen, ZHANG Guomin, LIANG Shuang, et al. Systematic review on immunology effect and protective efficacy of mumps attenuated live vaccine [J]. Chinese Journal of Vaccines and Immunization, 2011, 17(5): 426-430, 450.