中学生麻疹减毒活疫苗强化免疫的血清学和流行病学效果观察  

Observation on the Serological and Epidemiological Effect of Measles Attenuated Live Vaccine Supplementary Immunization Activities for Middle School Students

作　　者：何寒青[1] 陈恩富[1] 李倩[1] 赵艳荣[1] 严睿[1] 符剑[1] 唐学雯[1] 

机构地区：[1]浙江省疾病预防控制中心,杭州310051

出　　处：《中国疫苗和免疫》2011年第6期516-519,共4页Chinese Journal of Vaccines and Immunization

摘　　要：目的评价中学生麻疹减毒活疫苗(Measles Attenuated Live Vaccine,MV)强化免疫活动(Supplementary Immunization Activities,SIA)的血清学和流行病学效果,为浙江省制定消除麻疹策略提供参考。方法采集中学生接种MV前、后血标本,评价血清学效果。通过2008～2010年纵向抗体水平监测,分析人群血清学效果;根据接种对象年龄队列人群的麻疹发病率及发病构成比,评价流行病学效果。结果中学生接种MV后,抗体阳性率从85.92%上升到97.54%,阳转率(免疫前抗体阴性、免疫后阳性或免疫后较免疫前抗体≥4倍增高)为36.27%;麻疹抗体几何平均浓度(Geometric Mean Concentration,GMC)为1479.53毫国际单位/毫升(mIU/ml),显著高于接种前的496.89mIU/ml(F=391.39,P<0.05)。SIA目标人群2010年麻疹抗体阳性率和GMC均高于SIA前的2008年,其中GMC差异有统计学意义(t=47.70,P<0.05)。2010年SIA目标人群麻疹病例构成比显著低于2007年(Z=3.33,P<0.05),发病率与全人群发病率比也低于2007年。结论中学生MVSIA的血清学和流行病学保护效果良好,能加强该人群的免疫屏障,减少麻疹发病。建议常规组织开展中学生含麻疹成分疫苗接种,以加速消除麻疹。Objective To evaluate the serological and epidemiological effects of the measles attenuated live vaccine supplementary immunization activities （SIA）in middle school students, and to provide the evidence for making strategies of measles elimination. Methods Serological samples from 284 subjects were collected before and after vaccination, and the tested results were analyzed to evaluate the immune effect. Immunological antibody level against measles were investigated and compared by longitudinal serological survey at the year of 2008, 2010. Incidence and proportion of measles in the target subjects of SIA were analyzed to understand the epidemiological effects. Results Before and after vaccination, the positive rate of antibody was 85.92%, 97.54% respectively, and the sero-conversion rate （prevaccination antibody negative and postvaccination antibody positive or ≥4-fold titre increased after vaccination） was 36.27 %. Geometric mean concentration （GMC） was significant increased from 496.89mIU/ml to 1479.53mIU/ml after immunization （F=391.39, P〈0.05）. GMC of target subjects in SIA were increased significantly from 2008 to 2010（t=47.70, P〈0.05）. Incidence ratio and proportion of measles in the target subjects in SIA were decreased from 2007 to 2010（Z=3.33, P〈0.05）. Conclusion Highly immune effects achieved after SIA for middle school students, and the epidemiological effect was demonstrated by the increasing of antibody and decreasing of incidence at target subjects. The routine measles immunization activities for middle school students should be recommended at Zhejiang province.

关 键 词：中学生 麻疹减毒活疫苗 强化免疫活动 血清学效果 流行病学效果 

分 类 号：R186[医药卫生—流行病学] R511.1[医药卫生—公共卫生与预防医学]