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  

Vaccination Schedules, Reported Vaccination Coverage Rates, and Incidences of Measles,Mumps and Rubella of the 194 Member States of the World Health Organization

作　　者：马超[1] 郝利新[1] 苏琪茹[1] 温宁[1] 樊春祥[1] 杨宏[1] 王华庆[1] 李黎[1] 

机构地区：[1]中国疾病预防控制中心免疫规划中心,北京100050

出　　处：《中国疫苗和免疫》2015年第3期241-247,254,共8页Chinese Journal of Vaccines and Immunization

基　　金：中国疾病预防控制中心青年科学研究基金资助(课题编号:2015A103)

摘　　要：目的分析世界卫生组织（World Health Organization,WHO）194个成员国麻疹、流行性腮腺炎（流腮）和风疹减毒活疫苗常规免疫程序、报告接种率和发病水平,为我国优化含麻疹成分疫苗（Measles-containing Vaccine,MCV）免疫策略提供参考。方法汇总分析WHO网站公开数据,包括各国MCV常规免疫疫苗种类、剂次数和接种月龄、报告接种率和发病数据。结果 WHO194个成员国中,有47个（24.2%）国家实施1剂MCV常规免疫程序;139个（71.6%）国家实施2剂MCV常规免疫程序,且其中102个（52.6%）国家为2剂麻疹-流腮-风疹联合减毒活疫苗（Measles,Mumps and Rubella Combined Attenuated Live Vaccine;MMR）;另外8个国家实施≥3剂MCV常规免疫程序。第1剂（The 1stDose）MCV（MCV1）使用麻疹减毒活疫苗的68个国家中,有66个（97.1%）在≤9月龄接种;使用MMR的112个国家中,有109个（77.7%）在≥12月龄接种。自20世纪90年代以来,WHO各区域MCV1报告接种率一直以非洲区（Region for the Africa,AFR）最低。2009~2013年,麻疹发病率以WHO美洲区（Region for the Americas,AMR）最低（0.10/100万~1.38/100万）、AFR最高（100.0/100万~232.4/100万）;风疹发病率以WHO AMR最低（0.01/100万~0.02/100万）,WHO西太平洋区（Region for the Western Pacific,WPR）和欧洲区较高;流腮发病率以WHO WPR最高（211.5/100万~328.6/100万）。结论各国MCV常规免疫程序差别较大,采取≥2剂MMR免疫程序、且接种率较高的国家发病水平也较低。要同时实现消除麻疹、控制风疹和流腮,实施2剂MMR常规免疫程序非常必要。Objective To analyze routine immunization schedules for measles, mumps, and rubella con- taining vaccines （MCV） , MCV coverage levels, and measles incidence rates of all World Health Organi- zation member states. To provide evidence to inform the measles vaccination strategy in China. Methods We compiled and analyzed the publicly-accessible data from the WHO website, including vaccine type, number of doses, recommended ages for each dose, reported MCV coverage, and measles inci- dence rates. Results Among the 194 WHO member states, 47 （24： 2% ） use a one-dose MCV policy; 139 （71.6%） use a 2-dose policy, including 102 states that use 2 doses of MMR vaccine; and 8 coun-tries use 3 or more routine doses of MCV. Among 68 states using MV for the first dose （MCV1）, 66 （97. 1% ） administer the dose no later than 9 months age; among 112 states that use MMR for the first dose, 109 （77.7%） administer the dose after 1 year of age. The African Region （AFR） has had the lowest MCV1 coverage since 1990s. From 2009 to 2013, the WHO American Region （AMR） has had the lowest measles incidence （0. 10 -1.38 per million total population） while AFR had the highest （i00.0 -232. 4 per million） ; the rubella incidence was also lowest in AMR （0. 01 -0.02） , while it was much higher in the Western Pacific Region （WPR） and European Region; the WPR （211.5 -328.6） had the highest mumps incidence. Conclusion Routine MCV immunization sched- ules vary from country to country. Measles, rubella and mumps incidences were low in countries using ≥ 2 doses MMR that achieved high coverage. To eliminate measles and control rubella and mumps, 2 dose of MMR schedule is necessary.

关 键 词：世界卫生组织 成员国 含麻疹成分疫苗 免疫程序 接种率 发病率 

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]