流行性腮腺炎疫苗在学校暴发疫情中的保护效果  

Protection effectiveness of Mumps attenuated live vaccine against mump outbreak in schools

作　　者：吕海英[1] 王翠玲[1] 

机构地区：[1]广东省中山市疾病预防控制中心,528403

出　　处：《中国学校卫生》2015年第12期1845-1847,共3页Chinese Journal of School Health

摘　　要：目的了解流行性腮腺炎（简称流腮）疫苗在学校等集体单位流腮暴发疫情中的保护效果,为完善流腮疫苗免疫策略提供依据。方法收集中山市2010—2014年发生流腮暴发疫情的学校中病例数≥3例的班级内所有学生的流腮疫苗接种信息。按年龄分层,以接种流腮疫苗作为暴露因素,采用回顾性队列研究方法,评价流腮疫苗的保护效果。结果共有3所学校501名儿童被纳入研究对象,流腮总罹患率为14.97%（75/501）,接种组罹患率为13.59%（59/434）,未接种组罹患率为23.88%（16/67）,两组之间差异有统计学意义（χ2=4.824,P〈0.05）。流腮疫苗保护效果（VE）为43.1%（95%CI=7.2%~65.1%）。按流腮疫苗接种剂次分层分析,1剂次、2剂次和3剂次的RR值分别为88.0（95%CI=76.3%~101.4%）,88.2%（95%CI=76.1%~102.2%）和91.3%（95%CI=62.3%~133.9%）,均未显示保护作用（P值均〉0.05）。按最后1剂次接种日期与发病日期间隔分层分析,间隔〈1 a和2 a的RR值分别为82.1%（95%CI=70.0%~96.3%）和82.5%（95%CI=70.1%~97.0%）,确定有保护作用。间隔1 a、3 a、4 a、5 a、6 a和≥7 a的RR值分别为87.3%（95%CI=72.9%~104.6%）,92.7%（95%CI=77.3%~111.1%）,86.4%（95%CI=72.6%~102.8%）,88.1%（95%CI=73.7%~105.3%）,104.2%（95%CI=79.6%~136.3%）和88.1%（95%CI=75.9%~102.2%）,均未确定保护作用（P值均〉0.05）。结论接种疫苗是预防和控制流腮最有效措施。但接种时间超过3 a,对阻止流腮疫情在学校的暴发保护效果不佳。Objective To assessprotection effectiveness of the mumps attenuated live vaccine against mump outbreak occurring in schools and to provide basis for improving immunization strategy of mumps. Methods Information of mumps attenuated live vaccine among students of classes having more than three cases in the affected schools from 2012 to 2014 was collected. Institutions were divided into different age groups with having vaccined as exposure factor,and the history of vaccination with mumps attenuated live vaccine was analyzed. A historical cohort study was conducted. Results A total of 501 students in 3 schools were enrolled. It was found that the mumps incidence was 14. 97%（ 75 /501） during the outbreak. The attack rate was 13. 59%（ 59 /434）for those vaccinated,and 23. 88%（ 16 /67） for those unvaccinated,statistical difference was found in different rates（ χ2= 4. 824,P〈0. 05）. The estimated VE for Mu V was 43. 1%（ 95% CI = 7. 2%- 65. 1%）. Stratified analysis according mumps vaccination rate and dose indicated that the effectiveness of 1-dose mumps vaccination was 88. 0%（ 95% CI = 76. 3%- 101. 4%）,and 2-dose0. 882（ 95% CI = 0. 761- 1. 022）,3-dose 0. 913（ 95% CI = 0. 623- 1. 339）,respectively. All these situations showed no protective effect（ P〈0. 05）. Stratified analysis according time interval from the time of last mumps vaccine to disease showed that the effectiveness was 0. 821（ 95% CI = 0. 700- 0. 963） when time interval was less than 1 year,and 0. 825（ 95% CI = 0. 701- 0. 970）when time interval was 2 years. These two situations showed protective effect. Time interval of 1,3,4,5,6,over 7 years were 0.873（ 95% CI = 0. 729- 1. 046）,0. 927（ 95% CI = 0. 773- 1. 111）,0. 864（ 95% CI = 0. 726- 1. 028）,0. 881（ 95% CI = 0. 737-1. 053）,1. 042（ 95% CI = 0. 796- 1. 363） 0. 881（ 95% CI = 0. 759- 1. 022）,respectively. All these situations showed no protective effect（ P〈0. 05）. Conclusions Mu V is the most effective measure to prevent and control mump

关 键 词：流行性腮腺炎 疫苗 疾病暴发流行 学生 

分 类 号：R174.6[医药卫生—妇幼卫生保健] R373.16[医药卫生—公共卫生与预防医学]