安徽省六安市学校流行性腮腺炎暴发现场含腮腺炎成分疫苗保护效果评估  

Field evaluation on protection efficiency of mumps containing vaccine in mumps outbreaks in schools in Lu′an

作　　者：秦伟[1,2] 刘艳 张丽杰[2] 杨涛 王瑶[1] 许小康 孟祥梅 赵昌军 黎少毅 解少煜 李开春 吕勇[1] Qin Wei;Liu Yan;Zhang Lijie;Yang Tao;Wang Yao;Xu Xiaokang;Meng Xiangmei;Zhao Changun;Li Shaoyi;Xie Shaoyu;Li Kaichun;Lyu Yong(Lu＇an Prefectural Center for Disease Control and Prevention,Lu＇an 237008,Anhui,China;Chinese Field Epidemiology Training Program,Chinese Center for Disease Control and Prevention,Beijing 100050,China;Hangzhou Municipal Center for Disease Control and Prevention,Hangzhou 310021,Zhejiang,China;Jin＇an District Center for Disease Control and Prevention,Lu＇an 237001,Anhui,China)

机构地区：[1]六安市疾病预防控制中心,安徽六安237008 [2]中国现场流行病学培训项目,北京100050 [3]杭州市疾病预防控制中心,浙江杭州310021 [4]六安市金安区疾病预防控制中心,安徽六安237001

出　　处：《疾病监测》2018年第8期659-663,共5页Disease Surveillance

摘　　要：目的评估含腮腺炎成分疫苗(MuCV)的保护效果,为流行性腮腺炎免疫策略调整提供数据支持。方法利用2015–2016年在六安市发生的流行性腮腺炎暴发现场,采用回顾性队列研究方法评估MuCV的保护效果。结果接种2剂MuCV的保护效果要好于仅接种1剂次,其中接种1剂、2剂和3剂MuC V的保护效果分别为49.35%(95%CI:36.03%~59.89%)、66.04%(95%CI:45.54%~78.83%)和85.96%(95%CI:1.80%~97.99%)。接种第2剂与第1剂的时间间隔为3~4年时的保护效果最高,为78.68%(95%CI:34.30%~93.08%)。MuCV随接种后时间间隔的增加其疫苗保护效果呈现下降趋势,接种1剂后4年内的保护效果最好为72.78%(95%CI:39.29%~87.29%),4~6年降至52.73%(95%CI:38.31%~63.79%),超过10年后仅为27.67%(95%CI:–24.15%~57.86%)。接种1剂麻腮风、麻腮或单价流行性腮腺炎疫苗4年内能均能提供较好保护,但麻腮风疫苗感染流行性腮腺炎的累积风险随接种后时间推移高于其他两组。结论 MuCV保护效果随接种后时间增加而衰减,4年内疫苗保护效果最好。2剂MuCV的保护效果要好于1剂,接种第2剂与第1剂时间间隔3~4年保护效果最好,应尽快建立2剂免疫策略。Objective To evaluate the protection efficiency of mumps containing vaccine（MuCV） and provide evidence for the improvement of mump immunization strategy. Methods A retrospective cohort study was conducted among all school students during the mumps outbreaks occurred in Lu＇an from 2015 to 2016. Results The protection efficiency of 2 dose MuCV was better than that of 1 dose, the protection efficiency of 1 dose, 2 dose and 3 dose MuCV were 49.35%（95% CI：36.03%–59.89%）, 66.04%（95% CI： 45.54%–78.83%） and 85.96%（95% CI： 1.80%–97.99%）, respectively. This data showed the 2 dose MuCV vaccination had highest protection efficiency of 78.68% at an interval of 3–4 years between the 1 st dose and the 2 nd dose（95% CI： 34.30%– 93.08%）. The protection efficiency of 1 dose MuCV decreased with time, which was 72.78%within 4 years（95% CI： 39.29%–87.29%）, 52.73% during 4–6 years（95% CI： 38.31%–63.79%） and 27.67% after more than10 years（95% CI： –24.15%–57.86%）. Vaccination with 1 dose of measles-mumps-rubella（MMR）,measles and mumps combined vaccine（MM） or monovalent mumps vaccine（MuV） could provide better protection within 4 years. However, the cumulative risk of mumps was higher in MMR vaccination group than those in MM or MuV vaccination groups. Conclusion The protection efficiency of MuCV decreased with time, and the protection efficiency was best within 4 years after vaccination.The protection efficiency of 2 dose MuCV was better than that of 1 dose, and the highest protection efficiency could be achieved at an interval of 3–4 years. It is suggested to implement 2 dose MuCV immunization strategy as soon as possible.

关 键 词：流行性腮腺炎 含腮腺炎成分疫苗 疫苗保护效果 暴发 

分 类 号：R512.1[医药卫生—内科学]