中国幼托机构及中小学聚集性水痘疫情中疫苗保护效果的meta分析  

Effectiveness of vaccination in varicella outbreaks in kindergartens and primary and secondary schools in China: a meta-analysis

作　　者：朱琳[1] 韩一楠[1] 杨月[1] ZHU Lin;HAN Yi-nan;YANG Yue(Immunization Programme Department,Dalian Center for Disease Control and Prevention,Dalian Liaoning,116021,China)

机构地区：[1]大连市疾病预防控制中心免疫规划所,辽宁大连116021

出　　处：《职业与健康》2020年第16期2270-2273,共4页Occupation and Health

摘　　要：目的评价水痘疫苗在中国幼托机构及中小学聚集性水痘疫情中的保护效果。方法检索SinoMed、CNKI、万方、Pubmed、Cochrane图书馆、SCI、EMBASE数据库,筛选并提取2019年10月以前所有关于中国幼托机构及中小学聚集性水痘疫情中水痘疫苗保护效果的队列研究和病例对照研究。对水痘的疫苗保护效果进行meta分析,并对不同免疫程序和国产/进口疫苗的保护效果进行亚组分析,所有分析均应用RevMan 5.3完成。结果共纳入16篇文献,其中回顾性队列研究7篇,病例对照研究9篇,纳入接种组对象7 154例,对照组对象4 569例。队列研究结果显示,疫苗保护率(VE)=55%(95%CI:46%~63%),OR=0.45 (95%CI:0.37~0.54);病例对研究结果显示,VE=68%(95%CI:62%~73%),OR=0.32(95%CI:0.27~0.38);合并结果显示,VE=63%(95%CI:58%~67%),OR=0.37(95%CI:0.33~0.42),说明接种疫苗组患水痘的风险显著降低。亚组分析显示,接种2剂次的保护效果好于1剂次,VE=91%(95%CI:55%~98%),OR=0.09(95%CI:0.02~0.45);国产和进口水痘疫苗两者保护效果比较,差异无统计学意义(P>0.05)。结论水痘疫苗对中国幼托机构及中小学人群的保护效果较好,建议采取2剂次的免疫策略。Objective To evaluate the effectiveness of varicella vaccine in outbreaks in kindergartens and primary and secondary schools in China. Methods A total of SinoMed,CNKI,Wanfang Data,Pubmed,Cochrane Library,SCI Database and EMBASE were searched to screen and extract all cohort studies and case-control studies on the protective effect of varicella vaccine in outbreaks in kindergartens and primary and secondary schools in China before October 2019. Meta analysis was performed in protective effect of varicella vaccine,and the subgroup analysis was performed on protective effects of different immunization procedure and domestic/imported vaccines. All analyses were performed using RevMan 5.3. Results A total of 16 studies included in meta-analysis,and there were seven cohort studies and nine case-control studies,involving 7 154 participants in vaccination group and 2 979 in control group. The cohort study showed VE=55%(95%CI:46%-63%)and OR=0.45(95%CI :0.37-0.54),case-control study showed VE=68%(95%CI:62%-73%) and OR=0.32(95%CI:0.27-0.38),and merge results displayed VE=63%(95%CI:58%-67%)and OR=0.37(95% CI :0.33-0.42),indicating a lower risk in vaccination group. Subgroup analysis showed two dose vaccination group had a higher vaccine efficacy than one dose vaccination group[ VE = 91 %( 95 % CI : 55 %-98 %),OR=0.09(95%CI: 0.02-0.45)],and no statistically significant was observed between domestic and imported vaccines(P>0.05).Conclusion The varicella vaccine shows a good efficacy on population in kindergartens and primary and secondary school in China,and two dose immunization strategy is a good choice.

关 键 词：水痘 水痘疫苗 保护效果 META分析 

分 类 号：R181.3[医药卫生—流行病学]