水痘疫苗在学校水痘疫情中的保护效力分析  

Study on the vaccine efficacy of varicella vaccine in school varicella outbreaks

作　　者：黄恩妙[1] 王翠玲[1] HUANG Enmiao;WANG Cuiling(Zhongshan Center for Disease Control and Prevention,Zhongshan,Guangdong 528403,China)

机构地区：[1]中山市疾病预防控制中心,广东中山528403

出　　处：《河南预防医学杂志》2022年第3期171-173,183,共4页Henan Journal of Preventive Medicine

基　　金：中山市社会公益与基础研究项目(2021B1109)。

摘　　要：目的 评价不同免疫策略下水痘疫苗在学校水痘暴发疫情中的保护效力。方法 在2019年中山市发生水痘暴发疫情的学校中,选取病例数较多(>5例)的班级学生作为研究对象,采用回顾性队列研究的方法评价水痘疫苗的保护效力。结果 共有10个班级418名学生纳入研究,水痘疫苗总接种率为83.5%(349/418),1、2剂次接种率分别为72.5%(303/418)和11.0%(46/418)。小学生(6~11岁)与中学生(12~15岁)2剂次的接种率差异有统计学意义(χ^(2)=8.198,P=0.004),1剂次接种率差异无统计学意义(χ^(2)=1.638,P=0.201)。水痘疫苗总效力为32.5%(95%CI:6.7%~51.2%),2剂次水痘疫苗效力为94.8%(95%CI:63.3%~99.3%),接种1剂次水痘疫苗未显示保护效果(χ^(2)=2.345,P=0.126)。按1剂次水痘疫苗接种年限分层分析,接种年限<6年疫苗有保护效果(χ^(2)=6.720,P=0.010),疫苗效力为53.3%(95%CI:13.2%~74.9%);接种年限≥6年未显示保护效果(χ^(2)=1.182,P=0.277)。结论 接种水痘疫苗对学校水痘暴发疫情有保护作用,但由于1剂次水痘疫苗效力随接种年限的延长而减弱导致其保护效果有限,建议采取多种措施提高2剂次水痘疫苗的接种率。Objective To evaluate the vaccine efficacy of varicella vaccine under different immunization strategies in school varicella outbreaks. Methods A retrospective cohort study was conducted to evaluate the vaccine efficacy of varicella vaccine in schools with reported varicella outbreaks in Zhongshan city in 2019, and class students with more cases(more than 5 cases) were selected as research subjects. Results A total of 418 students from 10 classes were included in the study. The total inoculation rate of varicella vaccine was 83.5%(349/418), and the inoculation rate of 1 and 2 doses was 72.5%(303/418) and 11.0%(46/418), respectively. There was statistically significant difference in vaccination rate between primary school students(6-11 years old) and middle school students(12-15 years old) at 2 doses(χ^(2)=8.198, P=0.004), while there was no statistically significant difference in vaccination rate at 1 dose(χ^(2)=1.638, P=0.201). The total efficacy of varicella vaccine was 32.5%(95%CI: 6.7%-51.2%),two doses of vaccine’s was 94.8%(95%CI:63.3%-99.3%), and no protective effect of one dose of vaccine’s(χ^(2)=2.345,P=0.126).The stratified analysis was conducted according to the years after inoculation of one dose varicella vaccine: the vaccine with the inoculation years <6 years had protective effect(χ^(2)=6.720,P=0.010) and the efficacy was 53.3%(95% CI: 13.2%-74.9%), but the inoculation years ≥6 years had no protectivve effect(χ^(2)=1.182,P=0.277). Conclusions The inoculation of varicella vaccine has protective effect on the outbreak of varicella in schools. However, the protective effect is limited because the efficacy of one-dose varicella vaccine weakens with the extension of inoculation years. It is suggested to take various measures to improve the inoculation rate of two-dose varicella vaccine.

关 键 词：水痘疫苗 暴发疫情 回顾性队列研究 疫苗效力 

分 类 号：R186.1[医药卫生—流行病学]