水痘疫苗在学校水痘暴发疫情中保护效果的病例对照研究  

Case-control study on the effectiveness of varicella vaccine against varicella outbreak in school

作　　者：王翠玲[1] 吕海英[1] 李雷[1] 吴雯 蔡乾春[1] 陈小红[1] WANG Cui-ling;LV Hai-ying;LI Lei;WU Wen;CAI Qian-chun;CHEN Xiao-hong(Zhongshan Center for Disease Control and Prevention,Zhongshan,Guangdong 528400,China)

机构地区：[1]中山市疾病预防控制中心,广东中山528400

出　　处：《现代预防医学》2022年第23期4390-4393,共4页Modern Preventive Medicine

摘　　要：目的评价接种1剂水痘疫苗在学校水痘暴发疫情中的保护效果(vaccine effectiveness,VE)。方法采用1:2配对病例对照研究,收集中山市2013—2021年水痘暴发疫情调查资料,将病例数≥5例的班的所有病例(共942例)作为病例组,按1:2的比例选取同班、同年龄(±1岁)、同性别的1884名健康儿童作为对照组,调查其水痘疫苗接种史,采用条件logistic回归分析水痘疫苗保护效果。结果共调查3~14岁儿童2826名,儿童接种1剂水痘疫苗的保护效果为58%(95%CI:50%~66%),3~5岁、6~14岁儿童接种1剂水痘疫苗保护效果分别为75%(95%CI:62%~83%)和51%(95%CI:40%~61%)。儿童接种1剂后≤2年、3~5年、6~8年、≥9年的保护效果分别为78%(95%CI:66%~86%)、66%(95%CI:57%~74%)、51%(95%CI:36%~62%)、23%(95%CI:-11%~46%)。儿童接种1剂水痘疫苗的保护效果随接种后时间的延长而降低(趋势χ^(2)=13.071,P<0.001)。结论儿童接种1剂水痘疫苗有助于防控水痘暴发疫情,但其保护效果随接种后时间的延长而降低,难以阻断水痘传播。建议儿童及时接种2剂水痘疫苗,以预防学校水痘暴发疫情。Objective To estimate the vaccine effectiveness(VE)of one dose of varicella vaccine against varicella outbreak in school.Methods Data was collected from 2013 to 2021.A case-control study was conducted with 942 cases from classes with more than 5 cases,compared with 1884 controls matched by class,age and sex with a ratio of 1:2.Conditional logistic regression was used to estimate odds ratios(OR)in order to further obtain VE.Results A total of 2826 children were investigated.VE was 58%(95%CI:50%-66%)in children 3-14 years of age.VE were 75%(95%CI:62%-83%)in children 3-5 years of age and 51%(95%CI:40%-61%)in children 6-14 years of age,respectively.VE were 78%(95%CI:66%-86%),66%(95%CI:57%-74%),51%(95%CI:36%-62%)and 23%(95%CI:-11%-46%)in children investigated after their immunization of one dose of varicella vaccine for less than 2 years,3-5 years,6-8 years,and more than 9 years,respectively.The trend of gradual decreasing of VE over time was statistically significant(χ^(2)=13.071,P<0.001).Conclusions One dose of varicella vaccine provides a satisfactory protection in the varicella outbreak in school,but VE of varicella vaccine attenuates over time.One dose of varicella vaccine in children is not enough to block the transmission of varicella.Children should be vaccinated with two doses of varicella vaccine in time in order to prevent varicella outbreak in school.

关 键 词：水痘 病例对照研究 疫苗保护效果 

分 类 号：R511.5[医药卫生—内科学] R181.3[医药卫生—临床医学]