上海市静安区2017—2019年集体机构学生水痘疫苗应急接种效果评估  

Epidemiological evaluation for vaccine effectiveness of varicella attenuated live vaccine among students in collective institutions in Jing’an District, Shanghai from 2017 to 2019

作　　者：张小娟 敖建军 余平 权力 卑伟慧[1] 华瑞珏 黄瑾 ZHANG Xiaojuan;AO Jianjun;YU Ping;QUAN Li;BEI Weihui;HUARuijue;HUANG Jin(Immunization Planning Department,Center for Disease Control and Prevention,Jingan District,Shanghai(200072),China)

机构地区：[1]上海市静安区疾病预防控制中心免疫规划所,200072

出　　处：《中国学校卫生》2023年第1期139-142,共4页Chinese Journal of School Health

摘　　要：目的 了解集体机构学生水痘减毒活疫苗(varicella attenuated live vaccine, VarV)的接种情况,为分析疫苗接种的保护效果提供依据。方法 将2017—2019年静安区所有发生水痘疫情并开展应急接种的集体机构作为研究场所,将其涉及到的发病班级内所有学生(6 473名)作为研究对象,收集水痘发病信息、VarV接种情况,分析VarV的保护效果(vaccine effectiveness, VE)及不同状态下应急接种的效果。结果 学生无免疫史的比例逐年下降,2017年为7.5%、2018年为7.2%、2019年为4.9%;病例中VarV既往免疫史的比例(90.0%)低于非病例(93.5%),差异有统计学意义(χ^(2)=6.53,P<0.05);病例中VarV应急接种的比例(8.3%)低于非病例(44.1%),差异有统计学意义(χ^(2)=179.06,P<0.01);续发病例中VarV应急接种的比例(28.6%)低于非病例(44.1%),差异有统计学意义(χ^(2)=9.44,P<0.01);无既往免疫史且未开展应急接种的研究对象水痘罹患率最高(11.0%),有既往免疫史且开展了应急接种的研究对象水痘罹患率最低(1.0%);相对于无VarV免疫史的对象,接种1剂VarV后2年内有明确的保护效果,VE为63.1%(95%CI=11.0%~84.7%)。结论 接种1剂VarV保护效果不高;尽早开展VarV应急接种可以有效降低续发率。Objective To understand the vaccination of varicella attenuated live vaccine(VarV) among students in collective institutions, to provide a basis for analying the protective effect of vaccination. Methods All collective institutions with chickenpox epidemic and post-exposure vaccination in Jing’an District from 2017 to 2019 were investigated. All students(n=6 473) in the affected class were included. Vaccination status and the incidence information of disease were collected to analyze vaccine effectiveness(VE). ResultsThe proportion of study subjects without an immunization history decreased year by year, and 7.5% in 2017,7.2% in 2018, and 4.9% in 2019. The proportion with a history of one dose prior to exposure in cases was 90.0%, it was lower than 93.5% in the non cases(χ^(2)=6.53, P<0.05). The proportion with one dose as post-exposure prophylaxis in cases was 8.3%, it was much lower than 44.1% in the non cases(χ^(2)=179.06, P<0.01). The proportion with one dose as post-exposure prophylaxis in secondary cases was 28.6%, much lower than 44.1% in the non cases(χ^(2)=9.44, P<0.01).Unvaccinated ones and the second dose as post-exposure prophylaxis ones in cases had the highest rate of varicella development(11.0%), a history of one dose prior to exposure and one dose as post-exposure prophylaxis in cases had the lowest varicella rate(1.0%).There was a clear protective effect within two years after one dose of VarV inoculation, VE was 63.1%(95%CI=11.0%-84.7%). Conclusion The vaccine effectiveness of one-dose VarV was limited. Post-exposure prophylaxis as early as possible was highly effective in decreasing secondary attack rate.

关 键 词：水痘疫苗 接种 患病率 学生 

分 类 号：R186[医药卫生—流行病学] G4783[医药卫生—公共卫生与预防医学] R183[文化科学—教育学]