上海市金山区肠道病毒71型灭活疫苗接种情况及接种前后手足口病流行病学和病原学变化分析  

Coverage of inactivated enterovirus 71 vaccine and analysis of epidemiological and etiological changes of hand-foot-mouth disease before and after vaccination in Jinshan District of Shanghai

作　　者：姚红岑 周杰[1] 董兆鹏 孙箐爽 吴洪彦[1] 杜荐如 汤喜红[1] 李淑华[1] YAO Hongcen;ZHOU Jie;DONG Zhaopeng;SUN Qingshuang;WU Hongyan;DU Jianru;TANG Xihong;LI Shuhua(Jinshan District Center for Disease Control and Prevention,Shanghai 201599,China)

机构地区：[1]上海市金山区疾病预防控制中心,上海201599

出　　处：《中国生物制品学杂志》2023年第3期315-320,329,共7页Chinese Journal of Biologicals

基　　金：上海市卫健委科研课题(20194Y0399)。

摘　　要：目的 了解上海市金山区肠道病毒71型(enterovirus 71,EV71)灭活疫苗接种水平及其对该区手足口病(handfood-mouth disease,HFMD)流行病学和病原谱变化的影响,为改进该区HFMD防控策略提供依据。方法 收集上海市金山区免疫规划信息综合管理系统中2016—2019年EV71灭活疫苗接种资料,描述接种特征;提取“中国疾病监测报告信息系统”中2013—2019年金山区HFMD病例资料,获取同期该区HFMD病原监测信息,比较接种前后HFMD发病率、病原阳性检出率等的差异性。结果 2016年11月—2019年12月,金山区共接种EV71灭活疫苗63 521剂次,第1针接种率为22.57%,全程接种率为21.05%,两剂次基础免疫完成率为94.65%。不同年份、月份、现住址、年龄、户籍等接种率存在差异性(P均<0.05),第1针接种率2018年最高(33.45%),全程接种率2017年最高(30.78%),5—8月份接种量较大,6~11月龄接种率最高,1岁以上接种量最大,本市儿童接种率高于流动儿童。接种前后HFMD发病率差异无统计学意义(χ^(2)=0.427,P=0.513),接种后重症发病率、EV71阳性检出率、EV71感染HFMD估算发病率均显著降低(χ^(2)分别为15.312、41.431和432.342,P均<0.001)。结论 接种EV71灭活疫苗降低了金山区HFMD EV71感染和重症发生,但接种率水平较低,还需关注HFMD病原谱变化,预防其他肠道病毒感染。建议加强宣传和信息化手段提高接种率,加快联合疫苗研发,提供更多抗体保护。ObjectiveTo analyse the coverage of inactivated enterovirus 71(EV71)vaccine and the impact on hand-foodmouth disease(HFMD)epidemiological and etiological changes in Jinshan District,Shanghai,and provide evidence for improving the prevention and control strategy of HFMD in this area.MethodsThe vaccination data of inactivated EV71vaccine from 2016 to 2019 was collected in Jinshan Immunization Information Management System of Shanghai to describe the vaccination characteristics;The data of HFMD cases in Jinshan District from 2013 to 2019 were extracted from Chinese Disease Prevention and Control Information System,and the surveillance etiological information of HFMD in the same period was obtained,which was compared for the differences of HFMD incidence and pathogen positive detection rate before and after vaccination.ResultsFrom November 2016 to December 2019,a total of 63 521 doses of inactivated EV71vaccine were applied in Jinshan District,with the first shot coverage of 22.57%,the full shot coverage of 21.05% and the two-dose completion coverage of 94.65%.There were significant differences in coverage between different years,months,current addresses,age groups and registers(P<0.05).The highest coverage of first short was in 2018(33.45%),while full short in 2017(30.78%).More doses were applied during May to August,with highest coverage in 6 to 11 months old group and most doses in 1 year old group.The coverage of children in this city was higher than that of migrant children.There was no significant difference in the incidence of HFMD before and after vaccination(χ^(2)= 0.427,P =0.513 ),while the incidence of severe disease,the positive detection rate of EV71 and the estimated incidence of HFMD infected with EV71 decreased significantly after vaccination(χ^(2)= 15.312,41.431 and 432.342 respectively,each P<0.001).ConclusionVaccination with inactivated EV71 vaccine reduced the occurrence of HFMD EV71 infection and severe disease in Jinshan District,while the coverage was low,so it was necessary to pay attention

关 键 词：肠道病毒71型灭活疫苗 接种率 流行病学 病原学 手足口病 

分 类 号：R186[医药卫生—流行病学]