水痘疫苗纳入免疫规划对其发病率的影响  

Impact of inclusion of varicella vaccine into the immunization program on the incidence of varicella

作　　者：刘方珉 时黎明 姚烨 孙晓冬[1] 李智[1] 陆一涵[2] 张莉萍[3] 陆佳[3] LIU Fangmin;SHI Liming;YAO Ye;SUN Xiaodong;LI Zhi;LU Yihan;ZHANG Liping;LU Jia(Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;School of Public Health,Fudan University,Shanghai 200032,China;Minhang District Center for Disease Control and Prevention,Shanghai 201101,China)

机构地区：[1]上海市疾病预防控制中心,上海200336 [2]复旦大学公共卫生学院,上海200032 [3]上海市闵行区疾病预防控制中心,上海201101

出　　处：《上海预防医学》2023年第7期634-638,共5页Shanghai Journal of Preventive Medicine

基　　金：上海市闵行区自然科学研究课题(2020MHZ013)。

摘　　要：【目的】分析2013—2022年上海市闵行区水痘流行特征,评价水痘疫苗接种程序调整为2剂次并纳入上海市免疫规划对水痘发病率的影响。【方法】收集2013—2022年闵行区水痘报告病例资料,采用中断时间序列分析和分段回归模型,分析水痘免疫策略调整前后闵行区水痘报告发病率变化情况。【结果】2013—2022年上海市闵行区水痘年均报告发病率为76.58/10万,发病率最高为2017年(119.21/10万),最低为2022年(27.02/10万)。水痘发病有明显季节性,呈双峰分布,3—6月和10月—次年1月为发病高峰期。水痘免疫策略调整前(2013—2017年),水痘发病率呈上升趋势(z=2.20,P=0.03),调整后(2018—2022年)呈下降趋势(z=−2.25,P=0.02)。中断时间序列分析结果显示,水痘免疫策略调整后,水痘年报告发病率的水平变化量为−33.91/10万(t=−4.35,P<0.001),发病率斜率变化量为−28.61/10万(t=−12.16,P<0.001),发病率斜率为−17.59/10万。【结论】2013—2022年上海市闵行区水痘发病呈现明显的季节特征,将水痘疫苗接种程序调整为2剂次并纳入免疫规划后,第2剂次水痘疫苗接种量大幅增加,水痘发病率上升的趋势得到有效控制,发病率水平显著降低并呈现持续下降趋势。[Objective]To analyze the epidemiological characteristics of varicella in Minhang District,Shanghai from 2013 to 2022,and to evaluate the impact of adjusting the varicella vaccination program to a two-dose regimen and its inclusion in the Shanghai immunization program on the incidence of varicella.[Methods]Data on reported varicella cases from 2013 to 2022 in Minhang District were collected.Interrupted time series analysis and segmented regression models were used to analyze the changes in varicella incidence before and after the adjustment of varicella immunization strategies.[Results]From 2013 to 2022,the average annual incidence of varicella was 76.58/100000,with the highest incidence in 2017(119.21/100000)and the lowest in 2022(27.02/100000).The varicella incidence exhibited seasonal patterns with peaks occurring from March to June and October to January of the following year.Prior to the adjustment of varicella immunization strategies(2013‒2017),the varicella incidence showed an upward trend(z=2.20,P=0.03),while after the adjustment(2018‒2022),a adownward trend was observed(2018‒2022)(z=−2.25,P=0.02).Interrupted time series analysis showed that following the adjustment of varicella immunization strategies,an immediate change of−33.91/100000(t=−4.35,P<0.001)in varicella incidence was observed,and the incidence slope was−17.59/100000 with a decline of 28.61/100000(t=−12.16,P<0.001)compared to before inclusion.[Conclusion]The incidence of varicella in Minhang District,Shanghai from 2013 to 2022 exhibits distinct seasonal patterns.After adjusting the varicella vaccination program to a two-dose regimen and incorporating it into the immunization program,the second dose of varicella vaccine administration substantially increases.As a result,the rising trend of varicella incidence is effectively controlled,and the incidence level decreases significantly,showing a sustained downward trend.

关 键 词：水痘 发病率 疫苗 免疫规划 中断时间序列 

分 类 号：R1[医药卫生—公共卫生与预防医学] R511.5