四川省5所学校流感暴发疫情中2022—2023年季节性流感疫苗保护效果回顾性队列研究  

Protective effect of seasonal influenza vaccination among students in 5 primary/junior middle schools with influenza outbreaks in Sichuan province from 2022 to 2023:a retrospective cohort study

作　　者：李秋玲 张丽杰[1] 马会来[1] 张金瑞 李昀 杨建强 李媛媛 周丽君[5] 刘伦光[5] LI Qiuling;ZHANG Lijie;MA Huilai;ZHANG Jinrui;LI Yun;YANG Jianqiang;LI Yuanyuan;ZHOU Lijun;LIU Lunguang(China Field Epidemiology Training Program,Chinese Center for Disease Control and Prevention,Beijing 100050,China;Daxing District Center for Disease Control and Prevention,Beijing 102600,China;Wangcang County Center for Disease Control and Prevention,Guangyuan 628200,China;Zizhong County Center for Disease Control and Prevention,Neijiang 641200,China;Sichuan Provincial Center for Disease Control and Prevention,Chengdu 610041,China)

机构地区：[1]中国疾病预防控制中心中国现场流行病学培训项目,北京100050 [2]北京市大兴区疾病预防控制中心,北京大兴102600 [3]四川省旺苍县疾病预防控制中心,广元628200 [4]四川省资中县疾病预防控制中心,内江641200 [5]四川省疾病预防控制中心,成都610041

出　　处：《中国公共卫生》2024年第2期129-134,共6页Chinese Journal of Public Health

基　　金：中国现场流行病学培训项目(102393220020010000027);中美疾控中心合作项目(6NU2GGH002164-05-07)。

摘　　要：目的分析2022—2023年流感季接种流感疫苗在学校流感暴发疫情中的保护效果,为流感疫苗接种策略提供科学依据。方法以2023年2—4月四川省5所发生流感暴发疫情的小学、初中,幼小综合学校班级确诊病例数≥2例的班级学生为调查对象,采用回顾性队列研究方法评估流感疫情期间疫苗的保护效果。采用多因素logistic回归计算流感疫苗对临床诊断病例和确诊病例的保护效果[VE_(adj)=(1-RR_(adj))×100%],调整的变量为就读学段、学校和年龄组。结果共纳入4087名研究对象,流感疫苗接种率为19.0%。发病1352例,发病率为33.1%,其中,疑似病例401例、临床诊断病例659例、确诊病例292例。接种流感疫苗对临床诊断病例和确诊病例的VE_(adj)(95%CI)为26.0%(0.6%~44.9%)。分层分析显示,接种时间与发病时间间隔在[14,120]d和(120,180]d的VE_(adj)(95%CI)分别为78.3%(59.8%~88.3%)和58.6%(35.6%~73.4%),时间间隔>180 d无保护效果;接种四价流感疫苗接种时间与发病时间间隔在[14,120]d和(120,180]d的VE_(adj)(95%CI)分别为81.4%(63.8%~90.4%)和62.3%(40.7%~76.0%);接种时间与发病时间间隔为[14,120]d和(120,180]d对A(H1N1)亚型引起的流感暴发疫情的VE_(adj)(95%CI)分别为73.4%(12.1%~92.0%)和87.1%(74.7%~93.4%)。结论接种流感疫苗对学校暴发疫情中预防流感有一定的保护效果,当季接种时间与发病时间间隔在6个月内保护效果最佳,时间间隔越短保护效果越好,应采取综合政策措施积极推动流感疫苗预防接种工作。Objective To analyze protective effect of seasonal influenza vaccination among primary and junior middle school students during influenza outbreak in schools during 2022-2023 for developing influenza vaccination strategies.Methods A retrospective cohort study was conducted among 4087 students in 64 classes of 5 preschool/primary/junior middle schools with influenza outbreaks(at least two cases diagnosed in a class)during February-April 2023 in Sichuan province.The parents of the students were asked to answer an online questionnaire about the students'information on demographics,influenza situation,and the status of influenza vaccination.The cases'laboratory diagnosis and the students'detailed information on seasonal vaccination were further checked in the National Infectious Disease Surveillance Information System and the Sichuan Province Planned Immunization Information Management System using Identification Card Numbers of the students.Multivariate logistic regression was adopted to calculate adjusted relative risk(RR)of influenza of the influenza vaccinees for the estimation of adjusted vaccine effectiveness(VE_(adj))of influenza vaccination with following formula:VE_(adj)=(1-RR_(adj))×100%.Results Among all the students surveyed,1352(33.1%)had influenza onset during the outbreak period from April to June 2023,including 292 laboratory confirmed,659 clinically diagnosed,and 401 suspected cases.There were 19.0%of students had receiving seasonal influenza vaccination,the VE_(adj)(95%confidence interval[95%CI])of flu vaccination was 26.0%(0.6%-44.9%)for clinically diagnosed and laboratory confirmed cases;stratified analyses showed that for all the vaccinees with the interval time of within 14-120 days and within 121-180 days between the vaccination and influenza onset,the VE_(adj)(95%CI)were 78.3%(59.8%-88.3%)and 58.6%(35.6%-73.4%);for the vaccinees with the same two interval periods but receiving quadrivalent flu vaccine,the VE_(adj)(95%CI)were 81.4%(63.8%-90.4%)and 62.3%(40.7%-76.0%)and the VE_(adj)(95%CI)were

关 键 词：流行性感冒 暴发疫情 流感疫苗 保护效果 回顾性队列研究 

分 类 号：R511.7[医药卫生—内科学] R186[医药卫生—临床医学]