四川省2023年中小学校流感暴发疫情中流感疫苗保护效果病例对照研究  

The effectiveness of influenza vaccination in primary/secondary school influenza outbreaks in Sichuan province in 2023:a case-control study

作　　者：李秋玲 张丽杰[1] 马会来[1] 李昀 张金瑞 杨建强 李媛媛 周丽君[5] 刘伦光[5] Li Qiuling;Zhang Lijie;Ma Huilai;Li Yun;Zhang Jinrui;Yang Jianqiang;Li Yuanyuan;Zhou Lijun;Liu Lunguang(Chinese Field Epidemiology Training Program,Chinese Center for Disease Control and Prevention,Beijing 100050,China;Daxing District Center for Disease Control and Prevention,Bejing 102600,China;Wangcang County Center for Disease Control and Prevention,Guangyuan 628200,Sichuan,China;Zizhong County Center for Disease Control and Prevention,Neijiang 641200,Sichuan,China;Sichuan Provincial Center for Disease Control and Prevention,Chengdu 610041,Sichuan,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,北京102600 [3]四川省旺苍县疾病预防控制中心,四川广元628200 [4]四川省资中县疾病预防控制中心,四川内江641200 [5]四川省疾病预防控制中心,四川成都610041

出　　处：《中国疫苗和免疫》2024年第3期312-316,共5页Chinese Journal of Vaccines and Immunization

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：目的评价中小学校流感暴发疫情中流感疫苗(Influenza vaccine,InfV)和/或23价肺炎球菌多糖疫苗(23-valent pneumococcal polysaccharide vaccine,PPV23)的保护效果(Vaccine effectiveness,VE)。方法选择2023年2-4月四川省5所流感暴发疫情学校学生开展1∶1匹配的病例对照研究,分析2020-2023年三个流感季接种InfV和/或4.5年内接种PPV23对预防流感(包括实验室确诊和临床诊断病例)的VE,比较流感病例中接种和未接种者临床症状严重程度评分。结果病例组和对照组各纳入852例研究对象。2022/2023年流感季、2021/2022年流感季、2020/2021年流感季接种InfV的VE分别为29.96%(10.24%-45.34%)、24.31%(0.09%-42.66%)、19.00%(-10.37%-40.56%);三个流感季中任意流感季接种InfV、InfV+PPV23的VE(95%CI)分别为37.15%(22.36%-49.12%)、34.96%(8.25%-53.89%)。在流感病例中,任意流感季InfV接种和未接种病例的严重程度评分中位数均为9.0分(Z=-0.08,P=0.938),InfV+PPV23接种和未接种病例分别为8.0分、9.0分(Z=-3.11,P=0.002)。结论中小学生接种InfV对预防流感具有一定保护效果且随着流感季推移呈下降趋势,InfV与PPV23联合接种可减轻流感临床症状。Objective To evaluate the effectiveness of influenza vaccine(InfV)with and without prior 23-valent pneumococcal polysaccharide vaccine(PPV23)in primary and secondary school influenza outbreaks.Methods We selected students from 5 schools that had influenza outbreaks in Sichuan during February to April 2023 and conducted a 1∶1 matched case-control study.We analyzed InfV vaccine effectiveness(VE)for three influenza seasons,from 2020 to 2023,and/or PPSV23 given within the last 4.5 years for preventing influenza(including lab-and clinically-confirmed cases)and compared clinical symptom severity scores between vaccinated and unvaccinated influenza cases.Results Each case group and control group included 852 subjects.VEs(95%CI)for InfV vaccination in the 2022/2023,2021/2022,and 2020/2021 influenza seasons were 29.96%(10.24%-45.34%),24.31%(0.09%-42.66%),and 19.00%(-10.37%-40.56%),respectively;VEs(95%CI)for InfV and InfV+PPV23 vaccination in any of the three influenza seasons were 37.15%(22.36%-49.12%)and 34.96%(8.25%-53.89%).In any of the three influenza seasons,median severity scores for InfV-vaccinated and unvaccinated influenza cases were both 9.0 points(Z=-0.08,P=0.938),and for InfV+PPV23-vaccinated and unvaccinated cases were 8.0 and 9.0 points(Z=-3.11,P=0.002).Conclusions Influenza vaccination for primary and secondary school students showed a certain protective effectiveness against influenza;effectiveness declined over the influenza season.InfV vaccination combined with PPV23 can relieve clinical symptoms of influenza.

关 键 词：流感 暴发 流感疫苗 23价肺炎球菌多糖疫苗 保护效果 中小学校 

分 类 号：R186[医药卫生—流行病学] R186.3[医药卫生—公共卫生与预防医学]