世界卫生组织194个国家b型流感嗜血杆菌疫苗接种现况分析

Analysis of the current status of Haemophilus influenzae type b vaccine in 194 member countries of the World Health Organization

目的分析世界卫生组织(World Health Organization,WHO)194个成员国的b型流感嗜血杆菌(Haemophilus influenzae type b,Hib)疫苗接种现况,为优化调整我国Hib疫苗免疫策略提供科学依据。方法收集WHO六大区域内194个成员国的Hib疫苗免疫程序、疫苗类型及不同免疫规划目标人群接种率等公开数据,并进行描述性分析。结果在194个WHO成员国中,除了中国,有193个国家至少将1种Hib疫苗纳入国家免疫规划(National Immunization Program,NIP),有25个国家将Hib疫苗纳入高危人群免疫规划。纳入NIP的Hib疫苗种类有7种,其中纳入免疫规划最多的2款疫苗分别是白喉-破伤风-全细胞百日咳-b型嗜血流感杆菌-乙肝联合疫苗(122个国家)和白喉-破伤风-无细胞百日咳-b型嗜血流感杆菌-乙肝-灭活脊髓灰质炎联合疫苗(52个国家)。有136个国家实施3剂次免疫程序,57个国家实施4剂次免疫程序,3个国家实施5剂次免疫程序,其中57个国家实施6、10、14周龄免疫程序,占29.53%(57/193),32个国家实施2、4、6月龄免疫程序,占16.58%(32/193),18个国家实施2、4、6、18月龄免疫程序,占9.33%(18/193),12个国家实施2、3、4月龄免疫程序,占6.22%(12/193)。以上4种免疫程序占全球实施不同免疫程序国家的73.58%(142/193)。除西太平洋地区外,截至2022年,其他区域Hib疫苗接种率都维持在70%以上,其中东南亚区和欧洲区Hib疫苗接种率在90%以上。结论应充分考虑我国Hib相关疾病的负担、抗生素耐药性、目前国内Hib疫苗接种率、成本效益等情况,加快评估Hib疫苗纳入我国NIP的进程。

Objective This study aims to analyze the current status of Haemophilus influenzae type b(Hib)vaccine in 194 member countries of the World Health Organization(WHO)and provide a scientific basis for optimizing and adjusting the immunization strategy for Hib vaccines in China.Methods Publicly available data on Hib vaccine immunization procedures,vaccine types,and vaccination rates for target populations of different immunization programs were collected from 194 member countries in the six WHO regions,and descriptive analysis was performed.Results Among the 194 WHO member countries,all except China have included at least one type of Hib vaccine in their National Immunization Program(NIP),and 25 countries have included Hib vaccines in immunization programs for high-risk populations.Seven Hib vaccine types are included in the NIP worldwide.The two vaccines that have been included in most immunization programs are diphtheria-tetanus-whole-cell pertussis-Hib-hepatitis B combined vaccine(DTwP-Hib-HepB)(122 countries)and diphtheria-tetanus-acellular-cell pertussis-Hib-hepatitis B-inactivated poliovirus combined vaccine(52 countries).In the world,136 countries have implemented a 3-dose immunization program,57 countries have implemented a 4-dose immunization program,and 3 countries have implemented a 5-dose immunization program,of which 57 countries have implemented a 3-dose immunization program at 6,10 and 14 weeks of age,accounting for 29.53%(57/193).32 countries(16.58%)implemented immunization at 2,4 and 6 months of age,18 countries(9.33%)implemented immunization at 2,4,6 and 18 months of age,13 countries(6.22%)implemented immunization at 2,3 and 4 months of age.These immunization procedures account for 73.58%(142/193)of the different immunization procedures implemented globally.In addition to the Western Pacific region of the world,the Hib vaccine coverage rate in other regions is maintained at more than 70%by 2022,of which the Hib vaccine coverage rate in Southeast Asia and Europe is more than 90%.Conclusions China should fully consider the domestic burden of Hibrelated diseases,antibiotic resistance,current domestic HIB vaccine coverage rate,cost-effectiveness,and other factors to speed up the process of evaluating HIB vaccine for inclusion in our NIP.