23价肺炎球菌多糖疫苗和流行性感冒病毒裂解疫苗联合接种对老年人呼吸系统疾病防治效果观察与效益分析

Effectiveness of 23-Valent Penumococcal Polysaccharide and Split-Virus Influenza Vaccines to Prevent Respiratory Diseases for Elderly people

目的评价老年人群联合接种23价肺炎球菌多糖疫苗(23-Valent Penumococcal Polysaccharide Vaccine,PenV23)和流行性感冒(流感)病毒裂解疫苗(Split-Virus Influenza Vaccine,InfV-B),预防上呼吸系统疾病的效果和成本-效益。方法选取日照市城区部分预防接种门诊,在2005年联合接种过PenV23和InfV-B的151名老年人为接种组,抽取匹配的均未接种两种疫苗的188名社区人员为对照组。在基线调查的基础上,联合接种后2年内对接种组和对照组进行随访,记录入院诊断治疗情况、直接医疗费用等。结果 PenV23和InfV-B联合接种对上呼吸道感染的保护效率为60%(比值比为0.35,95%可信区间为0.153～0.794),差异有统计学意义(P=0.009)。联合接种疫苗组平均住院时间(20.00±5.66)d,对照组为(24.19±7.24)d,差异有统计学意义(t=5.82,P<0.001)。联合接种疫苗的效益成本比为4.03,净效益为177994.86元。结论社区老年人群联合接种PenV23和InfV-B能减少上呼吸系统疾病的发生,具有一定的保护效力,且能获得较高的成本效益。

Objective To assess the effectiveness of 23-valent penumococcal polysaccharide vaccine（PenV23） and Split-Virus influenza vaccine（InfV-B） for preventing upper respiratory diseases in the aging population.Methods151 people aged ≥60 years who inoculated the PenV23 and InfV-B vaccines at clinics during 2005 as trial group,and 188 people aged≥65 years didn＇t administered as control guoup from some comminity.On base line survey,both guoups were followed up two years after vaccination about incidence,hospitalization rate,treatment and direct medical cost.ResultsThe vaccine of PenV23 and InfV-B vaccination in upper respiratory tract infection was 60%（odds ratio OR） =0.35,95%CI（0.153-0.794）and the difference between the 2 groups was significant（P=0.009）.The people had recevied both vaccines,the mean duration of hospitalization in vaccinated vs unvaccinated control peple was 20.00 days：24.19 days（t=5.82,P0.001）.Benefit-cost ratio was 4.03,and the net benefit was ？77994.86.ConclusionIncidence of influenza-like illness for the elderly people in the community decreased by administered PenV23 and InfV-B vaccine.This vaccines had high cost-benefits.