2007年达州市麻疹疫苗强化免疫对麻疹流行的影响

The Impact of Measles Supplementary Immunization Activities for Measles Epidemic in Dazhou,2007

目的评价达州市麻疹减毒活疫苗强化免疫活动对麻疹发病的影响与效果,为消除麻疹提供策略措施依据。方法2007-09对全市所有8月龄～14岁儿童在1周内集中完成MV接种1剂,3年后利用2007年MV SIAs接种资料和免疫前后麻疹发病疫情资料,应用描述流行病学方法分析麻疹发病特征并评价控制麻疹效果。结果麻疹减毒活疫苗应种儿童1 179 782人,实种儿童1 163 999人,接种率为98.66%。2007-10起麻疹发病率迅速大幅度下降,2008-2010年分别降低为0.56/10万、0.23/10万和0.54/10万,比2007年(10.41/10万)下降了94.60%以上;目标人群各年龄队列发病率2008年下降80.87%～100%且2009年继续下降,<8月龄和>14岁的非目标人群同时下降95.12%和86.28%～100%;削平了03/07月的发病季节高峰,分别削平和削弱了4～9岁和0～3岁的发病年龄峰值,但低水平上0～3岁发病率仍相对较高于其他年龄人群,应给予重视。结论实施8月龄～14岁儿童麻疹减毒活疫苗能快速建立整体人群免疫屏障,大幅度减少全人群麻疹发病,是消除麻疹的重要策略,麻疹减毒活疫苗3～4年内继续开展8月龄～4岁儿童后续强化免疫活动,有助于消除麻疹目标按时实现。

Objective To evaluate the effect of Supplementary Immunization Activities（SIAs） of Measles attenuated live vaccine（MV）,provide theoretical basis for measles elimination.Methods All the children aged 8months-14 years in Dazhou were conducted MV SIAs on September,2007;the SIAs vaccinated 1 dose MV for each child within one week.Data of SIAs and measles prevalence was analyzed 3 years after by using descriptive epidemiological method to evaluate the characters of measles prevalence and the effect of MV SIAs.Results There were 1 179 782 target children,1 163 999 children were vaccinated,the coverage was 98.66%.The incidence of measles decreased rapidly after October,2007,the incidences of 2008,2009 and 2010 were 0.56/105,0.23/105 and 0.54/105 respectively,decreased by over 94.60% compare to the incidence of 2007（10.41/105）;the incidence of different age cohorts in target population decreased by 80.87%-100% in 2008,and continually decreased in 2009.The incidence of other age cohorts（children under 8 months and above 14 years） decreased by 95.12% and 86.28%-100% respectively.The seasonal incidence peak from March to July disappeared,the age peak at 4-9 years old and 0-3 years old disappeared and weakened respectively.But the incidence of 0-3 year-old children was still higher than others,which should be given enough attention.Conclusion MV SIAs of 8 months-14 year-old children could build the immunity barrier rapidly,and significantly decreased measles incidence of whole population,which is the important strategy of measles elimination.The follow-up campaign should be conduct during 3-4 years after first catch up campaign.It will help to realize the goal of measles elimination on time.