不同流行性腮腺炎疫苗接种率及剂次保护效果比较

Comparison of vaccination rate and dose protective effects between different mumps vaccines

目的评估流行性腮腺炎疫苗的保护效果,为制定控制腮腺炎规划提供依据。方法选择2008年7月-2010年6月学校暴发病例120例,采用1∶2配对的病例对照方法研究流行性腮腺炎疫苗保护效果。结果暴发病例主要集中在7～14岁的学龄儿童,占78.33%。2组平均年龄、免疫史来源以及明确的接种年龄差异无统计学意义(P值均>0.05),但免疫史差异有统计学意义(P<0.01)。以预防接种证(卡)记录统计,1剂次疫苗保护效果为61%,95%CI为11%～83%;≥2剂次疫苗保护效果为83%,95%CI为37%～96%。≥1剂次疫苗保护效果为69%,95%CI为40%～84%。估计接种率分别为73.41%,32.01%和82.43%。结论较低的疫苗接种率和/或较少的疫苗接种剂次是导致流行性腮腺炎暴发的主要原因。提高并维持高水平2剂次接种率是预防暴发的关键。

Objective To assess mumps vaccine effectiveness and its association with mumps outbreak. Methods 1 ： 2 matched case-control study was conducted among mumps outbreak in school settings from July 2008 to June 2010. Results A total of 120 mump case mainly aged 7-14 years （78.33%） and 240 controlled children were investigated. The ratio of male to female was 2.16 ： 1. There was significant difference in immunization rate, while no significant differences in age, place of vaccination and definite vaccination age between case and control group. Based on preventive inoculation cards/certificates, the effectiveness of 1-dose mumps vaccination was 61% [95% CI：11% -83% ） ;The effectiveness of ≥2-dose was 83% （95% CI：37% -96% ）. Two doses were more effective than a single dose. Overall vaccine effectiveness was 69% 195% CI：40%-84% ）. The mump immuniza- tion coverage rate among children was estimated to be 73.41% ,32.01% and 82.43% ,respectively. Conclusion The main rea- sons for mump outbreak might related with low immunization coverage and low dose vaccination. The key to prevent mumps outbreak was achieving and sustaining high coverage rate of 2-dose mumps vaccination.