四川地震灾区甲型肝炎疫苗群体性预防接种后四年保护效果分析

Evaluation on Four Years' Protective Effects after Hepatitis A Mass Campaign in the Earthquake Areas in Sichuan Province,China

目的评价2008年四川地震灾区甲型肝炎（甲肝）疫苗（Hepatitis A Vaccine,HepA）群体性预防接种后4年的保护效果。方法在被动监测分析中,选择都江堰、什邡、江油和茂县作为HepA群体性预防接种县（区、市,下同）,浦江、广汉、游仙和马尔康作为对照县,比较分析2005~2012年甲肝、细菌性痢疾（菌痢）等发病情况,数据来源于疾病监测信息报告管理系统。主动监测数据来源于2010年1月1日~12月31日,在四川省彭州、崇州、江油、绵竹、汶川、理县6个地震灾区县开展的甲肝监测项目。结果被动监测数据显示：2009-2012年HepA接种地区甲肝的年平均发病率为1.80/10万,比2005~2008年的年平均发病率（7.43/10万）降低了74.83%。HepA群体性预防接种地区免疫覆盖人群（〈15岁）,2008年以后甲肝年平均发病率均〈0.05/10万,低于对照地区。此外,HepA群体性预防接种以外的成人,甲肝发病率较群体性预防接种前也出现明显下降。主动监测数据显示：2010年6个监测县共实验室诊断12例甲肝,但无HepA群体性预防接种覆盖的年龄组人群。结论 2008年,四川地震灾区对18月龄~12岁儿童开展的HepA群体性预防接种,取得了良好的保护效果,同时也在HepA群体性预防接种地区建立了一定的免疫屏障,减少了成人甲肝发病。

Objective To evaluate the Four Years＇ protective effects after the hepatitis A mass vaccination in the earthquake areas in Sichuan, China. Methods We used the active and passive monitoring data to evaluate the incidence of hepatitis A and Bacillary Dysentery. The 2005-2012 passive monitoring data was collected from national notifiable disease report system （ NNDRS ） , Dujiangyan, Shifang , Jiangyou and Mao county were mass vaccination counties, and Pujiang, Guanghan, Youxian and Maerkang were control counties. We did the active monitoring project in 2010 in Pengzhou, Chouzhou, Jiangyou, Mianzhu, Wenchuan and Li counties. And the active monitoring data was from this project. Results The average hepatitis A incidence in vaccination areas was 1.80/100 000 from 2009 to 2012, reduced 74.83% compared with 2005-2008 average incidence （7.43/100 000）. The hepatitis A incidence in 〈 15 year-old Children, who had been covered with hepatitis A vaccination in the earthquake areas, was lower than 0. 05/100 000 in each year after 2008, and it was also lower than control counties. In additional, the adults incidence of hepatitis A who were no vaccination in earthquake areas was reduced as well after the children vaccinated in 2008. In the active monitoring project in 2010, there were only 12 hepatitis A cases diagnosed by laboratory, and all of them were adults. Conclusion The vaccination of hepatitis A for 18-month to 12-year old children in earthquake areas in 2008 had got a good protective effect, and which had established the immune barrier to reduce the incidence of adults hepatitis A.