世界卫生组织各区域和部分国家的消除麻疹免疫策略

Vaccination Strategy for Measles Elimination in Different Regions of the World Health Organization and Different Countries: a Review

自50年前麻疹疫苗研制成功并投入使用开始,人类积极探索通过免疫措施控制麻疹发病和死亡,消除并最终消灭麻疹,这逐渐成为全球各国一致努力的目标和方向。接种含麻疹成分疫苗(Measles-containing Vaccine,MCV),以提高人群免疫力,从而阻断麻疹病毒持续传播,这一免疫策略是消除麻疹的根本措施。无论是已经实现或接近消除麻疹目标的,还是正致力于降低麻疹发病和死亡率的国家和地区,虽然落实MCV免疫策略的具体措施和做法不同,但从实质上都是一致的,即通过常规免疫或补充免疫活动(Supplementary Immunization Activities,SIAs),及时为适龄儿童高接种率地接种2剂MCV,并通过大规模SIAs消除人群中已积累的免疫空白,提高群体免疫力。这一免疫策略是人类在应用MCV控制和消除麻疹过程中,不断探索、吸取成功经验和失败教训的基础上总结出来的,已成为各国的共识。不同国家和地区免疫策略组合有所不同,关键在于既定的免疫措施是否切实得以落实。

Controlling and eliminating measles through immunization has been the goal of each country and region globally since measles vaccine was licensed and implemented 50 years ago. Improving population immunity through vaccination with measles-containing vaccine （MCV） to interrupt measles virus transmission is the fundamental component of measles elimination strategy. All countries and regions worldwide, either those that have eliminated measles, those are approaching the elimination of measles, or those are striving to reduce measles mortality and morbidity, share the same vaccination strategy, al measures taken are different The essence of the strategy includes achieving and maintaining high coverage with 2 doses of MCV by routine immunization services, plus implementing supplementary immunization activities （SIAs） when required to close existing immunity gaps through SIAs. This well accepted vaccination strategy has been based on experiences and lessons learned from 50 years of human use of MCV to control and eliminate measles. Progress toward measles elimination varies in different countries and regions, however, the problem has not been whether the vaccination strategy is appropriate, but the extent to which such strategy was implemented.