河北省麻疹疫苗初始强化免疫的实施及效果评价

Evaluation on Effect of Implementation of Measles"Catch-up"Immunization Campaign with Hebei Province

河北省根据麻疹的发病和人力、物力、财力的现状 ,经专家论证 ,麻疹疫苗 (MV)强化免疫的具体实施策略定为 :“分地区轮流进行 ,用 4年时间完成MV初始强化免疫 ,然后进行分地区后续强化免疫的循环”。 1998～ 2 0 0 1年在全省完成了MV初始强化免疫 ,登记 8个月～ 14岁应种儿童 12 915 0 33人 ,接种 1192 0 936人 ,接种率 92 30 %。11个市报告接种率为 84 85 %～ 97 11%。 89 6 %的县 (区、市 ,下同 )报告接种率≥ 90 %,仅 10个县报告接种率 <80 %。血清学监测结果表明 ,强化免疫后 1个月 ,麻疹IgG抗体无论阳转率、几何平均滴度 ,还是预防显性感染抗体比例 ,都达高水平 ;免疫后 1～ 2年仍保持在较高水平。分析其实施的直接效果主要有 :消除了麻疹爆发和流行 ,降低了发病率 ;提高了人群免疫力 ,消除了易感人群累积 ,有利于阻断麻疹野病毒传播 ,也有利于麻疹流行病学监测的开展。其取得的间接效果主要有 :广泛的社会宣传动员取得了强大的社会效应 ,儿童家长 /监护人预防麻疹知识水平提高 ;同时对学龄儿童在校外进行大规模接种的尝试 ,为其它疫苗的接种提供了经验 ;MV初始强化免疫的经济、社会效益也很明显。

According to the status of measles episode and logistic situation and by the specialists′demonstration, the strategy of measles supplementary immunization in Hebei Province is to'Fulfill the measles'Catch-up'immunization campaign with in four years in districts in turn,then begin the circles of measles'Follow-up'immunization by district'.In 1998~2001,Hebei has fulfilled its measles 'Catch-up'immunization campaign,the number of registered children(8 months to 14 years old) was 12?915?033,11?920?936 were vaccinated by one dose measles vaccine(MV),the coverage rate was 92.30%.The reported MV coverage rate was 84.85%~97.11% distributed in 11 cities.Of all the counties,89.6% reached the 90% level of reported MV coverage rate,only 10 below the 80% level.Analyzing the data,it found that the decreasing trend of MV coverage rate followed with the increasing of age.The results of serology monitoring showed either the positive seroconversion rate or the GMT level of measles IgG antibody,or the ratio of preventing clinical infection raised to the highest level after one month of mass immunization.They still kept higher IgG antibody level after one or two years. The direct effects achieved through the implementation of measles'Catch-up'immunization were described as follows:eliminated the measles outbreak and epidemic,decreased the mortality,improved the immunity of population and eliminated accumulation of the susceptibles. All these were useful to interrupt the transmission of measles virus and to the work of measles epidemiological monitoring. At the same time,the indirect effects obtained were the enormous social effects,that are the extensive propaganda to people,the increment of knowledge of measles prevention to parents/guardians, the mass immunization to school age children outside the schools and providing experiences for other kinds of vaccination.The economic and social benefits of MV 'Catch-up' immunization are obvious.All these prove the right decision of measles'Catch-up'immunization campaign in the province.