甲型肝炎疫苗接种流行病学效果和经济效益分析

Epidemiology and cost-benefit analysis of hepatitis A vaccination

[目的 ] 观察本市国产甲肝减毒活疫苗免疫和流行病学效果 ,分析不同年龄组甲肝疫苗接种的经济效益。 [方法 ] 以整群随机分组方法观察接种组与对照组甲肝发病率 ,检测部分易感者的免后抗体水平 ,采用成本效益分析方法计算各年龄组效益费用比 (BCR)和净成本效益比 (NB)。 [结果 ] 对照组发现甲型肝炎 2 2例 ,接种组未发现甲肝病人 ,保护率为 10 0 %。免后 3个月抗体阳转率为 94% ,抗体滴度随时间缓慢下降 ,至 6 0个月抗体阳转率为 41.74% ,但仍有很好保护效果。甲肝疫苗接种后成本效益比值 ,5岁以下年龄组BCR均小于 1,10～ 39岁年龄组BCR均大于 1,其中 2 0～ 2 9岁组经济效益最高。 [结论 ] 本市预防接种甲肝疫苗能获得正效益 ,10～ 39岁组是首选接种人群 ,其中 2 0～ 2

To follow up the immunological and epidemiological effect of Chinese HAV vaccine and analyze its economical effect among different population immunized with HAV vaccine in Shanghai. Random cluster sampling method was used to observe hepatitis A morbidity and cost-effective analysis methods was used to calculate the ratio of benefit to cost(BCR) and net ratio of cost-effectiveness. 22 hepatitis A cases were found among the control group,but no cases were found among the immunized group.The protective rate was 100% 3 months after immunization,the antibody positive rate was 94%,with antibody titer falling slowly.60 months later,antibody positive rate fell to 41.74%,while the protective effect still existed.BCRs were less than 1 in the population with age below 5 years,but above 1 in age from 10 to 39.Among them,BCR was the highest in age from 20 to 29. [Conclusion] The economic effect is positive in the immunization of HAV vaccine.People aged from 10 to 39 are at the first choice for vaccination and people aged from 20 to 29 are focal objects.