嘉兴市高中生甲型H1N1流感疫苗接种保护效果评价

Epidemiological effects of the A( H1N1 ) influenza vaccine through an immunization program on senior high school students

目的评价甲型H1N1流感疫苗对高中生的流行病学保护效果,为制定防控措施提供科学依据。方法采用非随机对照临床试验方法,从嘉兴市选择5 760名高中生,设立甲型H1N1流感疫苗接种组和未接种组(对照组),随访观察1个流感流行周期(6个月)后,比较两组甲型H1N1流感病例、流感样病例、乙型流感病例的发生情况及其相关影响因素。结果不同性别、住宿情况高中生流感样、乙型流感和流感核酸阳性率差异均有统计学意义(P值均<0.05)。不同流感症状史高中生乙型流感和流感核酸阳性率差异均有统计学意义(P<0.05),不同季节性流感接种史高中生流感样病例发生率差异有统计学意义(P<0.05)。对照组中,不同性别、住宿情况、季流接种史高中生流感样病例、乙型流感病例和流感核酸阳性率差异均有统计学意义,不同流感症状史高中生流感样病例发生率差异有统计学意义(P值均<0.05)。结论高中男生较女生、住校生较走读生更易发生流感样病例、乙型流感和流感病毒核酸阳性。甲型H1N1流感疫苗流行病学保护效果虽未得到有效验证,但该疫苗接种可能不存在交叉保护作用。

Objective To evaluate the epidemiological effects on vaccine immunization program related to A（ H1NI ） influ- enza in the senior high school students, and to provide a scientific basis for prevention and control work with A（ H1N 1 ） influenza. Methods A total of 5 760 students were recruited and classified into vaccinated or control groups based on the status of immunization with A（H1N1）influenza vaccine by non-randomized clinical trial method. All subjects were followed up through one epidemic period （ 6 months ） , the incidence rates and related influence factors of influenza-like illnesses （ILI ） , A （ H1N1 ） influenza, and influenza B in these two groups were analyzed to evaluate the efficacy of the vaccine. Results Influenza A H1N1 influenza, ILI, influenza B, influenza virus nucleic acid positive cases incidence density between the vaccinated group and the control group had no significant difference（P〉0.05 ）. In all members or vaccinated group, sex and the different accommodation conditions were statistically difference in ILI, influenza B, influenza virus nucleic acid positive cases（ P〈0.05）, the history of flu-like symptoms had an effect on influenza B and influenza virus nucleic acid positive cases（P〈0.05） , the seasonal influenza vaccination had an effect on ILl（ P 〈0.05）. In control group, sex, the different accommodation conditions and seasonal influenza vaccination were statistically difference in ILI, influenza B, influenza virus nucleic acid positive cases （P〈O.05） , the history of flu-like symptoms had an effect on ILl （P〈0.05）. Conclusion Non-residents and male students are more likely than the boarders of ILl,influenza B, influenza virus nucleic acid positive cases. Although the epidemiological protective efficacy with A { H1N1 ） influenza vaccine has not been effectively verified, the cross-protection effect against the influenza-like illnesses and other seasonal influenzas is not noticed in this study.