天津市含麻疹成分疫苗接种率和抗体水平评价

Evaluation on measles containing vaccine immunization coverage rate and measles antibody level in Tianjin

目的对天津市含麻疹成分疫苗（measles containing vaccine,MCV）接种率和健康人群抗体水平进行评价。方法 2012-2014年采用多阶段随机抽样法抽取天津市0~44岁健康人群开展MCV接种率调查和麻疹血清学抗体监测。结果 2006-2013年8个出生队列993名儿童中,含麻疹成分疫苗首剂次（MCV1）接种年龄中位数从2006年8.42月龄提高到2013年的8.15月龄。8月龄及时接种率从2006年50.67%上升到2013年的90.90%。2006-2012年7个出生队列720名儿童中,含麻疹成分疫苗第2剂次MCV2接种年龄中位数从2006年21.99月龄提高到2012年的18.16月龄。18月龄及时接种率从2006年2.67%上升到2012年的71.11%。血清学监测共调查3 147人,年龄为0~44岁,麻疹抗体阳性率90.28%,几何平均浓度（geometric mean concentration,GMC）为912.83 m IU/ml。Logistic回归分析结果显示,〈8月龄麻疹易感性最高,其次30~34岁组,OR（95%CI）分别为7.27（3.93~13.46）和3.30（1.67~6.51）。对麻疹抗体阳性率和发病率进行秩相关分析,两者之间存在负相关（r=-0.73,P=0.007）。结论儿童高免疫覆盖率下,难以阻止成人间的麻疹传播,成人免疫亟待考虑。

Objective To evaluate the measles containing vaccine（ MCV） immunization coverage rate and measles antibody level in healthy population in Tianjin. Methods Multistage random sampling method was applied to draw health subjects of aged 0-44 years for MCV coverage rate investigation and measles serological surveillance in 2012- 2014.Results There were 993 children of eight birth cohorts from 2006 to 2013,the median of vaccinated age of MCV1 was raised from 8. 42 months of age in 2006 to 8. 15 months of age in 2013. Timely immunization coverage rate of eight months of age increased from 50. 67% in 2006 to 90. 90% in 2013. There were 720 children of seven birth cohorts from 2006 to2012,the median of vaccinated age of MCV2 changed from 21. 99 months of age in 2006 to 18. 16 months of age in 2012.Timely immunization coverage rate of 18 months of age increased from 2. 67% in 2006 to 71. 11% in 2012. 3 147 subjects were enrolled for serological investigation,measles antibody positive rate was 90. 28% totally,geometric mean concentration（ GMC） was 912. 83 m IU / ml. Logistic regression analysis showed that 〈8 months group had the highest risk for measles and then was 30-34 years group,the OR（ 95% CI） were 7. 27（ 3. 93-13. 46） and 3. 30（ 1. 67-6. 51） respectively.Spearman rank correlation analysis was applied to compare antibody level with morbidity of measles（ r =- 0. 73,P =0. 007）. Conclusions High immunization coverage rate in children couldn＇t stop measles virus transmission among adults,an adult immunization program need to be considered.