中国流感疫苗预防接种技术指南(2019—2020)

Technical guidelines for seasonal influenza vaccination in China(2019-2020)

流感是由流感病毒引起的一种急性呼吸道传染病,每年流感季节性流行在全球可导致300万至500万重症病例,29万至65万呼吸道疾病相关死亡。接种流感疫苗是预防流感病毒感染及其严重并发症的最有效手段。我国现已批准上市的流感疫苗有三价灭活流感疫苗(IIV3)和四价灭活流感疫苗(IIV4)。2018年,中国疾病预防控制中心印发了《中国流感疫苗预防接种技术指南(2018—2019)》(简称"2018年版指南")。为更好地指导我国流感预防控制和疫苗应用工作,国家免疫规划技术工作组流感疫苗工作组综合国内外最新研究进展,在2018年版指南的基础上进行了更新和修订,形成了《中国流感疫苗预防接种技术指南(2019—2020)》。本指南更新的内容主要为:第一,增加了新的研究证据,尤其是我国的研究结果,包括流感疾病负担、疫苗效果、接种疫苗可避免的疾病负担、疫苗安全性监测、疫苗预防接种成本效果等;第二,增加了一年来国家卫生健康委员会流感防控有关政策和措施;第三,更新了我国2019—2020年度国内批准上市及批签发的流感疫苗种类;第四,更新了本年度IIV3和IIV4组分。本指南建议:原则上,接种服务单位应为≥6月龄所有愿意接种流感疫苗且无禁忌证的人提供接种服务。对可接种不同类型、厂家疫苗产品的人群,可由受种者自愿选择接种任一种流感疫苗,无优先推荐。为降低高危人群罹患流感及感染后发生严重临床结局的风险,指南推荐6月龄至5岁儿童,60岁及以上老人,慢性病患者,医务人员,6月龄以下婴儿的家庭成员和看护人员,以及孕妇或准备在流感季节怀孕的女性为优先接种对象。首次接种流感疫苗的6月龄至8岁儿童应接种两剂次,间隔≥4周;2018—2019年度或以前接种过1剂及以上流感疫苗的儿童,建议接种1剂。9岁及以上儿童和成人仅需接种1剂。建议各地在疫苗供应到位后尽快安排接种工作,最好在10月底前完成免疫接种;对10月底前未接种的对象,整个流行季节都可以提供接种服务。孕妇在孕期的任一阶段均可接种流感疫苗。本指南适用于从事流感防控相关的各级疾病预防控制机构工作人员,预防接种点的接种人员,各级医疗机构儿科、内科、感染科等医务人员,以及各级妇幼保健机构的专业人员。根据国内外研究进展,本指南今后亦将定期更新、完善。

Influenza virus infection is a respiratory infectious disease.The World Health Organization(WHO)estimated that seasonal influenza epidemics have caused an annual 3 to 5 million severe cases,and 290000 to 650000 deaths globally.Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and complications from infection.Currently,China has licensed trivalent inactivated influenza vaccine(IIV3)and quadrivalent inactivated influenza vaccine(IIV4).In 2018,the Chinese Center for Disease Control and Prevention issued the"Technical Guidelines for Seasonal Influenza Vaccination in China(2018-2019)"("Guide 2018"for short).To strengthen the technical guidance for prevention and control of influenza and operational research on influenza vaccination in China,the National Immunization Advisory Committee(NIAC)Influenza Vaccination Technical Working Group(TWG),updated the 2018 technical guidelines and compiled the"Technical guidelines for seasonal influenza vaccination in China(2019-2020)".The main updates in this version include the following:First,new research evidences especially studies of China,including disease burden,effectiveness,Vaccine-avoidable disease burden,vaccine safety monitoring,and cost-effectiveness and cost-benefit.Second,policies and measures for influenza prevention and control issued by National Health Commission(PRC)in the past year.Thirdly,new type seasonal influenza vaccine licensed and issued in 2019-2020 in China.Fourth,northern hemisphere influenza vaccination composition for the 2019-2020 season which included trivalent and quadrivalent influenza vaccine.The recommendations described in this report include the following:Points of Vaccination clinics(PoVs)should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications.No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed,recommended,and appropriate product is available.To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups,the recommendations prioritize seasonal influenza vaccination for children aged 6-59 months,adults≥60 years of age,persons with specific chronic diseases,healthcare workers,the family members and caregivers of infants<6 months of age,and pregnant women or women who plan to become pregnant during the influenza season.Children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection.If they were vaccinated in 2018-2019 influenza season or a prior season,1 dose is recommended.People more than 8 years old require 1 dose of influenza vaccine.It is recommended that people receive their influenza vaccination by the end of October.Influenza vaccination should be offered as soon as the vaccination is available.For the people unable to be vaccinated before the end of October,influenza vaccination will continue to be offered for the whole season.Influenza vaccine is also recommended for use in pregnant women during any trimester.These guidelines are intended for use by staff members of the Centers for Disease Control and Prevention at all levels who work on influenza control and prevention,PoVs staff members,healthcare workers from the departments of pediatrics,internal medicine,and infectious diseases,and staff members of maternity and child care institutions at all levels.These guidelines will be updated periodically as new evidence becomes available.