灌云县2001-2018年出生儿童甲肝疫苗预防接种效果评价

Evaluation of the Effect of Hepatitis A Vaccination in Children Born in Guanyun County from 2001 to 2018

目的分析灌云县2001—2018年出生儿童甲型病毒性肝炎(甲肝)流行状况和甲肝疫苗接种情况。方法采用回顾性调查的方法,根据甲肝疫苗纳入儿童扩大免疫规划时间(2008年)和甲肝疫苗免疫程序,将2001—2018年出生儿童分为2001—2005年(免疫规划前)和2006—2018年(免疫规划后)两个阶段,对比分析两个阶段的出生儿童甲肝疫苗接种和甲肝发病的流行病学特征变化情况。结果免疫规划前儿童甲肝疫苗接种率低于40.00%,免疫规划后儿童甲肝疫苗接种率明显提高,2008—2017年出生的儿童甲肝疫苗接种率均保持在99.00%以上,2018年出生儿童接种率略下降至96.05%。实施扩大免疫规划后儿童甲肝疫苗接种率明显高于免疫规划前,差异有统计学意义(χ^(2)=81014.565,P<0.001)。2001—2005年每年出生的儿童均有甲肝病例报告,免疫规划前儿童甲肝总发病率为14.10/10万,其中2003年出生儿童甲肝发病率最高达成25.55/10万,2004年出生儿童甲肝发病率最低(5.06/10万)。2006年以后出生的儿童无甲肝病例发生。结论甲肝疫苗纳入国家扩大免疫规划后,灌云县适龄儿童甲肝疫苗接种率维持在较高水平,适龄儿童无甲肝发病病例报告。今后应在持续保持适龄儿童甲肝疫苗高接种率的基础上,开展重点人群的甲肝疫苗预防接种,提高群体免疫水平,是预防甲肝的根本措施。

Objective To analyze the prevalence of viral hepatitis A(hepatitis A)and hepatitis A vaccination among children born in Guanyun County from 2001 to 2018.Methods A retrospective survey was used,according to the time of inclusion of hepatitis A vaccine in the expanded programme of immunization for children(2008)and the schedule of hepatitis A vaccine immunization.Children born in 2001 to 2018 were divided into two phases:2001 to 2005(pre-immunization program)and 2006 to 2018(post-immunization program).The changes in epidemiological characteristics of hepatitis A vaccination and the incidence of hepatitis A in newborn children in two stages were compared and analyzed.Results The hepatitis A vaccination rate of children before the immunization program was lower than 40.00%,and the hepatitis A vaccination rate of children after the immunization program increased significantly.The hepatitis A vaccination rate of children born in 2008 to 2017 remained above 99.00%,and the vaccination rate of children born in 2018 dropped to 96.05%.The hepatitis A vaccination rate of children after the implementation of the expanded immunization program was significantly higher than that before the immunization program,the difference was statistically significant(χ^(2)=81014.565,P<0.001).Children born every year from 2001 to 2005 have reported cases of hepatitis A,and the total incidence of hepatitis A in children before the immunization program was 14.10/100000.Among them,the incidence of hepatitis A among children born in 2003 was the highest at 25.55/100000,and the incidence of hepatitis A among children born in 2004 was the lowest(5.06/100000).No cases of hepatitis A occurred in children born after 2006.Conclusion After the hepatitis A vaccine was included in the National Expanded Immunization Program,the hepatitis A vaccination rate of school-age children in Guanyun County remained at a high level,and there were no reported cases of hepatitis A in school-age children.In the future,on the basis of continuing to maintain a high hepatitis A vaccination rate among school-age children,we should carry out hepatitis A vaccination for key groups and improve the level of herd immunity,which is the fundamental measure to prevent hepatitis A.