四川省EV-A71疫苗接种现状与手足口病流行特征分析

Situation of EV-A71 vaccination and epidemiological characteristics of hand-foot-mouth disease in Sichuan Province

目的分析四川省EV-A71疫苗接种现状,初步探讨EV-A71疫苗接种对手足口病发病水平的影响,为手足口病科学防控提供依据。方法从“中国疾病预防控制信息系统”中获取2012—2020年四川省所有手足口病报告病例报告个案信息;EV-A71疫苗接种信息由全省21个市州疾病预防控制中心免疫规划部门上报获得。使用描述性流行病学方法进行分析,利用Excel 2007和R 4.1.3软件进行数据统计,构成比的比较选用χ^(2)检验。结果EV-A71疫苗上市后,2017—2020年四川省累计报告手足口病例520656例,平均发病率为104.74/10万,重症1770例。2017—2020年四川省累计报告接种EV-A71疫苗4056913剂次,5岁以下儿童四年估算接种率依次为9.90%、13.36%、11.23%和11.52%;全省各地区间接种率差异较大,成都平原及周边地区接种率高于四川省其他地区。EV-A71疫苗接种后,手足口重症病例数大幅度下降,EVA71在确诊病例中所占比例显著下降。结论EV-A71疫苗接种可在适龄儿童中形成免疫保护,有效降低EV-A71型手足口病重症的发生率。应继续监测EV-A71疫苗接种对手足口病发病的影响。

Objective To analyze the situation of EV-A71 vaccination in Sichuan Province,to preliminarily explore the impact of EV-A71 vaccination on the incidence of hand-foot-mouth disease(HFMD) and to provide evidence for scientific prevention and control of the disease.Methods Data of all reported cases of HFMD in Sichuan Province from 2012 to 2020 from the Chinese Information System for Disease Prevention and Control were retrieved.EV-A71 vaccination information was obtained through the reported data by the immunization planning departments of 21 municipal centers for disease prevention and control.The descriptive analysis was conducted for data analysis.Excel 2007 and R 4.1.3 software were used for statistics analysis.Chi-square test was used to compare the composition ratio.Results A total of 520 656 cases of HFMD were reported in Sichuan Province from 2017 to 2020 after the launch of EV-A71 vaccine.The average annual incidence rate was 104.74/105,and there were 1 770 severe cases.A total of 4 056 913 doses of EVA71 vaccine were vaccinated and reported in Sichuan Province from 2017 to 2020.The estimated vaccination rate of children under 5 years old was 9.90%,13.36%,11.23% and 11.52% in 2017,2018,2019 and 2020,respectively.The vaccination rates were distinctly different of the different regions of Sichuan Province.The rates in Chengdu plain and its surrounding areas were significantly higher than those in other regions of Sichuan Province.The number of severe cases and the proportion of EV-A71 in confirmed cases decreased significantly after EV-A71 vaccination.Conclusions The EV-A71 vaccine can provide effective immune protection in children of appropriate age and reduce the incidence of severe case caused by EV-A71.Continuous monitoring is required of the impact of EV-A71 vaccine on the incidence of HFMD.