池州市农村0～2岁儿童乙型肝炎疫苗接种及其免疫效果评价

Evaluation of the Efficacy of Hepatitis B Vaccination among Children of 0～2 Years Old in Rural Area of Chizhou City,Anhui Province

为了解池州市乙型肝炎 (乙肝 )疫苗接种现况和免疫效果 ,于 2 0 0 2年 12月 2 0日～ 2 0 0 3年 1月 2 0日 ,对所辖4个县 (区 ,下同 )进行了调查。 4个县 2 0个乡 (镇 )按 <1岁、1岁、2岁共抽查 4 2 0名儿童 ,检测乙肝病毒表面抗原(HBsAg)与抗体 (抗 HBs)。结果 :池州市农村儿童乙肝疫苗接种率达 99 2 9% ,首针及时接种率为 73 81% ;池州市农村乙肝疫苗接种主要有 3种方式 ,即分娩医院接种、首针分离接种和接种点接种 ,其中分娩医院接种和首针分离接种符合接种要求 ,其首针及时接种率 >93% ,全程及时接种率 >87% ;HBsAg阳性 3人 ,阳性率 0 71% ,抗 HBs阳性 2 75人 ,阳转率 6 5 4 8% ;另有 14 2名 (33 81% )儿童HBsAg和抗 HBs双阴性。因此加强农村儿童乙肝疫苗接种管理 ,明确分娩医院和接种点各自的职责 ,规范乙肝疫苗接种是确保乙肝疫苗纳入计划免疫后获得高质量、高效果的关键。同时提高农村孕妇住院分娩有助于提高儿童乙肝疫苗接种率。

In order to understand the status of implementation of hepatitis B vaccine and the immune effect, from December 20, 2002-January 20, 2003 420 children of 0-2 years old were randomly selected from 20 towns of 4 counties of Chizhou city. Their serum HBsAg and anti-HBs were tested. Being included in EPI, the HB vaccine coverage rate was 99.29% in rural children in Chizhou city, the timely first dose vaccination rate was 73.81%. There are three forms of vaccination in rural area of chizhou city, that are (1) three HB vaccine doses completed in hospital where the baby born; (2) one dose in hospital, two doses in inoculation site; (3) three doses in inoculation site. The first two forms meet the vaccination requirement, since the timely first dose of HB vaccination rate and the timely whole course vaccination rate could reach above 93% and >87% respectively. Compared with this, the quality of HB vaccination in Chizhou rural area remained to be improved. Of 420 rural children tested, the HBsAg positive rate was 0.71% (3/430), the anti-HBs positive seroconversion rate was 65.48% (275/420), in <1 year age group the anti-HBs seroconversion rate was 78.57% which decreased gradually along with the age growing, the HBsAg and anti-HBs both negative was 33.81% (143/420) indicating the lack of specific immune response. So, enhanding the HB vaccination management of rural children, defining the duties of each of hospitals and vaccination sites, standardizing HB vaccination are the key measures to ensure a high quality and efficacy of vaccination. Promoting pregnancy women to born their babies in hospitals is also helpful for HB vaccination.