中国近年含麻疹成分疫苗补充免疫活动前后麻疹发病情况分析

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目的了解中国(未包括香港、澳门特别行政区和台湾地区,下同)近年含麻疹成分疫苗(Measlescontaining Vaccine,MCV)补充免疫活动(Supplementary Immunization Activities,SIAs)的效果,为完善MCV免疫策略提供参考。方法采用描述性流行病学方法,对我国2004~2011年MCV SIAs资料与麻疹发病资料进行统计分析。结果 MCV SIAs对降低麻疹发病总体效果明显,但各省(自治区、直辖市,下同)效果有一定差异。2004~2011年,开展MCV SIAs第二年与MCV SIAs当年相比,目标儿童麻疹发病数,初次实施MCV SIAs的省最高降幅为99.54%,最低降幅为73.38%,中位数为96.14%(P25=90.78%,P75=97.97%);第二次实施MCV SIAs的省最高降幅为99.89%,最低降幅为16.67%,中位数为86.21%;第三次实施MCV SIAs的省最高降幅为91.89%,个别省不降反升,中位数为85.63%(P25=67.95%,P75=96.00%)。MCV SIAs后,低麻疹发病率持续时间长短不一,最长的4年,最短的≤1年。结论 MCV SIAs后,麻疹发病总体呈下降显著,但MCV SIAs后控制麻疹的效果取决于SIAs和常规免疫质量;消除麻疹的关键是保持高水平的常规免疫接种率(两剂次≥95%),MCV SIAs是低接种率地区阻断麻疹流行、迅速建立免疫屏障的一种补充免疫的策略。 Objective To understand the effects of supplemental immunization activities (SIAs) in measlescontaining vaccines (MCV) in China (excluding Hong Kong, Macao Special Administrative Region and Taiwan, the same below) in order to provide reference for improving MCV immunization strategies. Methods Descriptive epidemiological methods were used to analyze the data of MCV SIAs and the incidence of measles in China from 2004 to 2011. Results The overall effect of MCV SIAs in reducing the incidence of measles was obvious, but the effects of different provinces (autonomous regions and municipalities directly under the Central Government) were different. From 2004 to 2011, the number of children with measles onset in the second year of MCV SIAs compared with the year of MCV SIAs was 99.54%, the lowest decline was 73.38% and the median was 96.14% (P25 = 90.78%, P75 = 97.97%). The highest reduction rate of MCV SIAs in the second implementation was 99.89%, the lowest decrease was 16.67%, and the median was 86.21%. The highest reduction of MCV SIAs in the third implementation was 91.89% In some provinces, the rate of increase was 85.63% (P25 = 67.95%, P75 = 96.00%), with a rise of 85.63%. After the MCV SIAs, the incidence of low measles persisted for varying lengths of time, the longest 4 years and the shortest 1 years. Conclusion The incidence of measles decreased significantly after MCV SIAs, but the effect of controlling measles after MCV SIAs was dependent on SIAs and routine immunological quality. The key to eliminating measles was to maintain a high level of routine immunization (≥95% for two doses) MCV SIAs are a complementary immunization strategy that blocks the spread of measles in low-dose immunization settings and rapidly establishes an immune barrier.
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