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目的了解流行性腮腺炎(简称流腮)疫苗在学校等集体单位流腮暴发疫情中的保护效果,为完善流腮疫苗免疫策略提供依据。方法收集中山市2010—2014年发生流腮暴发疫情的学校中病例数≥3例的班级内所有学生的流腮疫苗接种信息。按年龄分层,以接种流腮疫苗作为暴露因素,采用回顾性队列研究方法,评价流腮疫苗的保护效果。结果共有3所学校501名儿童被纳入研究对象,流腮总罹患率为14.97%(75/501),接种组罹患率为13.59%(59/434),未接种组罹患率为23.88%(16/67),两组之间差异有统计学意义(χ2=4.824,P<0.05)。流腮疫苗保护效果(VE)为43.1%(95%CI=7.2%~65.1%)。按流腮疫苗接种剂次分层分析,1剂次、2剂次和3剂次的RR值分别为88.0(95%CI=76.3%~101.4%),88.2%(95%CI=76.1%~102.2%)和91.3%(95%CI=62.3%~133.9%),均未显示保护作用(P值均>0.05)。按最后1剂次接种日期与发病日期间隔分层分析,间隔<1 a和2 a的RR值分别为82.1%(95%CI=70.0%~96.3%)和82.5%(95%CI=70.1%~97.0%),确定有保护作用。间隔1 a、3 a、4 a、5 a、6 a和≥7 a的RR值分别为87.3%(95%CI=72.9%~104.6%),92.7%(95%CI=77.3%~111.1%),86.4%(95%CI=72.6%~102.8%),88.1%(95%CI=73.7%~105.3%),104.2%(95%CI=79.6%~136.3%)和88.1%(95%CI=75.9%~102.2%),均未确定保护作用(P值均>0.05)。结论接种疫苗是预防和控制流腮最有效措施。但接种时间超过3 a,对阻止流腮疫情在学校的暴发保护效果不佳。
Objective To understand the protective effect of mumps (Mumps) vaccines in outbreaks of cheeks in schools and other collective units, and to provide basis for improving immunization strategies of mumps vaccine. Methods Mumps vaccination information was collected from all the students in the class of ≥3 cases in schools where the outbreak of cheek gourd was reported in 2010-2014 in Zhongshan City. By stratified by age, mumps vaccine was used as exposure factor, and retrospective cohort study was used to evaluate the protective effect of mumps vaccine. Results A total of 501 children were included in the study. The total incidence of gills was 14.97% (75/501), that of the vaccinated group was 13.59% (59/434) and that of the unvaccinated group was 23.88% (16 / 67), the difference between the two groups was statistically significant (χ2 = 4.824, P <0.05). The protective effect of mumps vaccine (VE) was 43.1% (95% CI = 7.2% -65.1%). According to the sub-stratification analysis of mumps vaccination, the RRs were 88.0% (95% CI = 76.3% ~ 101.4%), 88.2% (95% CI = 76.1% ~ 102.2%) and 91.3% (95% CI = 62.3% -133.9%), respectively. No protective effect was observed (P> 0.05). According to the stratified analysis of the last inoculation date and the onset date, the RRs of interval <1 a and 2 a were 82.1% (95% CI = 70.0% -96.3%) and 82.5% (95% CI = 70.1% ~ 97.0%), to determine a protective effect. RRs at intervals of 1 year, 3 years, 4 years, 5 years, 6 years and ≥7 days were 87.3% (95% CI = 72.9% -104.6%), 92.7% (95% CI 77.3% -111.1% (95% CI = 72.6% -102.8%), 88.1% (95% CI = 73.7% -105.3%), 104.2% (95% CI = 79.6% -136.3%) and 88.1% (95% CI = 75.9% ~ 102.2%), no protective effect was determined (P> 0.05). Conclusion Vaccination is the most effective measure to prevent and control gills. However, the inoculation time exceeded 3 years and the effect of preventing outbreaks of mumps epidemic in schools was not good.