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目的了解某学校一起突破性水痘暴发情况,为探讨水痘减毒活疫苗保护效率和控制疫情提供参考。方法收集暴发疫情全部病例,对疫苗接种史和患病史进行回顾,计算罹患率并分析疫苗有效率。结果全部184名学生中,累计发生水痘11例(突破病例10例),无并发症及死亡,总体罹患率6.3%,水痘疫苗总覆盖率95.4%;1剂次和2剂次水痘减毒活疫苗接种者罹患率分别为9.0%和0,差异有统计学意义(χ2=8.927,P=0.012);免疫史≥3年儿童出现突破病例是<3年儿童的7.62倍(95%CI=0.943~61.617)。结论水痘减毒活疫苗高覆盖率可降低发病率并防止重症水痘,但接种时间≥3年后保护性降低,可能出现突破性病例。应提高2剂次接种率,并适当扩大应急接种范围。
Objective To understand the outbreak of a breakthrough chickenpox in a school and provide reference for the protection efficiency and control of the live attenuated varicella vaccine. Methods All cases of outbreaks were collected. The vaccination history and history of vaccination were reviewed, and the attack rate was calculated and the vaccine efficiency was analyzed. Results Of all the 184 students, 11 cases of chickenpox (10 breakthrough cases) occurred without complication and death, with an overall attack rate of 6.3% and a total varicella vaccine coverage of 95.4%. One dose and two doses of attenuated varicella The incidence of vaccination was 9.0% and 0 respectively, with statistical significance (χ2 = 8.927, P = 0.012). The breakthrough rate of children with immunization history ≥3 years was 7.62 times higher than that of children <3 years (95% CI 0.943 ~ 61.617). Conclusions The high coverage of attenuated live attenuated varicella vaccine may reduce the morbidity and prevent severe chickenpox. However, the protective efficacy may be reduced after 3 years of inoculation, which may lead to breakthrough cases. Should increase the dose of 2 doses, and appropriate to expand the scope of emergency vaccination.