| 庄昉成,姜器,龚岳平,莫世华,忻亚娟,钱汶,陈念良,张淑雅,柴少爱,毛江森.甲型肝炎减毒活疫苗（H2株）10年流行病学效果观察[J].Chinese journal of Epidemiology,2001,22(3):188-190 |
| 甲型肝炎减毒活疫苗（H2株）10年流行病学效果观察 |
| Epidemiological effects of live attenuated hepatitis Avaccine(H2-strain):results of A 10-year observation |
| Received:June 23, 2000 |
| DOI： |
| KeyWord: 甲型肝炎 疫苗 流行病学 |
| English Key Word: Hepatitis A Vaccine Epidemiology |
| FundProject: |
| Author Name | Affiliation | | ZHUANG Fangcheng | Institute of Viral Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, China | | JIANG Qi | 台州市椒江区卫生防疫站 | | GONG Yueping | 嵊泗县卫生防疫站 | | 莫世华 | 浙江省卫生防疫站 | | 忻亚娟 | Institute of Viral Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, China | | 钱汶 | Institute of Viral Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, China | | 陈念良 | Institute of Viral Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, China | | 张淑雅 | Institute of Viral Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, China | | 柴少爱 | Institute of Viral Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, China | | 毛江森 | Institute of Viral Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, China |
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| Abstract: |
| 目的 观察在甲型肝炎 (甲肝 )高发县、区用甲肝减毒活疫苗 (H2 株 )大面积接种后长期的流行病学保护效果。方法 选择浙江省嵊泗县和椒江区二个试点。二组小学生定群研究,观察 4年。试点内 1～ 15岁儿童普遍接种甲肝活疫苗。部分研究对象作血清中和试验、免疫回忆反应及免后 10年抗体检测。结果 接种组与未接种组甲肝发病率差别具有显著性 (P <,0.0 1),疫苗保护率为10 0 %。疫苗接种率与甲肝发病率二者具有明显负相关。全人口甲肝发病率分别下降了 94.5 %和90.3%,1～ 15岁儿童组发病专率分别下降了 96.9%和 97.9%,10年期间没有发生甲肝流行。血清学检测结果 :免后阴性血清,用体外中和法验证有 6 3.8%仍有中和作用,加强免疫 1针后回忆反应明显。免后 10年抗 HAV IgG的阳性率为 80.2 %。结论 甲肝减毒活疫苗 (H2 株 )长期的流行病学效果明显。通过普遍接种甲肝活疫苗,第一次在甲肝高发地区和高发年龄组消除了甲肝的发生与流行。 |
| English Abstract: |
| Objective To assess the long-term epidemiological effects after a mass vaccination program, using live attenuated hepatitis A vaccine (H2-strain).Methods Shengsi county and Jiaojiang city in Zhejiang province were chosen where high incidence rate of hepatitis A was observed.Mass vaccination program of H2-strain vaccine was carried out on 1-15 year olds.Cohort studies included two groups were carried out in Shengsi.Cases reported program on hepatitis A was under the national standard on clinical diagnosis and partly through laboratory monitor of anti-HAV IgM and IgG, ELISA and Abbott EIA.Population size was estimated by the yearly reports of census bureau of the county and the city. Serum tests including neutralization test, immune-recall responses, and anti-HAV IgG were performed 10 years after the initial immunization.Results The morbidity of hepatitis A was significantly different between vaccinated groups and non-vaccinated groups (P <0.01)in the cohort study.The protective efficacy in the site was 100 percent.There was a significantly negative correlation of regression between vaccine coverage and hepatitis A morbidity.In both sites, hepatitis A incidence rate showed decrease of 94.5% and 90.3% in whole population, with 96.9% and 97.9% in 1-15 year olds respectively.Neutralization test showed that 63.8% of the serum negative to ELISA after vaccination could still neutralize certain HAV.Immune-recall response after the booster was seen in vaccine group with 80.2% positive rate of anti HAV-IgG, 10 years after immunization among vaccinees in both sites.Not a single hepatitis A case was identified.Conclusion Live attenuated hepatitis A vaccine seemed to have obviously long-term epidemiological effects. |
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