| 马蕊,孙美平,孙木,侯文俊,蒋贵英,彭兴慧,吴疆.北京市小学生水痘疫苗应急接种效果及影响因素评价[J].Chinese journal of Epidemiology,2009,30(6):559-563 |
| 北京市小学生水痘疫苗应急接种效果及影响因素评价 |
| Effectiveness on post-exposure vaccination of varicella and its influencing factors in elementary schools in Beijing |
| Received:October 06, 2008 |
| DOI： |
| KeyWord: 水痘疫苗 应急接种 影响因素 |
| English Key Word: Varicella vaccine Post-exposure vaccination Influencing factors |
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| Abstract: |
| 目的 评价北京市小学生水痘疫苗应急接种效果及其影响因素.方法 对2007年5-7月北京市4个区(县)49起小学水痘疫情应急接种进行前瞻性观察.将应急接种前发生水痘病例的班级和同楼层或同排平房无病例班级的全体7882名学生作为观察对象;收集水痘病史、疫苗接种史、病例个案等资料,采用描述流行病学方法评价水痘疫苗应急接种保护效果.结果 水痘疫苗应急接种总体保护率为85.26%.首例水痘病例既往有疫苗接种史、疫情发现及时、病例数少、距首例病例发病时间短的水痘疫苗应急接种保护效果较好;分别对水痘疫苗应急接种前已发生病例班级和同楼层或同排平房无病例班级的应急接种效果进行分析,疫苗保护率分别为84.26%和87.06%.首例病例既往有水痘疫苗接种史的应急接种保护率分别为92.09%和93.06%,均高于首例病例既往无疫苗接种史的学校.应急接种前仅发生1例病例的疫曲接种保护率分别为83.09%和93.02%,均高于应急接种前已发生2～3例病例的学校.首例病例发病后<5 d完成消毒、隔离和应急接种等综合措施的疫苗保护率分别为86.60%和92.73%,均高于首例病例发病后<5 d完成消毒、隔离、但≥5 d完成应急接种的学校.此外,学校教室为平房、无校车或食堂、无住宿、学生间无搭伴包车或就餐的学校应急接种后疫苗保护率较高.结论 北京市小学生水痘疫苗应急接种具有较高的保护率,有利于控制水痘疫情. |
| English Abstract: |
| Objective To evaluate the effectiveness of post-exposure varicella vaccination in elementary schools in Beijing and to explore its influencing factors. Methods From May to July 2007, variceila cases from 49 elementary schools in 4 districts in Beijing were observed prospectively. The study included 7882 children who were from the same classrooms, same floor or same bungalow areas with the varicella cases. Vaccination status, history on varicella and onset of rashes were collected to calculate the secondary attack rate among those children under observation and then the effectiveness of vaccine was calculated. Results The protection rate on post-exposure vaccination among children under observation was 85.26%. The rates were higher when the 1st case had received varicella vaccine before the onset, vaccines were administered soon after the exposure or there were less varicella cases occurred in the schools. For children in the same class, same floor or bungalow with varicella cases before post-exposure vaccination, the average rates of protection by vaccination were 84.26% and 87.06%, respectively. When the 1st case had received varicella vaccine prior to the onset, the post-exposure protection rates reached 92.09% and 93.06%, respectively, higher than that of the case when the 1st case had received no vaccination. When the administration of vaccine right after the occurrence of first varicella case, the rates of the effectiveness of vaccine were 83.09% and 93.02%, both of which were higher than that of vaccine administered after the occurrence of 2 or 3 cases. When the vaccine administration of vaccination combined with the isolation of the already infected cases or within 5 days after the onset of the 1st case, the vaccine effectiveness could reach 86.60% and 92.73%, both were higher than otherwise. However, in those schools that bungalows were used as classrooms but without bus, canteen from school or student lodgings, it seemed that post exposure vaccination was more effective in preventing varicella from occurring. Conclusion Varicella vaccination after exposure in elementary schools in Beijing was effective in prevention and control of the disease. Immediate administration together with the isolation of cases could maximize the effectiveness of the vacine. |
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