中国流感疫苗预防接种技术指南(2018-2019)

冯录召; 彭质斌; 王大燕; 杨鹏; 杨娟; 张延炀; 陈健; 姜世强; 徐莉立; 康敏; 陈涛; 郑亚明; 郑建东; 秦颖; 赵梦娇; 谭亚运; 李中杰; 冯子健

Abstract

冯录召,彭质斌,王大燕,杨鹏,杨娟,张延炀,陈健,姜世强,徐莉立,康敏,陈涛,郑亚明,郑建东,秦颖,赵梦娇,谭亚运,李中杰,冯子健.中国流感疫苗预防接种技术指南(2018-2019)[J].Chinese journal of Epidemiology,2018,39(11):1413-1425

中国流感疫苗预防接种技术指南(2018-2019)

Technical guidelines for seasonal influenza vaccination in China, 2018-2019

Received:October 10, 2018

DOI：10.3760/cma.j.issn.0254-6450.2018.11.001

KeyWord: 流感疾病负担疫苗预防接种技术指南

English Key Word: Influenza Disease burden Vaccine Vaccination Technical guideline

FundProject:中国疾病预防控制中心应急反应机制运行项目（131031001000015001）

Author Name	Affiliation	E-mail
Feng Luzhao	Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Peng Zhibin	Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Wang Dayan	National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Yang Peng	Infectious Disease & Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing 100013, China
Yang Juan	School of Public Health, Fudan University, Shanghai 200032, China
Zhang Yanyang	Institute for Immunization Prevention and Planning, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
Chen Jian	Institute for Communicable Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
Jiang Shiqiang	Department for Immunization Prevention and Planning, Nanshan District Center for Disease Control and Prevention, Shenzhen 518055
Xu Lili	Institute for Communicable Disease Control and Prevention, Qinghai Center for Disease Prevention and Control, Xining 810007, China
Kang Min	Institute for Communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
Chen Tao	National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Zheng Yaming	Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Zheng Jiandong	Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Qin Ying	Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Zhao Mengjiao	Department for Emergency Management, Jinan Center for Disease Control and Prevention, Jinan 250021, China
Tan Yayun	Department for Communicable Disease Control and Prevention, Suzhou Center for Disease Control and Prevention, Suzhou 215004, China
Li Zhongjie	Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China	lizj@chinacdc.cn
Feng Zijian	Chinese Center for Disease Control and Prevention, Beijing 102206, China	fengzj@chinacdc.cn

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Abstract:

接种流感疫苗是预防流感病毒感染及其并发症的最有效手段。目前，我国国内批准上市的灭活流感疫苗为三价（ⅡV3）和四价（ⅡV4）疫苗，包括裂解疫苗和亚单位疫苗。流感疫苗在我国大多数地区属于第二类疫苗，实行自愿、自费接种。为指导我国流感预防控制和疫苗应用工作，中国CDC国家免疫规划技术工作组流感疫苗工作组综合国内外最新研究进展，对2014年版指南进行了更新和修订，形成了《中国流感疫苗预防接种技术指南（2018－2019）》。本指南主要更新了以下内容：流感的流行病学和疾病负担，流感疫苗的种类、2018－2019年度流感疫苗抗原组份、ⅡV3和ⅡV4疫苗的免疫反应、免疫持久性、免疫原性、效力、效果、安全性、成本效果和成本效益等；并基于现有的科学证据，提出了2018－2019年度流感疫苗预防接种的建议。本指南建议：原则上，接种服务单位应为≥6月龄所有愿意接种流感疫苗且无禁忌证的人提供接种服务。对可接种不同类型、厂家疫苗产品的人群，可由受种者自愿选择接种任一种流感疫苗，无优先推荐。为降低高危人群罹患流感及感染后发生严重临床结局的风险，指南推荐6月龄至5岁儿童、≥60岁老年人、慢性病患者、医务人员、<6月龄婴儿的家庭成员和看护人员以及孕妇或准备在流感季节怀孕的女性为优先接种对象；首次接种流感疫苗的6月龄至8岁儿童应接种2剂次，间隔≥4周；2017－2018年度或以前接种过≥1剂次流感疫苗的儿童，建议接种1剂次；≥9岁儿童和成年人仅需接种1剂次。建议各地防疫部门在疫苗供应到位后尽快安排接种工作，最好在10月底前完成免疫接种；对10月底前未接种的对象，整个流行季节都可以提供接种服务；孕妇在孕期的任一阶段均可接种流感疫苗。本指南适用于从事流感防控相关的各级CDC工作人员，预防接种点的接种人员，各级医疗机构儿科、内科、感染科等医务人员，以及各级妇幼保健机构的专业人员。

English Abstract:

Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and its complications. Currently, China has licensed trivalent (ⅡV3) and quadrivalent inactivated influenza vaccine (ⅡV4), including split-virus influenza vaccine and subunit vaccine. In most parts of China, influenza vaccine is a category Ⅱ vaccine, which means influenza vaccination is voluntary, and recipients need to pay for it. To strengthen the technical guidance for prevention and control of influenza and the operational research on influenza vaccination in China, the National Immunization Advisory Committee (NIAC), Influenza Vaccine Technical Working Group (TWG), updated the 2014 technical guidelines and compiled the "Technical guidelines for seasonal influenza vaccination in China (2018-2019)", based on most recent existing scientific evidences. The main updates include:epidemiology and disease burden of influenza, types of influenza vaccines, northern hemisphere influenza vaccination composition for the 2018-2019 season, and, ⅡV3 and ⅡV4 vaccines'major immune responses, durability of immunity, immunogenicity, vaccine efficacy, effectiveness, safety, cost-effectiveness and cost-benefit. The recommendations include:Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for any influenza vaccine product for persons who can accept ≥ 1 licensed, recommended, and appropriate products. To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups, the recommendations prioritize seasonal influenza vaccination for children aged 6-60 months, adults ≥ 60 years of age, persons with specific chronic diseases, healthcare workers, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to pregnant during the influenza season. Children aged 6 months to 8 years old require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. If they were vaccinated in previous influenza season, 1 dose is recommended. People ≥ 9 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as the vaccination is available. Influenza vaccination should continue to be available for those unable to be vaccinated before the end of October during the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for CDC members who are working on influenza control and prevention, PoVs members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and members of maternity and child care institutions at all levels.

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