2017－2018年流感流行季儿童接种流感疫苗效果社区队列研究

朱军礼; 吕梅斋; 骆淑英; 陈高尚; 庞志峰; 章光明; 吴晓虹

Abstract

朱军礼,吕梅斋,骆淑英,陈高尚,庞志峰,章光明,吴晓虹.2017－2018年流感流行季儿童接种流感疫苗效果社区队列研究[J].Chinese journal of Epidemiology,2020,41(5):747-752

2017－2018年流感流行季儿童接种流感疫苗效果社区队列研究

Evaluation of influenza vaccine effectiveness in 2017-2018 influenza season based on community children cohort study

Received:July 30, 2019

DOI：10.3760/cma.j.cn112338-20190730-00563

KeyWord: 流感疫苗队列研究疫苗效果

English Key Word: Influenza vaccine Cohort study Vaccine effectiveness

FundProject:金华市科学技术研究计划公益类项目（2017-4-073）

Author Name	Affiliation	E-mail
Zhu Junli	Division of Communicable Disease Prevention and Control, Jinhua Prefectural Center for Disease Control and Prevention, Jinhua 321002, China	zyzhujunli@163.com
Lyu Meizhai	Division of Communicable Disease Prevention and Control, Yongkang County Center for Disease Control and Prevention, Yongkang 321300, China
Luo Shuying	Department of Immunization Program, Yiwu County Center for Disease Control and Prevention, Yiwu 322000, China
Chen Gaoshang	Division of Communicable Disease Prevention and Control, Jinhua Prefectural Center for Disease Control and Prevention, Jinhua 321002, China
Pang Zhifeng	Division of Communicable Disease Prevention and Control, Jinhua Prefectural Center for Disease Control and Prevention, Jinhua 321002, China
Zhang Guangming	Division of Communicable Disease Prevention and Control, Jinhua Prefectural Center for Disease Control and Prevention, Jinhua 321002, China
Wu Xiaohong	Division of Communicable Disease Prevention and Control, Jinhua Prefectural Center for Disease Control and Prevention, Jinhua 321002, China

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Abstract:

目的评价6~72月龄儿童接种流感疫苗效果。方法采用社区队列研究设计，2017年10-12月，从浙江省永康和义乌两市10家儿童接种门诊招募了1 752名6~72月龄儿童。每名儿童入队列后，完成知情同意和问卷调查，并随访至2018年4月30日，观察记录流感样病例（ILI）发病、门诊就诊和自行服药及流感疫苗接种情况。以ILI、门诊就诊和自行服药的发生次数为因变量，采用广义线性模型（GLM）拟合，估算流感疫苗效果（VE）值。结果 1 752名儿童中，男童925名（52.80%），月龄M=30.00月，累计随访观察308 166人天，平均每天有5.27‰发生ILI、3.41‰因ILI去医院门诊就诊、1.45‰因ILI自行服药治疗；共有643名儿童接种了流感疫苗，与未接种儿童相比，流感疫苗对ILI、门诊就诊和自行服药的VE值分别为23.5%（95% CI：15.1%~31.1%）、19.3%（95% CI：8.2%~29.1%）和25.8%（95% CI：9.3%~39.3%）。643名接种儿童，接种后与接种前比，流感疫苗针对36~72月龄儿童ILI、门诊就诊和自行服药的VE值分别为31.9%（95% CI：12.7%~46.9%）、32.6%（95% CI：8.6%~50.3%）和44.3%（95% CI：11.9%~64.8%），而对6~35月龄儿童，VE值均无统计学意义。2016-2018年流感疫苗不同接种暴露VE值评估，两个流感流行季均有接种史的，仅2017-2018年流感流行季有接种史的，流感疫苗VE值，均有统计学意义；仅2016-2017年流感流行季有接种史的，VE值均无统计学意义。结论流感流行季接种流感疫苗一定程度可预防ILI发病、门诊就诊和自行服药，且对36~72月龄儿童保护效果优于6~35月龄儿童。

English Abstract:

Objective To assess the effectiveness of influenza vaccine in children aged 6-72 months. Methods The cohort study was conducted based on community child vaccination clinics in Yiwu and Yongkang counties of Zhejiang province. From October 2017 to December 2017, a total of 1 752 children aged 6-72 months were enrolled from 10 child vaccination clinics. The questionnaire survey was conducted after the written consents were obtained from the parents or legal guardians of the children. Then, a follow up was conducted for enrolle children until 30 April 2018, the influenza vaccination status and the number of influenza-like illness (ILI) cases, hospital visit due to ILI, self-medication due to ILI were observed and recorded every month. Vaccine effectiveness (VE) was estimated by using the generalized linear model (GLM) where dependent variables were the number of ILI cases, hospital visit and self-medication respectively. Results Of the 1 752 children, 925 (52.80%) were boys and the median age was 30.00 months. The cumulative observation was 308 166 person days at the end of 2017-2018 season, with 5.27 ILI cases per 1 000 person days, 3.41 hospital visit due to ILI per 1 000 person days, 1.45 self-medication due to ILI per 1 000 person days. Of the 1 752 children, 643 received the influenza vaccination in 2017-2018 season. Compared with unvaccinated children, the VE was 23.5% against ILI case number (95%CI:15.1%-31.1%), 19.3% against hospital visit due to ILI (95%CI:8.2%-29.1%) and 25.8% against self-medication due to ILI (95%CI:9.3%-39.3%). Modeling splitting 643 children with 2017-2018 vaccination into those before and after vaccination, the influenza VE was 31.9% against ILI case number (95%CI:12.7%-46.9%), 32.6% against hospital visit due to ILI (95%CI:8.6%-50.3%) and 44.3% against self-medication due to ILI (95%CI:11.9%-64.8%) in children aged 36-72 months. However, the children aged 6-35 months showed no significant VEs. For the VE analysis in children with different vaccination status, the VEs were significant if they received vaccination in both 2016-2017 season and 2017-2018 season or only in 2017-2018 seasons. The VE was not demonstrated among the children who were immunized only in 2016-2017 season. Conclusion Influenza vaccination is moderate effective in preventing the incidence of ILI and hospital visit and self-medication in children in influenza season, the protection effect in children aged 36-72 months is better than that in children aged 6-35 months.

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