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目的探讨免疫后时间及流行强度对接种1剂水痘疫苗效力的影响。方法对广州市天河区2011年1~6月发病的1~15岁水痘病例,采用1︰1配对的病例对照研究方法,对不同年龄、处在不同流行强度时的1剂次水痘疫苗效力(vaccine effectiveness)进行分析,并评价两者对疫苗效力的影响。结果调查601病例/对照对子,总的疫苗效力为70.33%(95%CI:60.42%~77.76%,P<0.01),1岁组疫苗效力为90%(95%CI:65.27%~97.12%,P<0.01),随年龄增长,疫苗效力呈下降趋势(χ2趋势=12.68,P<0.01),≥10岁组病例与对照暴露率差异无统计学意义(P>0.05),疫苗基本失去保护效力。集体单位2~15岁病例511对子疫苗效力为66.67%(95%CI:54.52%~75.57%,P<0.01),水痘罹患率越高,疫苗效力越低,罹患率在15%以上时,疫苗效力差异无统计学意义(P>0.05),疫苗基本失去保护效力。结论接种1剂水痘疫苗约10%初次免疫失败;免疫后时间及流行强度对疫苗效力均有明显影响,后者影响更大。若将1剂免疫程序改为2剂免疫程序,对控制儿童水痘暴发将具有重要意义。
Objective To investigate the effect of time and intensity of immunization on the efficacy of vaccinating one varicella vaccine. Methods A case-control study of 1: 1 pairs of chicken pox aged 1-15 years old was performed in Tianhe District of Guangzhou City from January to June in 2011. The efficacy of 1 dose of varicella vaccine against different age and strength vaccine effectiveness, and evaluate the impact of both on vaccine efficacy. Results The total vaccine efficacy was 601 (95% CI: 60.42% -77.76%, P <0.01) and 90% for the 1-year-old vaccine group (95% CI: 65.27% -97.12% , P <0.01). With the increase of age, the vaccine efficacy showed a downward trend (χ2 trend = 12.68, P <0.01). There was no significant difference in the exposure rates between the cases of 10 and 10 years old (P> 0.05) Effectiveness. The efficacy of 511 pairs of vaccine in group 2 to 15 years old was 66.67% (95% CI: 54.52% -75.57%, P <0.01). The higher the incidence of chickenpox, the lower the efficacy of vaccine. When the attack rate was above 15% Vaccine efficacy was no significant difference (P> 0.05), the vaccine lost almost no protective effect. CONCLUSION: About 10% of primary vaccination with varicella vaccine failed the first immunization. The time and intensity of immunization had a significant effect on the vaccine efficacy, while the latter had a greater impact. Changing a single immunization program to a two-dose immunization program would be of great importance in controlling the chickenpox outbreak in children.