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目的:评价乙肝疫苗扩免策略实施效果。方法:分析烟台市新生儿乙肝疫苗接种及影响因素,整群随机检测1 543名7～12月龄儿童乙肝表面抗体(Anti-HBs)水平;描述分析15岁以下儿童乙肝发病状况。结果:烟台市新生儿乙肝疫苗接种率、及时率保持在97%以上,阳性母亲的新生儿77.35%采用乙肝免疫球蛋白(HBIG)联合阻断;5μg啤酒酵母扩免乙肝疫苗具有较高的免疫原性,80.75%儿童能够产生保护性应答,接种医院级别及父母乙肝感染状况是影响免疫应答的因素;扩免策略实施后儿童乙肝发病率大幅下降,5年降低了78.99%。结论:烟台市新生儿乙肝疫苗免疫策略效果显著,强化产科培训,正确把握接种禁忌,普及孕妇HBV检测,完善低/无应答者免疫将进一步降低乙肝发病率。
Objective: To evaluate the effect of hepatitis B vaccine expansion strategy. Methods: The neonatal hepatitis B vaccination and its influencing factors in Yantai City were analyzed. Anti-HBs levels of 1 543 children aged 7-12 months were randomly detected in the cluster. The incidence of hepatitis B in children under 15 years old was analyzed. Results: The vaccination rate and timely rate of hepatitis B vaccination in newborns in Yantai were above 97%, 77.35% of the newborns in positive mothers were blocked with HBIG and hepatitis B vaccine with 5μg S. cerevisiae was highly immunized 80.75% of children can have protective response, and the level of hospital infection and the status of HBV infection among parents are the factors that affect the immune response. The incidence of hepatitis B in children after the expansion strategy is greatly reduced, reducing by 78.99% in 5 years. Conclusion: The immunization strategy of neonatal hepatitis B vaccine is significant in Yantai City. Obstetric training should be strengthened, the taboo of immunization should be correctly grasped, the detection of HBV in pregnant women should be popularized, and the immunity of low / non-responders should be further lowered to reduce the incidence of hepatitis B.