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目的了解北京市顺义区水痘疫苗接种后突破病例的发病特点及规律。方法采用流行病学方法,对2008-2011年水痘突破病例资料进行分析。结果顺义区2008-2011年共报告水痘突破病例1 217例,占总病例的31.32%;主要聚集在城区、后沙峪镇、仁和镇等地;发病年龄集中于4~12岁组,呈单峰型,7岁组最高;最后1剂水痘疫苗接种时间和发病的间隔与发热症状病例数(χ2=21.043,P=0.000)和出疹程度(χ2=4.45,P=0.035)成正比;免疫史满3年者发病是不足3年者的4.27倍;在北京接种的突破病例比外地接种者症状轻(χ2=8.256,P=0.016);接种国产疫苗比进口疫苗突破病例出疹程度更重(χ2=15.81,P=0.003)。结论为进一步控制水痘疫情,可考虑入学前接种水痘疫苗;将国内水痘疫苗程序推广为2剂,免疫史满3年者可加强1剂,应急接种范围也可扩大到免疫史超过3年者;水痘突破病例比原发性水痘症状轻,国产疫苗是否与进口疫苗有一定差距成为一个问题。
Objective To understand the characteristics and rules of the breakthrough cases of varicella vaccination in Shunyi District of Beijing. Methods Epidemiological methods were used to analyze the cases of chickenpox breakthrough from 2008 to 2011. Results A total of 1 217 cases of chickenpox breakthrough were reported in Shunyi District from 2008 to 2011, accounting for 31.32% of the total cases. The majority of cases were found in urban areas, Hou Shayu Town and Renhe Town. The age of onset was mainly in the 4-12 age group, Peak type, the highest in the 7-year-old group; the last vaccination time and incidence of chickenpox were proportional to the number of fever cases (χ2 = 21.043, P = 0.000) and the degree of rash (χ2 = 4.45, P = 0.035) The incidence of breakthrough vaccination in Beijing was significantly lower than that of those vaccinated in other places (χ2 = 8.256, P = 0.016); the vaccination of domestic vaccines was more severe than the breakthrough of imported vaccines (χ2 = 15.81, P = 0.003). Conclusions In order to further control the epidemic situation of chickenpox, pre-admission vaccination of varicella can be considered; the program of varicella vaccine in China can be extended to two doses; the history of vaccination can be enhanced by one year after the expiration of three years; the scope of emergency vaccination can be extended to more than three years; Chickenpox breakthrough cases than primary chickenpox symptoms light, whether the domestic vaccine and imported vaccine have a certain gap has become a problem.