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兰州羊肉轮状病毒疫苗预防 5 岁以下儿童胃肠炎的效果。

Effectiveness of Lanzhou lamb rotavirus vaccine in preventing gastroenteritis among children younger than 5 years of age.

机构信息

Beijing Center for Disease Prevention and Control, No. 16, Hepingli Middle Road, Beijing 100013, People's Republic of China; Research Center for Preventive Medicine of Beijing, No. 16, Hepingli Middle Road, Beijing 100013, People's Republic of China.

Beijing Center for Disease Prevention and Control, No. 16, Hepingli Middle Road, Beijing 100013, People's Republic of China; Research Center for Preventive Medicine of Beijing, No. 16, Hepingli Middle Road, Beijing 100013, People's Republic of China.

出版信息

Vaccine. 2019 Jun 12;37(27):3611-3616. doi: 10.1016/j.vaccine.2019.03.069. Epub 2019 May 20.

Abstract

BACKGROUND

Lanzhou Lamb rotavirus (LLR) vaccine was licensed in China in 2000. It was the only vaccine available in private market before 2018. However, the data about the post-marketing effectiveness is very limited. To assess the vaccine effectiveness (VE), we conducted a case-control study based on the hospital surveillance system in Beijing from 2015 to 2017.

METHODS

Seven hospitals located in seven districts in Beijing, from October 1, 2015, to March 31, 2017, were included. The VE of LLR vaccine was assessed in laboratory-confirmed rotavirus infection among children younger than five years old through a case-control design, using rotavirus-negative cases as controls. LLR vaccination was documented from a vaccination registry. VE was estimated adjusting for age group, gender, study site, the month of illness onset and interval days between illness onset to sampling through a logistic regression model.

RESULTS

A total of 598 cases and 1766 controls were included in this study. The vaccine average coverage rate during 2015-2017 among children younger than five years old was 10.8% in Beijing. The adjusted VE for LLR vaccine of 1 dose versus 0 dose was 34.9% (95%CI, 5.3-55.3). We also obtained the adjusted VE of 87.7% (95%CI, 32.7-97.8) for patients with the severity score ≥11, 36.2% (95%CI, 4.7-57.3) for children of 2-35 months age group and 40.8% (95%CI, 7.8-61.9) against G9 rotavirus infection. Vaccinated cases were less likely to have watery stool (OR = 0.42) and have diarrhea longer than 5 days (OR = 0.47) than unvaccinated cases.

DISCUSSION

LLR vaccine conferred protection against rotavirus disease. Children who were vaccinated presented with less severe clinical manifestations. An immunization schedule of receiving all three doses in the first year should be preferred.

摘要

背景

兰州轮状病毒(LLR)疫苗于 2000 年在中国获得许可。在 2018 年之前,它是私人市场上唯一可用的疫苗。然而,关于上市后效果的数据非常有限。为了评估疫苗效果(VE),我们在北京的医院监测系统基础上进行了一项病例对照研究,时间为 2015 年至 2017 年。

方法

2015 年 10 月 1 日至 2017 年 3 月 31 日,北京的七个区的七家医院被纳入研究。通过病例对照设计,使用轮状病毒阴性病例作为对照,评估了实验室确诊的 5 岁以下儿童中 LLR 疫苗的 VE。从疫苗接种登记处记录 LLR 疫苗接种情况。通过逻辑回归模型,调整年龄组、性别、研究地点、发病月份和发病至采样的间隔天数,估计 VE。

结果

这项研究共纳入 598 例病例和 1766 例对照。2015-2017 年,北京 5 岁以下儿童的疫苗平均覆盖率为 10.8%。1 剂 LLR 疫苗与 0 剂疫苗相比,VE 为 34.9%(95%CI,5.3-55.3)。我们还获得了严重程度评分≥11 的患者的调整 VE 为 87.7%(95%CI,32.7-97.8),2-35 个月龄组的 VE 为 36.2%(95%CI,4.7-57.3),G9 轮状病毒感染的 VE 为 40.8%(95%CI,7.8-61.9)。与未接种疫苗的病例相比,接种疫苗的病例水样便(OR=0.42)和腹泻持续时间超过 5 天(OR=0.47)的可能性较低。

讨论

LLR 疫苗对轮状病毒病有保护作用。接种疫苗的儿童临床表现较轻。应优先选择在第一年接种三剂的免疫程序。

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