Global yellow fever vaccination coverage from 1970 to 2016: an adjusted retrospective analysis
Global yellow fever vaccination coverage from 1970 to 2016: an adjusted retrospective analysis
复制标题
DOI：
10.1016/s1473-3099(17)30419-x
复制
发表时间：
2017-11-01
影响因子：
56.3
通讯作者：
Reiner, Robert C., Jr.
中科院分区：
文献类型：
--
作者：
Shearer, Freya M.;Moyes, Catherine L.;Reiner, Robert C., Jr.
背景过去2年来，安哥拉和巴西爆发了大量黄热病疫情，加上全球疫苗储备短缺，突出表明迫切需要评估目前的控制战略。本研究的目的是在高空间分辨率下估计1970年至2016年的全球黄热病疫苗接种覆盖率，并计算仍需接种疫苗以达到疫情预防人群覆盖阈值的人数。（例如，世卫组织报告和卫生服务提供者登记册）报告1939年5月1日至2016年10月29日期间的黄热病疫苗接种活动。为了解释疫苗接种活动的目标不确定性，我们计算了三个人口覆盖率值，以涵盖替代方案。我们将这些数据与人口统计信息相结合，并跟踪疫苗接种覆盖率，以估计1970年至2016年期间有黄热病病毒传播风险的国家中每个二级行政区划曾接种黄热病疫苗的人口比例。但在黄热病风险区的现代覆盖率方面仍存在明显差距。我们估计，在存在黄热病病毒传播风险的地区，仍有3.937亿至4.729亿人需要接种疫苗，以达到世卫组织建议的80%人口覆盖率阈值;这占黄热病风险区人口的43%至52%，相比之下，1970年需要接种疫苗的人口比例为66%至76%。解释我们的结果突出了黄热病疫苗接种覆盖率的重要差距，有助于改善疫情风险的量化，并帮助指导未来疫苗接种工作和应急储备的规划。版权所有（C）作者。爱思唯尔有限公司出版
Background Substantial outbreaks of yellow fever in Angola and Brazil in the past 2 years, combined with global shortages in vaccine stockpiles, highlight a pressing need to assess present control strategies. The aims of this study were to estimate global yellow fever vaccination coverage from 1970 through to 2016 at high spatial resolution and to calculate the number of individuals still requiring vaccination to reach population coverage thresholds for outbreak prevention.Methods For this adjusted retrospective analysis, we compiled data from a range of sources (eg, WHO reports and health-service-provider registeries) reporting on yellow fever vaccination activities between May 1, 1939, and Oct 29, 2016. To account for uncertainty in how vaccine campaigns were targeted, we calculated three population coverage values to encompass alternative scenarios. We combined these data with demographic information and tracked vaccination coverage through time to estimate the proportion of the population who had ever received a yellow fever vaccine for each second level administrative division across countries at risk of yellow fever virus transmission from 1970 to 2016.Findings Overall, substantial increases in vaccine coverage have occurred since 1970, but notable gaps still exist in contemporary coverage within yellow fever risk zones. We estimate that between 393.7 million and 472.9 million people still require vaccination in areas at risk of yellow fever virus transmission to achieve the 80% population coverage threshold recommended by WHO; this represents between 43% and 52% of the population within yellow fever risk zones, compared with between 66% and 76% of the population who would have required vaccination in 1970.Interpretation Our results highlight important gaps in yellow fever vaccination coverage, can contribute to improved quantification of outbreak risk, and help to guide planning of future vaccination efforts and emergency stockpiling. Copyright (C) The Author(s). Published by Elsevier Ltd.