First Outbreak Response Using an Oral Cholera Vaccine in Africa: Vaccine Coverage, Acceptability and Surveillance of Adverse Events, Guinea, 2012
First Outbreak Response Using an Oral Cholera Vaccine in Africa: Vaccine Coverage, Acceptability and Surveillance of Adverse Events, Guinea, 2012
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DOI：
10.1371/journal.pntd.0002465
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发表时间：
2013-10-01
影响因子：
3.8
通讯作者：
Grais, Rebecca F.
中科院分区：
文献类型：
--
作者：
Luquero, Francisco J.;Grout, Lise;Grais, Rebecca F.
背景：尽管世界卫生组织(WHO)对两种安全有效的口服霍乱疫苗(OCV)进行了资格预审，但对可接受性、潜在的资源转移、成本和实施及时宣传活动的可行性的担忧阻碍了它们的使用。2012年，几内亚卫生部在无国界医生的支持下，组织了第一次大规模疫苗接种运动，使用两剂OCV(Shanchol)作为额外的控制措施，以应对正在进行的全国流行病。总体而言，共交付了316,250支疫苗。在这里，我们介绍了疫苗接种覆盖率、可接受性和不良事件监测的结果。方法/主要研究结果：我们进行了横断面整群调查并实施了不良事件监测。研究人群包括12个月以上、有资格接种疫苗并居住在疫苗接种目标地区(几内亚福雷卡里亚和博法)的个人。数据来源是通过疫苗接种卡核实的家庭访谈以及疫苗接种站和保健中心监测不良事件的通知。共有5248人参加了调查，其中博法3993人，福雷卡里亚1255人。总体而言，博法和福雷卡里亚第一轮接种率分别为89.4%[95%CI：86.4-91.8%]和87.7%[95%CI：84.2-90.6%]，第二轮接种率分别为79.8%[95%CI：75.6-83.4%]和82.9%[95%CI：76.6-87.7%]。BOFA和Forecariah两剂疫苗接种率分别为75.8%[95%CI：71.2-75.9%]和75.9%[95%CI：69.8-80.9%]。儿童的疫苗接种率较高。未接种疫苗的主要原因是缺勤。未发现严重不良事件。结论/意义：广为接受的大规模疫苗接种活动在人口流动的偏远地区达到了很高的覆盖率。尽管不应将预防霍乱疫苗视为全球霍乱控制的长期解决方案，但应将其作为一种额外的工具纳入应对措施。
Background: Despite World Health Organization (WHO) prequalification of two safe and effective oral cholera vaccines (OCV), concerns about the acceptability, potential diversion of resources, cost and feasibility of implementing timely campaigns has discouraged their use. In 2012, the Ministry of Health of Guinea, with the support of Medecins Sans Frontieres organized the first mass vaccination campaign using a two-dose OCV (Shanchol) as an additional control measure to respond to the on-going nationwide epidemic. Overall, 316,250 vaccines were delivered. Here, we present the results of vaccination coverage, acceptability and surveillance of adverse events.Methodology/Principal Findings: We performed a cross-sectional cluster survey and implemented adverse event surveillance. The study population included individuals older than 12 months, eligible for vaccination, and residing in the areas targeted for vaccination (Forecariah and Boffa, Guinea). Data sources were household interviews with verification by vaccination card and notifications of adverse events from surveillance at vaccination posts and health centres. In total 5,248 people were included in the survey, 3,993 in Boffa and 1,255 in Forecariah. Overall, 89.4% [95% CI: 86.4-91.8%] and 87.7% [95% CI: 84.2-90.6%] were vaccinated during the first round and 79.8% [95% CI: 75.6-83.4%] and 82.9% [95% CI: 76.6-87.7%] during the second round in Boffa and Forecariah respectively. The two dose vaccine coverage (including card and oral reporting) was 75.8% [95% CI: 71.2-75.9%] in Boffa and 75.9% [95% CI: 69.8-80.9%] in Forecariah respectively. Vaccination coverage was higher in children. The main reason for non-vaccination was absence. No severe adverse events were notified.Conclusions/Significance: The well-accepted mass vaccination campaign reached high coverage in a remote area with a mobile population. Although OCV should not be foreseen as the long-term solution for global cholera control, they should be integrated as an additional tool into the response.