A population profile of measles susceptibility in Tianjin, China.
A population profile of measles susceptibility in Tianjin, China.
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DOI：
10.1016/j.vaccine.2016.04.094
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发表时间：
2016-06-08
期刊：
影响因子：
5.5
通讯作者：
Su X
中科院分区：
文献类型：
--
作者：
Boulton ML;Wang X;Zhang Y;Montgomery JP;Wagner AL;Carlson BF;Ding Y;Li X;Gillespie B;Su X
麻疹是一种传染性很强的疾病，需要95%的群体免疫力才能阻断传播。麻疹是中国的消灭目标，尽管疫苗接种覆盖率很高，但尚未达到消灭目标。我们建立了中国天津市0 ~ 49岁居民麻疹免疫力的人群分布图。参与者来自社区人口登记册或社区免疫记录。麻疹IgG抗体的状态进行了评估，使用干血斑。我们研究了麻疹IgG抗体状态和独立变量之间的关系，包括城市化，性别，疫苗接种，麻疹病史和年龄。2,818人报名参加。麻疹IgG抗体阴性率从1月龄婴儿的50.7%上升到7月龄婴儿的98.3%。接种8个月后，符合接种条件的年龄、婴幼儿麻疹IgG阴转比例均有所下降。总体而言，7.8%的9个月或以上的参与者缺乏麻疹免疫力，其中包括20-39岁的10%以上。在多变量模型中，年龄和疫苗接种状态与麻疹IgG状态显著相关。与接种疫苗相比，未接种疫苗的阳性IgG状态的几率高0.337倍（95% CI：0.217，0.524）。在中国天津，对麻疹免疫的人的比例低于群体免疫阈值，20-39岁的人中不到90%表现出保护。天津的免疫接种计划成功地为较年轻的年龄组接种了疫苗，尽管考虑到未免疫的成年人比例很大，仅对婴儿和儿童的高免疫覆盖率并不能提供保护性群体免疫。
Measles is a highly infectious illness requiring herd immunity of 95% to interrupt transmission. Measles is targeted for elimination in China, which has not reached elimination goals despite high vaccination coverage. We developed a population profile of measles immunity among residents aged 0 through 49 years in Tianjin, China. Participants were either from community population registers or community immunization records. Measles IgG antibody status was assessed using dried blood spots. We examined the association between measles IgG antibody status and independent variables including urbanicity, sex, vaccination, measles history, and age. 2,818 people were enrolled. The proportion measles IgG negative increased from 50.7% for infants aged 1 month to 98.3% for those aged 7 months. After 8 months, the age of vaccination eligibility, the proportion of infants and children measles IgG negative decreased. Overall, 7.8% of participants 9 months of age or older lacked measles immunity including over 10% of those 20–39 years. Age and vaccination status were significantly associated with measles IgG status in the multivariable model. The odds of positive IgG status were 0.337 times as high for unvaccinated compared to vaccinated (95% CI: 0.217, 0.524). The proportion of persons in Tianjin, China immune to measles was lower than herd immunity threshold with less than 90% of people aged 20–39 years demonstrating protection. Immunization programs in Tianjin have been successful in vaccinating younger age groups although high immunization coverage in infants and children alone won’t provide protective herd immunity, given the large proportion of non-immune adults.