Impact of Vaccination on the Epidemiology of Varicella: 1995-2009
Impact of Vaccination on the Epidemiology of Varicella: 1995-2009
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DOI：
10.1542/peds.2013-4251
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发表时间：
2014-07-01
期刊：
影响因子：
8
通讯作者：
Saddier, Patricia
中科院分区：
文献类型：
--
作者：
Baxter, Roger;Tran, Trung N.;Saddier, Patricia
背景技术背景：当水痘疫苗于1995年在美国获得许可时，人们担心儿童接种疫苗可能会增加青少年对水痘易感的人数，并将疾病转移到年龄较大的人群，在那里它可能会更严重。我们在1994年至1995年进行了一系列的5个横断面研究（疫苗前），2000年，2003年，2006年和2009年在北方加州的Kaiser Permanente进行，以评估儿童和青少年水痘流行病学的变化，以及所有年龄段人群水痘住院率的变化。在每项研究中，通过电话调查从大约8000名5 - 19岁的成员中获得关于水痘病史和过去一年中水痘发生的信息;计算所有成员的水痘住院率。1995年至2009年期间，5至19岁儿童水痘的总发病率从每1000人年25.8人降至1.3人，在不同年龄组（5-9岁、10-14岁和15-19岁）中下降了90%至95%。在所有年龄组，包括15至19岁的青少年中，易患水痘的儿童和青少年比例也有所下降（从1995年的15.6%降至2009年的7.6%）。从1994年到2009年，普通成员人群中年龄调整后的水痘住院率从每10万人2.13人下降到0.25人，下降幅度接近90%。在水痘疫苗问世后的15年里，观察到水痘发病率和住院率大幅下降，没有证据表明水痘负担向老年群体转移。
BACKGROUND: When varicella vaccine was licensed in the United States in 1995, there were concerns that childhood vaccination might increase the number of adolescents susceptible to varicella and shift disease toward older age groups where it can be more severe.METHODS: We conducted a series of 5 cross-sectional studies in 1994 to 1995 (prevaccine), 2000, 2003, 2006, and 2009 in Kaiser Permanente of Northern California to assess changes in varicella epidemiology in children and adolescents, as well as changes in varicella hospitalization in people of all ages. For each study, information on varicella history and varicella occurrence during the past year was obtained by telephone survey from a sample of similar to 8000 members 5 to 19 years old; varicella hospitalization rates were calculated for the entire membership.RESULTS: Between 1995 and 2009, the overall incidence of varicella in 5-to 19-year-olds decreased from 25.8 to 1.3 per 1000 person-years, a similar to 90% to 95% decline in the various age categories (5-9, 10-14, and 15-19 years of age). The proportion of varicella-susceptible children and adolescents also decreased in all age groups, including in 15-to 19-year-olds (from 15.6% in 1995 to 7.6% in 2009). From 1994 to 2009, age-adjusted varicella hospitalization rates in the general member population decreased from 2.13 to 0.25 per 100 000, a similar to 90% decline.CONCLUSIONS: In the 15 years after the introduction of varicella vaccine, a major reduction in varicella incidence and hospitalization was observed with no evidence of a shift in the burden of varicella to older age groups.