Effectiveness of a vaccination programme for an epidemic of meningococcal B in New Zealand
Effectiveness of a vaccination programme for an epidemic of meningococcal B in New Zealand
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DOI：
10.1016/j.vaccine.2011.06.120
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发表时间：
2011-09-16
期刊：
影响因子：
5.5
通讯作者：
O'Hallahan, Jane
中科院分区：
文献类型：
--
作者：
Arnold, Richard;Galloway, Yvonne;O'Hallahan, Jane
自1991年以来，新西兰经历了脑膜炎球菌B病的长期流行。自2001年最近一次高峰以来，这一流行病已大大减少。2004年，为控制这一流行病，引入了一种株特异性疫苗MeNZB，使20岁以下的人的覆盖率达到81%。该疫苗分阶段推广，可以比较每年接种疫苗和未接种疫苗的人的发病率，使用泊松回归模型估计2001-2008年20岁以下人群的疫苗有效性，包括对年份、季节、年龄、种族、地区和社会经济状况的调整。进一步的分析研究了剂量反应关系，一年后疫苗效果的减弱，以及对其他脑膜炎球菌diseases.The初步分析估计MeNZB疫苗的有效性为77%（95%CI 62-85）后，3剂，平均随访时间为3.2年的交叉保护。有证据表明，2次给药后的保护作用为47%（95% CI 16-67），一年后没有证据表明有效性减弱。侵袭性肺炎球菌疾病和流行性脑膜炎球菌B菌株的同时建模表明，一定程度的残余混杂，使有效性估计值降低至68%。有证据表明MeNZ B对非流行株有一定的交叉保护作用，MeNZ B疫苗对新西兰脑膜炎球菌B病流行株有效。在2004年7月至2008年12月期间，由于引入MeNZB疫苗，新西兰估计避免了210例流行性菌株病例（95% CI 100-380）、6例死亡和15-30例严重后遗症病例。(C)2011爱思唯尔有限公司保留所有权利。
New Zealand has experienced a prolonged epidemic of meningococcal B disease since 1991. The epidemic has waned significantly since its most recent peak in 2001. A strain-specific vaccine, MeNZB, was introduced to control the epidemic in 2004, achieving 81% coverage of people under the age of 20. The vaccine was rolled out in a staged manner allowing the comparison of disease rates in vaccinated and unvaccinated individuals in each year.Vaccine effectiveness in people aged under 20 years is estimated using a Poisson regression model in the years 2001-2008, including adjustments for year, season, age, ethnicity, region and socioeconomic status. Further analyses investigate the dose response relationship, waning of the vaccine effect after one year, and cross-protection against other strains of meningococcal disease.The primary analysis estimates MeNZB vaccine effectiveness to be 77% (95% Cl 62-85) after 3 doses and a mean follow-up time of 3.2 years. There is evidence for a protective effect after 2 doses 47% (95% CI 16-67), and no evidence for a waning of effectiveness after one year. Simultaneous modelling of invasive pneumococcal disease and epidemic strain meningococcal B suggests a degree of residual confounding that reduces the effectiveness estimate to 68%. There is evidence for some cross-protection of MeNZB against non-epidemic strains.The MeNZB vaccine was effective against the New Zealand epidemic strain of meningococcal B disease. Between July 2004 and December 2008 an estimated 210 epidemic strain cases (95% Cl 100-380), six deaths and 15-30 cases of severe sequelae were avoided in New Zealand due to the introduction of the MeNZB vaccine. (C) 2011 Elsevier Ltd. All rights reserved.