Evaluation of varicella vaccine effectiveness during outbreaks in schools or nurseries by cross-sectional study
Evaluation of varicella vaccine effectiveness during outbreaks in schools or nurseries by cross-sectional study
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DOI：
10.1016/j.vaccine.2021.04.009
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发表时间：
2021-05-04
期刊：
影响因子：
5.5
通讯作者：
Yoshikawa, Tetsushi
中科院分区：
文献类型：
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作者：
Kawamura, Yoshiki;Hattori, Fumihiko;Yoshikawa, Tetsushi
目的：本研究的目的是阐明日本学校和托儿所水痘暴发期间疫苗的有效性 (VE)。方法：暴发定义为同一机构 21 天内出现 3 起或更多水痘病例。收集水痘疫苗接种状况和水痘病史等临床信息。如果儿童在水痘爆发期间患有水痘，则会收集有关缺勤、发烧和疾病严重程度的信息。结果：2018年9月至2020年1月，我院周边报告4起疫情，涉及3所小学和1所托儿所。这项研究总共分析了 676 名儿童。 76 名儿童（11.2%）未接种疫苗，309 名儿童（45.7%）接种了一剂疫苗，291 名儿童（43.0%）接种了两剂疫苗。国家免疫规划对象的学前班2（1～2岁）至学前6班（5～6岁）的儿童大部分接种了两剂。与此同时，大多数三年级以上的儿童接受单剂治疗。 75 名儿童（11.1%）患有水痘。从学前班到三年级，水痘患病率大于 10%。单剂和两剂水痘疫苗调整后的VE分别为57.8%和89.0%。未接种疫苗的儿童缺勤的天数明显长于单剂接种者（P = 0.0145）。未接种疫苗的儿童比单剂接种者（P = 0.0046）和两剂接种者（P = 0.0258）有更严重的皮疹。结论：虽然水痘暴发期间单剂疫苗的 VE 不高，但两剂疫苗的 VE 与之前报道的病例对照研究相似。 ？ 2021 Elsevier Ltd. 保留所有权利。
Objective: The aim of this study was to elucidate vaccine effectiveness (VE) during varicella outbreaks in schools and nurseries in Japan. Methods: An outbreak was defined as emergence of three or more cases of varicella within 21 days at the same institute. Clinical information such as varicella vaccination status, and history of varicella was collected. If a child had varicella during the outbreak, information about absences, fever, and disease severity was collected. Results: From September 2018 to January 2020, four outbreaks were reported around our institute from three elementary schools and one nursery. A total of 676 children were analyzed in this study. Seventysix children (11.2%) were unvaccinated, 309 (45.7%) had received one dose of vaccine, and 291 (43.0%) had received two doses. Most children in Pre-K2 (1?2 years old) to Pre-K6 (5?6 years old), who were the targets of the national immunization schedule, received two doses. Meanwhile, most children older than third grade received single dose. Seventy-five children (11.1%) had varicella. Varicella prevalence from Pre-K5 to the third grade was greater than 10%. The adjusted VEs of single-and two-dose of varicella vaccine were 57.8% and 89.0%. The number of days absent was significantly longer in unvaccinated children than single-dose recipients (P = 0.0145). Unvaccinated children had significantly more severe skin eruptions than single-dose recipients (P = 0.0046) and two-dose recipients (P = 0.0258). Conclusions: Although VEs of single-dose varicella vaccination during outbreaks was not high, the VE of two-dose vaccination was similar to that in a previously reported case-control study. ? 2021 Elsevier Ltd. All rights reserved.