2017—2022年广元市14岁以下儿童水痘突破病例流行特征分析

doi:10.12183/j.scjpm.2025.1305

摘要/Abstract

摘要： 目的分析广元市14岁以下儿童水痘突破病例流行特征,为水痘防控提供科学依据。方法收集2017—2022年广元市14岁以下儿童水痘突破病例信息,采用描述性流行病学方法分析水痘突破病例流行特征,使用Pearson相关分析法分析突破病例疫苗接种时年龄与接种至发病时间间隔相关关系。结果 2017—2022年广元市共报告14岁以下儿童突破病例957例,占水痘总病例的25.30%,突破病例比例呈现上升趋势（c²_趋势=130.283,P<0.01）,不同月份、县区、职业、年龄突破病例在水痘总病例中的比例差异均有统计学意义（均P<0.01）。突破病例以5—7、10—12月为双高峰,利州区（53.29%）、学生（82.76%）为主,男女性别比1.10∶1。1、2剂突破病例分别报告852、105例,1剂突破病例首次接种至发病时间中位数为8.00（5.84,9.85）年,2剂疫苗接种至发病时间间隔中位数为4.15（2.30,6.06）年,1剂和2剂突破病例接种至发病时间分布差异有统计学意义（c²=14.737,P<0.01）。突破病例首剂接种时年龄与接种至发病时间间隔呈现显著负相关（r=-0.236,P<0.01）。原发病例发病率963.29/10万,突破率为316.74/10万,水痘疫苗整体保护率为69.01%,1、2剂保护率分别为63.96%、85.51%。结论广元市14岁以下儿童水痘突破病例在水痘总病例中比例呈现上升趋势,接种疫苗可有效降低水痘发病率,接种2剂次疫苗比接种1剂次更能有效防控水痘。

关键词: 水痘, 突破病例, 流行特征, 疫苗效果

Abstract: Objective To investigate the epidemiological characteristics of varicella breakthrough cases among children under 14 years of age in Guangyuan City from 2017 to 2022, with the aim of providing a scientific foundation for the prevention and control of varicella. Methods Data on varicella breakthrough cases in children under 14 were collected for the period 2017-2022 in Guangyuan City. Descriptive epidemiological methods were employed to analyze the characteristics of these cases. Pearson correlation analysis was utilized to assess the relationship between the age at initial vaccination and the interval from vaccination to disease onset. Results From 2017 to 2022, a total of 957 breakthrough cases were reported in Guangyuan City among children under 14, constituting 25.30% of all reported varicella cases. The proportion of breakthrough cases demonstrated a significant increase (c²_{for trend}=130.283, P<0.01). Statistically significant variations in the proportion of breakthrough cases were identified across different months, districts, occupations, and age cohorts (all P<0.01). The incidence exhibited a bimodal distribution with peaks from May to July and from October to December. The majority of cases were reported in Lizhou District (53.29%) and among students (82.76%), with a male-to-female ratio of 1.10: 1. A total of 852 and 105 breakthrough cases were reported in recipients of one and two vaccine doses, respectively. The median interval from vaccination to onset was 8.00 (IQR: 5.84, 9.85) years for single-dose recipients and 4.15 (IQR: 2.30, 6.06) years for two-dose recipients. The difference in the temporal distribution of onset post-vaccination between the one-dose and two-dose groups was statistically significant (c²=14.737, P<0.01). A significant negative correlation was observed between the age at first-dose vaccination and the interval to disease onset (r=-0.236, P<0.01). The incidence rate among unvaccinated individuals was 963.29 per 100 000, whereas the breakthrough infection rate among vaccinated individuals was 316.74 per 100 000. The overall vaccine effectiveness (VE) was calculated to be 69.01%. The VE for the one-dose and two-dose schedules was 63.96% and 85.51%, respectively. Conclusions The proportion of varicella breakthrough cases relative to total varicella incidence among children under 14 in Guangyuan City is on an upward trend. Varicella vaccination is effective in reducing disease incidence, with a two-dose vaccination schedule affording substantially greater protection against varicella than a single-dose regimen.

Key words: Varicella, Breakthrough cases, Epidemiological characteristics, Vaccine effectiveness

中图分类号:

R183.3

李晓玲, 杨广树. 2017—2022年广元市14岁以下儿童水痘突破病例流行特征分析[J]. 华南预防医学, 2025, 51(12): 1305-1309.

LI xiaoling, YANG Guangshu. Epidemiological characteristics of varicella breakthrough cases in children under 14 years of age in Guangyuan, 2017-2022[J]. South China Journal of Preventive Medicine, 2025, 51(12): 1305-1309.

参考文献

[1] 马涛,丁松宁,陈聪,等. 丙类管理和疫苗接种策略下南京市水痘流行特征[J]. 中华疾病控制杂志,2024,28(4):393-401.
[2] 朱明轮,崔艳梅,邢秀伟,等. 水痘突发公共卫生事件流行病学特征分析[J]. 中国病原生物学杂志,2024,19(2):183-186,195.
[3] 潘兴强,张丹丹,马瑞,等. 宁波市2011—2016年出生儿童水痘突破病例流行病学特征[J]. 中国疫苗与免疫,2024,30(3):303-306.
[4] 徐莉娟. 2010—2021年四川省广元市水痘流行病学特征分析[J]. 预防医学情报杂志,2023,39(5):476-480.
[5] 张传云,蒋薇薇. 2020—2021年合肥市蜀山区儿童水痘突破病例流行病学特征及疫苗保护效果分析[J]. 实用预防医学,2024,31(5):608-611.
[6] 李兰娟,任红,高志良,等. 传染病学[M]. 9版. 北京:人民卫生出版社,2018:85-88.
[7] 王颖,江媚,华丽,等. 海珠区14岁以下儿童水痘突破病例特征分析[J]. 预防医学,2024,26(6):523-526.
[8] 杨连建,杨长娟,段清浩. 重庆市沙坪坝区2019—2023年水痘突破病例的流行特征分析[J]. 现代预防医学,2024,51(20):3677-3681.
[9] 王亚,周宗良,王宏. 重庆市永川区水痘疫苗不同接种剂次下突破病例流行病学分析[J]. 中国公共卫生管理,2024,40(2):252-258.
[10] Zhang Z, Liu N, Zhang J, et al.Epidemiological characteristics of varicella under different immunisation strategies in Suzhou prefecture, Jiangsu Province[J]. Vaccines, 2022, 10(10): 1745.
[11] Chen Y, Ma R, Zhang Y, et al.Effects of varicella vaccine time of first dose and coverage of second dose, Beijing and Ningbo, China, 2012-2018[J]. China CDC Wkly, 2022, 2(36): 696-699.
[12] 殷大鹏,卢莉,刘燕敏. 水痘疫苗预防接种专家共识[J]. 首都公共卫生,2023,17(5):257-266.
[13] 王翠玲,吕海英,李雷,等. 水痘疫苗在学校水痘暴发疫情中保护效果的病例对照研究[J]. 现代预防医学,2022,49(23):4390-4393.
[14] 王洋,胡永玲,胡平. 应用青岛市6~13岁人群病例对照研究评价水痘减毒活疫苗保护效果[J]. 中国疫苗与免疫,2021,27(1):95-97.
[15] 张嘉陵,谷利妞,孙莉莉,等. 连云港市35起水痘突发公共卫生事件中突破病例流行病学特征分析[J]. 实用预防医学,2021,28(6):728-730.
[16] Pan X Q, Shu M M, Ma R, et al.Varicella breakthrough infection and effectiveness of 2-dose varicella vaccine in China[J]. Vaccine, 2018, 36(37): 5665-5670.