摘要
目的模拟和预测不同免疫策略对水痘发病的远期影响。方法使用水痘疫苗的免疫效果参数,建立水痘动力学模型。设定5种情景,分别为无疫苗干预、12~24月龄儿童自愿或常规接种一剂疫苗(下简称一剂自愿接种及一剂常规接种)、分别在12~24月龄和6岁自愿或常规接种两剂(下简称两剂自愿接种及两剂常规接种)。对5种情景下,50年内水痘自然病例和突破病例进行模拟预测。结果与无疫苗干预相比,50年间,一剂自愿接种总计可减少25.65%的自然病例;一剂常规接种在减少42.06%自然病例的基础上,减少了一个发病高峰;两剂自愿接种减少了26.71%的自然病例;两剂常规接种减少43.94%自然病例。与一剂自愿接种相比,一剂常规接种增加了52.07%的突破病例,两剂自愿接种减少了55.14%的突破病例;两剂常规接种增加了33.9%的突破病例。结论两剂常规接种在控制水痘自然病例上效果最好,但会造成突破病例的增加,两剂自愿接种减少突破病例的效果最明显。
Objective To predict the potential impact of different immunization strategies on varicalla incidence. Methods A deterministic realistic age-structured model that fits 1-and 2-dose vaccine efficacy was developed. Five scenarios was included： no vaccination; assuming voluntary vaccination, 1-dose vaccination in 12-24 months old, and 2-dose vaccination with 2 nd dose in 6 years old; assuming 90% coverage, 1-dose vaccination in 12-24 months old, and 2-dose vaccination with2 nd dose in 6 years old. Varicella and breakthrough incidence was analyzed. Results Model predicts that the 1-dose voluntary vaccination program and 1-dose vaccination program with 90% coverage would reduce varicella cases by 25.65%and 42.06%, respectively over 50 years; 2-dose voluntary vaccination program and 2-dose vaccination program with 90%coverage would reduce varicella cases by 26.71% and 43.94%, respectively. Compare with 1-dose voluntary vaccination program, 1-dose vaccination program with 90% coverage and 2-dose vaccination program with 90% coverage would increase breakthrough infection by 52.07% and 33.9%, respectively, while 55.14% of breakthrough infection would be reduced by 2-dose voluntary vaccination. Conclusion 2-dose vaccination program with 90% coverage should be the most effective one in case control while breakthrough infection would increase largely. 2-dose voluntary vaccination was the most effective one in breakthrough infection reducing.
作者
倪莉红
吴德平
许建雄
NI Li-hong;WU De-ping;XU Jian-xiong(Guangzhou Center for Disease Control and Prevention, Guangzhou,Guangdong 510440,China)
出处
《热带医学杂志》
CAS
2018年第5期689-692,共4页
Journal of Tropical Medicine
基金
广东省医学科学技术研究基金(A2016311)
关键词
水痘
数学模型
免疫策略
Varicella
Mathematical model
Vaccine program
