两剂次含腮腺炎成分疫苗对儿童增量保护效果

马冰欣; 靳玉惠; 吴起乐; 孙辉; 王瑶; 陈亚飞; 朱欣宇; 潘璠; 张欢; 宋健; 秦伟

doi:10.16835/j.cnki.1000-9817.2025177

两剂次含腮腺炎成分疫苗对儿童增量保护效果

doi: 10.16835/j.cnki.1000-9817.2025177

马冰欣^{1, 2},
靳玉惠³,
吴起乐⁴,
孙辉⁵,
王瑶²,
陈亚飞²,
朱欣宇⁶,
潘璠²,
张欢²,
宋健¹,
秦伟^{1, 2, ,}

1.
安徽医科大学公共卫生学院流行病与卫生统计学系，合肥 237032
2.
安徽医科大学附属六安市疾病预防控制中心免疫预防科
3.
合肥市疾病预防控制中心免疫规划科
4.
马鞍山市疾病预防控制中心免疫预防科
5.
淮南市疾病预防控制中心传染病防控与免疫规划科
6.
皖南医学院公共卫生学院预防医学系

基金项目:

安徽医科大学公共卫生学院高峰学科项目(协同育人创新项目) 2024GWXTYRY003

详细信息

作者简介:
马冰欣(2002-)，女，安徽宿州人，在读硕士，主要从事疫苗可预防传染病监测与控制工作

靳玉惠(1973-)，女，安徽合肥人，硕士，主任医师，主要从事疫苗可预防传染病监测与控制工作

通讯作者:
秦伟，E-mail: Luancdc@163.com

利益冲突声明 所有作者声明无利益冲突。
马冰欣与靳玉惠为共同第一作者。
中图分类号: R179 R512.1 R186
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- 文章访问数: 6
- HTML全文浏览量: 4
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- 被引次数: 0
出版历程
- 收稿日期: 2025-02-25
- 修回日期: 2025-04-10
- 网络出版日期: 2025-07-04
- 刊出日期: 2025-06-25

Incremental effectiveness of two-dose of mumps-containing vaccine in chidren

MA Bingxin^{1, 2},
JIN Yuhui³,
WU Qile⁴,
SUN Hui⁵,
WANG Yao²,
CHEN Yafei²,
ZHU Xinyu⁶,
PAN Fan²,
ZHANG Huan²,
SONG Jian¹,
QIN Wei^{1, 2
, ,}

1.
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei (237032), Anhui Province, China

摘要

摘要: 目的评估两剂次含腮腺炎成分疫苗(MuCV)对儿童增量保护效果，为优化流行性腮腺炎免疫策略提供依据。方法采用1∶2频数匹配的病例对照研究，以安徽省六安市、合肥市、马鞍山市和淮南市在2023年9月1日—2024年6月30日报告的托幼机构或学校的流行性腮腺炎病例作为病例组(383例)，选择同班级的健康儿童作为对照组(766例)，收集研究对象的MuCV免疫史，评估第2剂MuCV的增量疫苗保护效果(VE)。组间比较使用χ²检验或t检验；采用Cox回归模型分析配对资料中病例组与对照组接种2剂MuCV的OR值及其95%可信区间(CI)，并计算增量VE。结果病例组和对照组儿童在性别、年龄、MuCV接种剂次及最后1剂次接种时间间隔上差异均无统计学意义(χ²/t值分别为0.05，0.20，0.94，-0.02，P值均>0.05)。病例组和对照组接种2剂MuCV比例分别为26.63%和29.37%，第2剂MuCV总增量VE为40.73%(95%CI=3.03%~63.77%，P < 0.05)。亚组分析显示，第2剂与第1剂MuCV间隔超过1年和间隔在1年以内的增量VE分别为54.13%(95%CI=1.90%~78.56%，P < 0.05)和30.63%(95%CI=-28.59%~62.58%，P>0.05)；幼儿园儿童第2剂MuCV增量VE为30.36%(95%CI=-25.95%~61.50%，P>0.05)，中小学生第2剂MuCV增量VE为66.73%(95%CI=14.92%~86.99%，P < 0.05)；最后1剂MuCV接种5年内增量VE为28.78%(95%CI=-27.46%~60.21%，P>0.05)，接种超过5年增量VE为66.07%(95%CI=-41.56%~91.87%，P>0.05)。结论第2剂MuCV可为儿童提供额外保护，但2剂MuCV之间的间隔在1年以内增量VE有限，应考虑优化当前流行性腮腺炎的免疫策略。
- 腮腺炎疫苗 /
- 接种 /
- 回归分析 /
- 儿童
Abstract: Objective To evaluate the incremental vaccine effectiveness (VE) of two-dose of the mumps-containing vaccine (MuCV) in chidren, so as to provide a basis for optimizing mumps immunization strategies. Methods A 1∶2 frequency-matched case-control study was conducted by using reported mumps cases in childcare centers or schools from Lu'an, Hefei, Ma'anshan and Huainan cities of Anhui Province from September 1, 2023 to June 30, 2024, as a case group(383 cases). And healthy children in the same classroom were selected as a control group(766 cases). The MuCV immunization histories of participants were collected to estimate the incremental VE of the second dose of MuCV against mumps. Group comparisons were performed using the Chi-square test or t-test. For matched case-control pairs, the Cox regression model was employed to calculate the odds ratio (OR) with 95% confidence interval (CI) for two-dose MuCV vaccination and to estimate the incremental vaccine effectiveness (VE). Results There were no statistically significant differences between the case and control groups regarding gender, age, dosage of MuCV vaccination and the time interval since the last dose vaccination(χ²/t=0.05, 0.20, 0.94, -0.02, P>0.05). The proportions of the case and control groups vaccinated with two doses of MuCV were 26.63% and 29.37%, respectively, and the overall incremental VE of the second dose of MuCV was 40.73% (95%CI=3.03%-63.77%, P < 0.05). Subgroup analyses revealed that the incremental VE for children with a period of ≥1 year between the two doses of MuCV was 54.13% (95%CI=1.90%-78.56%, P < 0.05), while for children with a period of < 1 year, it was 30.63% (95%CI=-28.59%-62.58%, P>0.05). The incremental VE of the second dose of MuCV was 30.36% (95%CI=-25.95%-61.50%, P>0.05) in kindergarten children and 66.73% (95%CI=14.92%-86.99%, P < 0.05) in elementary and secondary school students. The incremental VE was 28.78% (95%CI=-27.46%-60.21%, P>0.05) within five years of the last dose of MuCV vaccination and 66.07% (95%CI=-41.56%-91.87%, P>0.05) for vaccinations administered beyond five years. Conclusions The second dose of MuCV may offer additional protection for children; however, extending the interval between two-dose of MuCV (< 1 year) has shown limited incremental protective effects. Therefore, it is crucial to consider optimizing current immunization strategies for mumps.
- Mumps vaccine /
- Vaccination /
- Regression analysis /
- Child
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

2) 马冰欣与靳玉惠为共同第一作者。

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表 1 安徽省4个地市MuCV增量保护效果病例对照调查对象基本特征分布比较

Table 1. Comparison of basic characteristics distribution of MuCV incremental VE for survey subjects of a case-control study in four cities of Anhui Province

组别	人数	地区					学段
组别	人数	六安市	合肥市	马鞍山市	淮南市	χ²值	幼儿园	小学	中学	χ²值
病例组	383	120(31.33)	114(29.77)	75(19.58)	74(19.32)	0.00	116(30.29)	247(64.49)	20(5.22)	0.00
对照组	766	240(31.33)	228(29.77)	150(19.58)	148(19.32)		232(30.29)	494(64.49)	40(5.22)

组别	人数	性别			2019年10月前出生			MuCV接种剂次
组别	人数	男	女	χ²值	是	否	χ²值	第1剂	第2剂	χ²值
病例组	383	241(62.92)	142(37.08)	0.05	351(91.64)	32(8.36)	0.02	281(73.37)	102(26.63)	0.94
对照组	766	477(62.27)	289(37.73)		704(91.91)	62(8.09)		541(70.63)	225(29.37)
注： ()内数字为构成比/%，P值均>0.05。

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表 2 安徽省4个地市MuCV增量保护效果病例对照的Cox回归模型分析(n=1 149)

Table 2. Cox regression model analysis of a case-control study on the incremental VE in four cities of Anhui Province(n=1 149)

自变量	选项	粗OR值 (95%CI)	校正OR值 (95%CI)	增量VE (95%CI)/%
MuCV接种剂次	第1剂	1.00	1.00	1.00
	第2剂	0.78(0.53~1.13)	0.59(0.36~0.97)^*	40.73(3.03~63.77)^*
	间隔<1年	0.71(0.39~1.28)	0.69(0.37~1.29)	30.63(-28.59~62.58)
	间隔≥1年	0.81(0.51~1.28)	0.46(0.21~0.98)^*	54.13(1.90~78.56)^*
学段	幼儿园第1剂	1.00	1.00	1.00
	第2剂	0.73(0.42~1.27)	0.70(0.39~1.26)	30.36(-25.95~61.50)
	中小学第1剂	1.00	1.00	1.00
	第2剂	0.82(0.49~1.36)	0.33(0.13~0.85)^*	66.73(14.92~86.99)^*
最后1剂接种时间间隔	<5年第1剂	1.00	1.00	1.00
	第2剂	0.71(0.41~1.22)	0.71(0.40~1.27)	28.78(-27.46~60.21)
	≥5年第1剂	1.00	1.00	1.00
	第2剂	0.60(0.20~1.76)	0.34(0.08~1.42)	66.07(-41.56~91.87)
注： ^*P < 0.05；因变量流行性腮腺炎发病情况以否为参照。

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