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目的通过对蓝田县新生儿乙肝疫苗接种效果分析,评价预防效果和接种前后流行特征变化,为今后制定预防对策提供依据。方法乙肝疫苗采用5μg“0、1、6”免疫程序对新生儿于出生后24 h内接种首针;对2003—2010年乙肝疫情进行分析,采用χ2检验、周期性检验、游程检验等方法处理数据,应用回顾性流行病学调查方法分析和评价。结果该县2003—2010年新生儿累计接种乙肝疫苗94 716人次,全程接种33 623人,首针及时接种率平均80.0%,由44.91%上升至99.27%,各年间差异有统计学意义(χ2=6 854.75,P<0.01)。3针全程接种率平均94.57%,由62.25%上升至99.78%,各年间差异有统计学意义(χ2=6 490.75,P<0.01)。实施新生儿乙肝疫苗接种前后,0~4岁组乙肝平均发病率分别为23.82/10万和9.39/10万(χ2=11.18,P<0.01);5~9岁组平均发病率分别为20.36/10万和5.89/10万(χ2=10.93,P<0.01);2组接种前后发病率差异均有统计学意义;发病率呈下降趋势,周期为2 a(P<0.01),<10岁儿童下降最明显。结论新生儿乙肝疫苗接种是降低人群乙肝发病率的重要策略。
Objective To analyze the effect of hepatitis B vaccination in newborns of Lantian County and evaluate the preventive effect and the change of epidemic characteristics before and after inoculation, so as to provide basis for the future prevention and treatment measures. Methods Hepatitis B vaccine was immunized with 5μg “0,1,6 ” immunization program to inoculate the newborns within 24 hours after birth. The epidemic situation of hepatitis B in 2003-2010 was analyzed using χ2 test, periodic test, run test and so on Methods Data were processed and analyzed using retrospective epidemiological methods. Results From 2003 to 2010, 94 716 newborns were vaccinated against hepatitis B vaccine, 33 623 were inoculated throughout the year. The timely first-dose vaccination rate was 80.0% from 44.91% to 99.27%, with significant difference between years (χ2 = 6 854.75, P <0.01). The 3-needle vaccination coverage rate averaged 94.57%, from 62.25% to 99.78%. There was significant difference between years (χ2 = 6 490.75, P <0.01). The average incidence of hepatitis B in 0 ~ 4 years old group was 23.82 / 100000 and 9.39 / 100000 (χ2 = 11.18, P <0.01) before and after the newborn hepatitis B vaccination. The average incidence rates of 5 ~ 9 years old group were 20.36 / (P <0.01). The incidences of the two groups were statistically different before and after inoculation. The incidence rate showed a decreasing trend with a cycle of 2 years (χ2 = 10.93, P <0.01) The most obvious decline. Conclusion Neonatal hepatitis B vaccination is an important strategy to reduce the incidence of hepatitis B in the population.