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目的评价2008年四川地震灾区甲型肝炎(甲肝)疫苗(Hepatitis A Vaccine,HepA)群体性预防接种后4年的保护效果。方法在被动监测分析中,选择都江堰、什邡、江油和茂县作为HepA群体性预防接种县(区、市,下同),浦江、广汉、游仙和马尔康作为对照县,比较分析2005~2012年甲肝、细菌性痢疾(菌痢)等发病情况,数据来源于疾病监测信息报告管理系统。主动监测数据来源于2010年1月1日~12月31日,在四川省彭州、崇州、江油、绵竹、汶川、理县6个地震灾区县开展的甲肝监测项目。结果被动监测数据显示:2009~2012年HepA接种地区甲肝的年平均发病率为1.80/10万,比2005~2008年的年平均发病率(7.43/10万)降低了74.83%。HepA群体性预防接种地区免疫覆盖人群(<15岁),2008年以后甲肝年平均发病率均<0.05/10万,低于对照地区。此外,HepA群体性预防接种以外的成人,甲肝发病率较群体性预防接种前也出现明显下降。主动监测数据显示:2010年6个监测县共实验室诊断12例甲肝,但无HepA群体性预防接种覆盖的年龄组人群。结论 2008年,四川地震灾区对18月龄~12岁儿童开展的HepA群体性预防接种,取得了良好的保护效果,同时也在HepA群体性预防接种地区建立了一定的免疫屏障,减少了成人甲肝发病。
Objective To evaluate the protective effect of Hepatitis A Vaccine (HepA) after 4 years of vaccination in 2008 in Sichuan earthquake-stricken areas. Methods In the passive monitoring and analysis, Dujiangyan, Shifang, Jiangyou and Mao County were selected as the control counties for HepA population immunization (districts, cities, the same below), Pujiang, Guanghan, Youxian and Malcolm, and comparative analysis of hepatitis A , Bacillary dysentery (bacillary dysentery) and other incidence, the data from the disease monitoring information reporting management system. The data of active monitoring come from the monitoring project of Hepatitis A conducted in the 6 quake-hit counties in Pengzhou, Chongzhou, Jiangyou, Mianzhu, Wenchuan and Lixian of Sichuan Province from January 1 to December 31, Results According to the passive monitoring data, the average annual incidence of hepatitis A in HepA vaccinated areas from 2009 to 2012 was 1.80 / 100 000, which was 74.83% lower than the annual average incidence (7.43 / 100 000) in 2005-2008. HepA population vaccination immunization coverage of the population (<15 years), after 2008, the average annual incidence of hepatitis A were <0.05 / 100,000, lower than the control area. In addition, HepA groups other than vaccination outside of adults, hepatitis A incidence than the group before vaccination also showed a significant decline. Active monitoring data show that: in 2010 six counties in a total of 12 cases of laboratory diagnosis of hepatitis A hepatitis A, but no HepA group vaccination coverage of age groups. Conclusion In 2008, the HepA mass vaccination conducted in children aged 18 months to 12 years in Sichuan earthquake-stricken areas achieved good protective effect. At the same time, a certain immune barrier was established in HepA group vaccination area, reducing the incidence of hepatitis A Disease.