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目的评价中学生麻疹减毒活疫苗(Measles Attenuated Live Vaccine,MV)强化免疫活动(Supplementary Immunization Activities,SIA)的血清学和流行病学效果,为浙江省制定消除麻疹策略提供参考。方法采集中学生接种MV前、后血标本,评价血清学效果。通过2008～2010年纵向抗体水平监测,分析人群血清学效果;根据接种对象年龄队列人群的麻疹发病率及发病构成比,评价流行病学效果。结果中学生接种MV后,抗体阳性率从85.92%上升到97.54%,阳转率(免疫前抗体阴性、免疫后阳性或免疫后较免疫前抗体≥4倍增高)为36.27%;麻疹抗体几何平均浓度(Geometric Mean Concentration,GMC)为1479.53毫国际单位/毫升(mIU/ml),显著高于接种前的496.89mIU/ml(F=391.39,P<0.05)。SIA目标人群2010年麻疹抗体阳性率和GMC均高于SIA前的2008年,其中GMC差异有统计学意义(t=47.70,P<0.05)。2010年SIA目标人群麻疹病例构成比显著低于2007年(Z=3.33,P<0.05),发病率与全人群发病率比也低于2007年。结论中学生MVSIA的血清学和流行病学保护效果良好,能加强该人群的免疫屏障,减少麻疹发病。建议常规组织开展中学生含麻疹成分疫苗接种,以加速消除麻疹。
Objective To evaluate the serological and epidemiological effects of Measles Attenuated Live Vaccine (MV) Supplementary Immunization Activities (SIA) in Zhejiang Province. Methods The middle and high school students were vaccinated with blood samples before and after MV to evaluate the serological effects. The serological efficacy of the population was analyzed by monitoring vertical antibody levels from 2008 to 2010. The epidemiological effects were evaluated according to the incidence of measles and the proportion of the incidence of measles in the age-matched cohorts. Results The positive rate of antibody in middle school students increased from 85.92% to 97.54% after vaccination. The positive rate (positive antibody before immunization, positive after immunization or higher than 4 times before immunization) was 36.27%. The geometric mean concentration of measles antibody (Geometric Mean Concentration, GMC) was 1479.53 milliunits per milliliter (mIU / ml), significantly higher than 496.89mIU / ml before inoculation (F = 391.39, P <0.05). In 2010, the positive rate of measles antibody and GMC in target population of SIA were all higher than those before SIA in 2008, with a significant difference in GMC (t = 47.70, P <0.05). The incidence of measles cases among the target population of SIA in 2010 was significantly lower than that in 2007 (Z = 3.33, P <0.05), and the incidence of morbidity to the general population was also lower than in 2007. Conclusions The serological and epidemiological protective effect of middle school students MVSIA is good, which can strengthen the immune barrier and reduce the incidence of measles. Regular organizations are recommended to carry out measles vaccination of secondary school students to speed up the elimination of measles.