Talley Leisel, Salama Peter
International Emergency and Refugee Health Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
Am J Trop Med Hyg. 2003 May;68(5):545-6. doi: 10.4269/ajtmh.2003.68.545.
Measles is a major cause of mortality in complex emergencies. Both high vaccination coverage and vaccine efficacy are required to prevent major epidemics of measles in such situations. Evaluation of field vaccine efficacy is a critical but underutilized component of program monitoring in emergencies, and is particularly important in rural areas where the integrity of the cold chain is difficult to guarantee. In July 2000, we evaluated the field vaccine efficacy for measles vaccination by comparing the incidence of cases in vaccinated and unvaccinated groups during a two-stage cluster survey of 563 children in Ethiopia. Approximately 30% of the measles cases occurred in vaccinated children. Estimated field vaccine efficacy for measles was 66.9% in children 9-36 months old. The finding of a field vaccine efficacy for measles less than 80% warrants formal assessment of measles vaccine efficacy, particularly in famine emergencies where measles is associated with a high case fatality rate.
麻疹是复杂紧急情况中导致死亡的主要原因。在这种情况下，需要高疫苗接种覆盖率和疫苗效力来预防大规模麻疹疫情。评估现场疫苗效力是紧急情况中项目监测的关键但未充分利用的组成部分，在难以保证冷链完整性的农村地区尤为重要。2000年7月，我们通过在埃塞俄比亚对563名儿童进行的两阶段整群调查中比较接种疫苗组和未接种疫苗组的病例发生率，评估了麻疹疫苗接种的现场疫苗效力。约30%的麻疹病例发生在接种疫苗的儿童中。9至36个月大儿童的麻疹现场疫苗效力估计为66.9%。麻疹现场疫苗效力低于80%这一发现值得对麻疹疫苗效力进行正式评估，尤其是在麻疹与高病死率相关的饥荒紧急情况中。
