De Wals Philippe, Deceuninck Geneviève, Boulianne Nicole, De Serres Gaston
Quebec National Public Health Institute and Department of Preventive and Social Medicine, Laval University, Quebec City, Quebec.
JAMA. 2004 Nov 24;292(20):2491-4. doi: 10.1001/jama.292.20.2491.
Meningococcal polysaccharide vaccines are of limited effectiveness. New protein-polysaccharide conjugate vaccines have yet to be evaluated in field conditions.
To assess the effectiveness of a serogroup C conjugate meningococcal vaccine in an outbreak setting.
DESIGN, SETTING, AND PARTICIPANTS: Population-based observational study of cases of invasive serogroup C meningococcal disease from 1996 through 2002 in Quebec identified from the provincial registry of notifiable diseases and from the provincial reference laboratory. In 2001, a mass immunization campaign with a conjugate vaccine was conducted to control an emerging epidemic. The number of vaccinated individuals was extracted from meningococcal immunization registries.
Incidence of invasive meningococcal disease before and 1 year after the campaign in vaccinated and unvaccinated individuals.
Vaccination coverage of those 2 months to 20 years was 82.1%. After the campaign, the number of cases of serogroup C disease decreased from 58 in 2001 to 27 in 2002, and the incidence from 7.8 per million to 3.6 per million. Vaccine effectiveness was found to be 96.8% (95% confidence interval, 75.0%-99.9%). There was no observed increase in the incidence of the other serogroups.
The new conjugate vaccine was effective in controlling an emerging epidemic of serogroup C meningococcal disease, as well as providing short-term protection across a wide age range.
脑膜炎球菌多糖疫苗效果有限。新型蛋白质 - 多糖结合疫苗尚未在现场条件下进行评估。
评估C群结合脑膜炎球菌疫苗在疫情暴发情况下的效果。
设计、地点和参与者:基于人群的观察性研究,研究对象为1996年至2002年魁北克省侵袭性C群脑膜炎球菌病病例,数据来自省级法定传染病登记处和省级参考实验室。2001年,开展了一项使用结合疫苗的大规模免疫运动以控制新出现的疫情。接种疫苗的个体数量从脑膜炎球菌免疫登记处提取。
运动前后接种疫苗和未接种疫苗个体中侵袭性脑膜炎球菌病的发病率。
2个月至20岁人群的疫苗接种覆盖率为82.1%。运动后,C群疾病病例数从2001年的58例降至2002年的27例,发病率从每百万7.8例降至每百万3.6例。疫苗有效性为96.8%(95%置信区间,75.0% - 99.9%)。未观察到其他血清群发病率增加。
新型结合疫苗在控制新出现的C群脑膜炎球菌病疫情方面有效,并且在较宽年龄范围内提供了短期保护。