在涉及日托和小学的暴发疫情中，MMR 疫苗的有效性。

MMR vaccine effectiveness in an outbreak that involved day-care and primary schools.

机构信息

Epidemiological Surveillance Unit of Barcelona-Zona Sud. Department of Health, Generalitat of Catalonia, Barcelona, Spain.

出版信息

Vaccine. 2011 Oct 19;29(45):8024-31. doi: 10.1016/j.vaccine.2011.08.056. Epub 2011 Sep 3.

DOI:10.1016/j.vaccine.2011.08.056

PMID:21893145

Abstract

OBJECTIVE

In 2006, a large measles outbreak occurred in Catalonia (Spain), where the immunization schedule included two doses of MMR vaccine at 15 months and 4 years. The aim of this study was to investigate the vaccine effectiveness (VE) of MMR in children attending day-care and pre-school centres and to estimate the number of cases that would have been avoided by administering the first dose of MMR at 12 months.

METHODS

A retrospective cohort study was carried out between October 2006 and January 2007 in day-care and pre-school centres with confirmed measles cases. VE was calculated in children aged ≥15 months without previous measles infection. Cases avoided by advancing the first dose of MMR to 12 months were estimated by calculating the basic and effective reproduction number in centres where transmission outside the class was observed.

RESULTS

Fifteen centres and 1394 children were included. There were 77 confirmed cases (attack rate=5.5%). Vaccination coverage of the 1121 children aged ≥15 months was 91.6% and VE was 96% (95%CI 89-98%). There were 33 (41%) cases in the 81 children aged 12-14 months. Advancing the first dose to 12 months would have prevented 74 cases (91.5%) and lowered the attack rate from 41% to 8.6%.

CONCLUSIONS

Over 90% of cases in children aged 12-14 months would have been avoided by MMR administration at 12 rather than 15 months. We strongly recommend advancing the first dose of MMR to 12 months in order to reduce the risk of measles outbreaks.

摘要

目的

2006 年，西班牙加泰罗尼亚地区发生了大规模麻疹疫情，免疫计划包括在 15 个月和 4 岁时接种两剂麻疹、腮腺炎、风疹联合疫苗。本研究旨在调查在日托和学前中心接种麻疹、腮腺炎、风疹联合疫苗的儿童的疫苗有效性（VE），并估计通过在 12 个月时接种第一剂麻疹、腮腺炎、风疹联合疫苗可预防的病例数。

方法

2006 年 10 月至 2007 年 1 月，在有确诊麻疹病例的日托和学前中心进行了回顾性队列研究。在≥15 个月且无既往麻疹感染的儿童中计算 VE。通过计算在班级外传播观察到的中心的基本和有效繁殖数，来估计将第一剂麻疹、腮腺炎、风疹联合疫苗提前至 12 个月可预防的病例数。

结果

共纳入 15 个中心和 1394 名儿童。确诊病例 77 例（发病率为 5.5%）。1121 名≥15 个月的儿童的疫苗接种率为 91.6%，VE 为 96%（95%CI 89-98%）。81 名 12-14 个月的儿童中有 33 例（41%）。将第一剂提前到 12 个月可预防 74 例（91.5%），将发病率从 41%降低至 8.6%。