芬兰轮状病毒免疫计划的第一年经验。

First year experience of rotavirus immunisation programme in Finland.

机构信息

Department of Vaccination and Immune Protection, National Institute for Health and Welfare (THL), Mannerheimintie 166, Helsinki, Finland.

出版信息

Vaccine. 2012 Dec 17;31(1):176-82. doi: 10.1016/j.vaccine.2012.10.068. Epub 2012 Nov 1.

DOI:10.1016/j.vaccine.2012.10.068

PMID:23122991

Abstract

INTRODUCTION

This study aimed to estimate the impact of rotavirus (RV) immunisation programme on the total hospital treated acute gastroenteritis (AGE) burden, as well as, on severe RV disease burden in Finland during the first year after immunisation programme introduction. Such studies can also be considered as a vaccine-probe-study, where unspecific disease burden prevented by immunisation is assumed to be caused by the agent the vaccine is targeted against.

METHODS

The RV related outcome definitions were based on data registered in the National Hospital Discharge Register coded using ICD 10 codes. Incidences of hospitalised and hospital outpatient cases of AGE and RVGE were compared prior (1999-2005) and after (2010) the start of the programme among children under 5 years of age. ICD 10 codes utilised were A00-A09, R11 and K52.

RESULTS

The reductions in disease burden, when the post-introduction year was compared to pre-vaccine era, were 80.3% (95% CI 74.5-84.7) in hospital inpatient RVGE among toddlers less than 1 year of age and 53.9% (95% CI 49.8-57.7) when the total inpatient AGE burden was considered in the same age group. For the corresponding hospital outpatient cases the reductions were 78.8% (95% CI 48.4-91.3) and 12.5% (7.1-17.7). The overall vaccine impact against confirmed RVGE in age cohorts eligible for vaccination before the RV season 2010 was 97% (95% CI 90.7-99.0). If the total reductions, both in diagnosed RVGE, as well as in cases without definite microbial diagnosis, were expected to be RVGE, population based estimates for the total disease burden can be obtained: for inpatient RVGE in children less than 1 year of age the estimate is 10.5/1000 pyrs, while the diagnosed specific incidence was less than half of that, 4.9/1000 pyrs.

DISCUSSION

During the first post-vaccination year 2010, RV immunisation programme clearly managed to control the severe, hospital treated, forms of RVGE. The total disease burden is a more valuable end point than mere diagnosed cases as laboratory confirmation practises change after vaccine introduction. Our study is limited by the very short post-introduction follow up.

摘要

简介

本研究旨在评估轮状病毒（RV）免疫计划对芬兰免疫计划推出后第一年总医院治疗急性胃肠炎（AGE）负担以及严重 RV 疾病负担的影响。此类研究也可以被视为疫苗探针研究，其中免疫预防的非特异性疾病负担被假定为由疫苗针对的病原体引起。

方法

基于 ICD-10 编码在国家住院登记处注册的数据，对 RV 相关结局定义进行了定义。在 5 岁以下儿童中，比较了疫苗接种前（1999-2005 年）和接种后（2010 年）时期住院和门诊 AGE 和 RVGE 病例的发病率。使用的 ICD-10 代码为 A00-A09、R11 和 K52。

结果

与疫苗前时代相比，在引入后一年，1 岁以下幼儿住院 RVGE 疾病负担减少 80.3%（95%CI 74.5-84.7），同一年龄组总住院 AGE 负担减少 53.9%（95%CI 49.8-57.7）。对于相应的门诊病例，减少了 78.8%（95%CI 48.4-91.3）和 12.5%（7.1-17.7）。在 2010 年 RV 季节之前有资格接种疫苗的年龄组中，针对确诊的 RVGE，总体疫苗接种效果为 97%（95%CI 90.7-99.0）。如果将 RVGE 以及无明确微生物诊断的病例的总减少量都预计为 RVGE，则可以获得基于人群的总疾病负担估计值：1 岁以下儿童住院 RVGE 的估计值为 10.5/1000 人年，而确诊的特定发病率则不到一半，为 4.9/1000 人年。