Singleton Rosalyn J, Holman Robert C, Person Marissa K, Steiner Claudia A, Redd John T, Hennessy Thomas W, Groom Amy, Holve Stephen, Seward Jane F
From the *Alaska Native Tribal Health Consortium, Anchorage, AK; †Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services (USDHHS), Atlanta, GA; ‡Healthcare Cost and Utilization Project, Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, USDHHS, Rockville, MD; §Indian Health Service (IHS), USDHHS, Santa Fe, NM; ¶Arctic Investigations Program, NCEZID, CDC, USDHHS, Anchorage, AK; ‖Immunization Services Division, CDC, USA USDHHS, Atlanta, GA; **Tuba City Regional Health Care, IHS, USDHHS, Tuba City, AZ; and ††Division of Viral Diseases, National Center for Immunization and Respiratory Disease, CDC, GA.
Pediatr Infect Dis J. 2014 Mar;33(3):276-9. doi: 10.1097/INF.0000000000000100.
Routine childhood varicella vaccination, implemented in 1995, has resulted in significant declines in varicella-related hospitalizations in the United States. Varicella hospitalization rates among the American Indian (AI) and Alaska Native (AN) population have not been previously documented.
We selected varicella-related hospitalizations, based on a published definition, from the Indian Health Service inpatient database for AI/ANs in the Alaska, Southwest and Northern Plains regions (1995-2010) and from the Nationwide Inpatient Sample for the general US population (2007-2010). We analyzed average annual hospitalization rates prevaccine (1995-1998) and postvaccine (2007-2010) for the AI/AN population, and postvaccine for the general US population.
From 1995-1998 to 2007-2010, the average annual varicella-related hospitalization rate for AI/ANs in the 3 regions decreased 95% (0.66-0.03/10,000 persons); the postvaccine rate appears lower than the general US rate (0.06, 95% confidence interval: 0.05-0.06). The rate declined in all AI/AN pediatric age groups. Infants experienced the highest prevaccine (14.07) and postvaccine (0.83) hospitalization rates. Adults experienced low rates in both periods. Varicella vaccination rates in 19- to 35-month-old AI/AN children during fiscal years 2008-2010 were 88.1-91.0%.
Widespread use of varicella vaccine in AI/AN children was accompanied by substantial declines in varicella-related hospitalizations consistent with high varicella vaccine effectiveness in preventing severe varicella outcomes.
1995年实施的儿童常规水痘疫苗接种使美国与水痘相关的住院率显著下降。此前尚未记录美国印第安人（AI）和阿拉斯加原住民（AN）人群的水痘住院率。
我们根据已发表的定义，从阿拉斯加、西南部和北部平原地区AI/ANs的印第安卫生服务住院数据库（1995 - 2010年）以及美国总体人群的全国住院样本（2007 - 2010年）中选取与水痘相关的住院病例。我们分析了AI/AN人群疫苗接种前（1995 - 1998年）和接种后（2007 - 2010年）的年均住院率，以及美国总体人群接种后的年均住院率。
从1995 - 1998年到2007 - 2010年，这3个地区AI/ANs与水痘相关的年均住院率下降了95%（从0.66降至0.03/10000人）；接种后率似乎低于美国总体人群的比率（0.06，95%置信区间：0.05 - 0.06）。所有AI/AN儿童年龄组的比率均下降。婴儿在疫苗接种前（14.07）和接种后（0.83）的住院率最高。两个时期成年人的住院率都较低。2008 - 2010财政年度，19至35个月大的AI/AN儿童的水痘疫苗接种率为88.1% - 91.0%。
AI/AN儿童广泛接种水痘疫苗后，与水痘相关的住院率大幅下降，这与水痘疫苗在预防严重水痘后果方面的高效性相符。
