Wang Zhifang, Yan Rui, He Hanqing, Li Qian, Chen Guohua, Yang Shengxu, Chen Enfu
Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, P. R. China.
Cixi City Center for Disease Control and Prevention, Cixi, Ningbo, P. R. China.
PLoS One. 2014 Feb 20;9(2):e89361. doi: 10.1371/journal.pone.0089361. eCollection 2014.
The reported coverage of the measles-rubella (MR) or measles-mumps-rubella (MMR) vaccine is greater than 99.0% in Zhejiang province. However, the incidence of measles, mumps, and rubella remains high. In this study, we assessed MMR seropositivity and disease distribution by age on the basis of the current vaccination program, wherein the first dose of MR is administered at 8 months and the second dose of MMR is administered at 18-24 months.
Cross-sectional serological surveys of MMR antibodies were conducted by collecting epidemiological data in Zhejiang province, China in 2011. In total, 1015 participants were randomly selected from two surveillance sites. Serum MMR-specific immunoglobulin G levels were tested by enzyme-linked immunosorbent assay. The geometric mean titers and seroprevalence with 95% confidence intervals (CIs) were calculated by age and gender. Proportions of different dose of vaccine by age by vaccine were also identified. Statistically significant differences between categories were assessed by the Chi-square test.
Over 95% seroprevalence rates of measles were seen in all age groups except <7 months infants. Children aged 5-9 years were shown lower seropositivity rates of mumps while elder adolescences and young adults were presented lower rubella seroprevalence. Especially, rubella seropositivity was significantly lower in female adults than in male. Nine measles cases were unvaccinated or unknown vaccination history. Among them, 66.67% (6/9) patients were aged 20-29 years while 33.33% (3/9) were infants aged 8-12 months. In addition, 57.75% (648/1122) patients with mumps were children aged 5-9 years, and 50.54% (94/186) rubella cases were aged 15-39 years.
A timely two-dose MMR vaccination schedule is recommended, with the first dose at 8 months and the second dose at 18-24 months. An MR vaccination speed-up campaign may be necessary for elder adolescents and young adults, particularly young females.
据报道，浙江省麻疹风疹（MR）或麻疹腮腺炎风疹（MMR）疫苗的接种率超过99.0%。然而，麻疹、腮腺炎和风疹的发病率仍然很高。在本研究中，我们根据当前的疫苗接种计划评估了MMR血清阳性率和按年龄划分的疾病分布情况，其中MR的第一剂在8个月时接种，MMR的第二剂在18至24个月时接种。
2011年在中国浙江省收集流行病学数据，对MMR抗体进行横断面血清学调查。总共从两个监测点随机选取了1015名参与者。通过酶联免疫吸附测定法检测血清中MMR特异性免疫球蛋白G水平。按年龄和性别计算几何平均滴度和95%置信区间（CI）的血清阳性率。还确定了按年龄和疫苗划分的不同剂量疫苗的比例。通过卡方检验评估类别之间的统计学显著差异。
除7个月以下婴儿外，所有年龄组的麻疹血清阳性率均超过95%。5至9岁儿童的腮腺炎血清阳性率较低，而青少年和年轻成年人的风疹血清阳性率较低。特别是，成年女性的风疹血清阳性率明显低于男性。9例麻疹病例未接种疫苗或疫苗接种史不明。其中，66.67%（6/9）的患者年龄在20至29岁之间，33.33%（3/9）为8至12个月大的婴儿。此外，57.75%（648/1122）的腮腺炎患者为5至9岁儿童，50.54%（94/186）的风疹病例年龄在15至39岁之间。
建议及时接种两剂MMR疫苗，第一剂在8个月时接种，第二剂在18至24个月时接种。对于青少年和年轻成年人，特别是年轻女性，可能有必要开展加快MR疫苗接种的活动。
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