National Immunization Program, and.
The Institute of Immunization Program, Henan provincial Center for Disease Control and Prevention, Zhengzhou, Henan, China;
Pediatrics. 2015 Apr;135(4):e1032-7. doi: 10.1542/peds.2014-1947. Epub 2015 Mar 2.
In July 2013, the National Immunization Program of China was notified by the US Centers for Disease Control and Prevention that measles was detected in 3 newly adopted, special needs children with cerebral palsy (CP) from China. We report an investigation of measles transmission in China that led to infection of these children. Interviews were conducted with welfare institute staff and panel physicians; health records of the potentially exposed population were reviewed; and immunization coverage was assessed among institute residents. Five residents with CP, all unvaccinated against measles, among who were the 3 adoptees, were linked epidemiologically into 3 generations of measles transmission antecedent to the US outbreak. In a random sample of residents, first dose of measles containing vaccine (MCV1) and MCV2 coverage was 16 of 17 (94%) and 7 of 11 (64%) among children with CP, and 100% (32 of 32) and 96% (21 of 22) among children without CP. Vaccinators reported reluctance to vaccinate children with CP because the China pharmacopeia lists encephalopathy as a contraindication to vaccination. Panel physicians reported to investigators no necessity of vaccination for adoptees to the United States if US parents sign an affidavit exempting the child from vaccination. We recommend that the China pharmacopeia vaccine contraindications be reviewed and updated, the United States should reconsider allowing vaccination exemptions for internationally adopted children unless there are true medical contraindications to vaccination, and US pediatricians should counsel adopting parents to ensure that their child is up-to-date on recommended vaccinations before coming to the United States.
2013 年 7 月，中国国家免疫规划收到美国疾病控制与预防中心的通知，称在中国新收养的 3 名患有脑瘫（CP）的特殊需要儿童中检测到麻疹。我们报告了一起在中国导致这些儿童感染麻疹的传播调查。对福利院工作人员和专家组医生进行了访谈；审查了潜在暴露人群的健康记录；并评估了福利院居民的免疫接种率。5 名患有 CP 的居民均未接种麻疹疫苗，其中包括 3 名被收养者，他们与美国疫情前的 3 代麻疹传播病例有流行病学联系。在居民的随机样本中，CP 儿童的麻疹疫苗（MCV1）和 MCV2 首剂接种率分别为 17 名儿童中的 16 名（94%）和 11 名儿童中的 7 名（64%），而无 CP 儿童的接种率分别为 32 名儿童中的 100%和 22 名儿童中的 21 名（96%）。疫苗接种人员报告说，他们不愿意为 CP 儿童接种疫苗，因为中国药典将脑病列为疫苗接种的禁忌症。专家组医生报告调查人员，只要美国父母签署一份豁免儿童接种疫苗的宣誓书，他们就没有必要为前往美国的收养儿童接种疫苗。我们建议审查和更新中国药典的疫苗禁忌症，美国应重新考虑允许国际收养儿童接种疫苗豁免，除非儿童有真正的医学接种禁忌症，并且美国儿科医生应向收养父母提供咨询，以确保他们的孩子在前往美国之前已按建议接种了疫苗。
