台湾地区不同价次肺炎球菌结合疫苗对儿童侵袭性肺炎球菌疾病的有效性：一项全国性研究
Effectiveness of Pneumococcal Conjugate Vaccines of Different Valences Against Invasive Pneumococcal Disease Among Children in Taiwan: A Nationwide Study.
作者信息
Su Wei-Ju, Lo Hsiu-Yun, Chang Chia-Hsuin, Chang Luan-Yin, Chiu Cheng-Hsun, Lee Ping-Ing, Lu Chun-Yi, Hsieh Yu-Chia, Lai Mei-Shu, Lin Tzou-Yien
机构信息
From the *Division of Acute Infectious Diseases, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan, Republic of China; † Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan, Republic of China; ‡Department of Pediatrics, §Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; ¶Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China; and ‖Ministry of Health and Welfare, Taipei City, Taiwan, Republic of China.
出版信息
Pediatr Infect Dis J. 2016 Apr;35(4):e124-33. doi: 10.1097/INF.0000000000001054.
BACKGROUND
For the scarcity of data, we investigated the vaccine effectiveness (VE) of the combined use of pneumococcal conjugate vaccines (PCVs) of different valences against invasive pneumococcal disease (IPD) in children.
METHODS
We conducted a matched case-control study using the national IPD surveillance database and the national vaccination registry. Four age-matched, gender-matched and neighborhood-matched controls were identified for each incident IPD case ≦5 years with disease onsets between October 2007 and December 2013. Conditional logistic regression was used to assess VE against all serotype and serotype 19A IPD.
RESULTS
In 523 cases (median age: 28.5 months; range: 2.0-69.4 months) and 2086 controls (28.7; 2.2-70.1), a similar VE against all-serotype IPD was found between PCV13 (76%; 61-85%) and combined 7-valent PCV (PCV7)/10-valent PCV (PCV10) plus PCV13 (78%; 56-89%). The VE for PCV7/PCV10 was slightly lower (48%; 32-60%). Regarding serotype 19A, a significantly reduced risk was observed for both PCV13 (82%; 63-91%) and combined PCV7/PCV10 plus PCV13 (87%; 61-96%). PCV7/PCV10 had only a borderline protective association (31%; 4-51%). For children receiving PCV13 alone, VE against all-serotype IPD did not differ between starting the dosing at ≥2 (78%; 56-89%) or <2 (74%; 51-87%) years of age. VE was 81% (69-88%) within 6 months of the last dose of PCV and 19% (95% CI: -21 to 45%) after 2 years.
CONCLUSIONS
PCVs are effective against IPD during immunization with either the same or with a mixed series, but protection might be differential over time.
背景
由于数据匮乏，我们调查了不同价次的肺炎球菌结合疫苗（PCV）联合使用对儿童侵袭性肺炎球菌疾病（IPD）的疫苗效力（VE）。
方法
我们使用国家IPD监测数据库和国家疫苗接种登记处进行了一项匹配病例对照研究。对于2007年10月至2013年12月期间发病的每例≤5岁的IPD病例，确定4名年龄匹配、性别匹配和社区匹配的对照。使用条件逻辑回归评估针对所有血清型和19A血清型IPD的VE。
结果
在523例病例（中位年龄：28.5个月；范围：2.0 - 69.4个月）和2086名对照（28.7；2.2 - 70.1）中，PCV13（76%；61 - 85%）与7价PCV（PCV7）/10价PCV（PCV10）加PCV13（78%；56 - 89%）之间针对所有血清型IPD的VE相似。PCV7/PCV10的VE略低（48%；32 - 60%）。关于19A血清型，PCV13（82%；63 - 91%）和PCV7/PCV10加PCV13（87%；61 - 96%）均观察到风险显著降低。PCV7/PCV10仅有边缘性保护关联（31%；4 - 51%）。对于仅接种PCV13的儿童，在≥2岁（78%；56 - 89%）或<2岁（74%；51 - 87%）开始接种时，针对所有血清型IPD的VE无差异。在最后一剂PCV后的6个月内VE为81%（69 - 88%），2年后为19%（95%CI： - 21至45%）。
结论
PCV在使用相同或混合接种程序免疫期间对IPD有效，但随着时间推移保护作用可能存在差异。
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