Andrade Ana Lucia, Minamisava Ruth, Tomich Lisia Moura, Lemos Ana Paula, Gorla Maria Cecilia, de Cunto Brandileone Maria Cristina, Domingues Carla Madga S, de Moraes Camile, Policena Gabriela, Bierrenbach Ana Luiza
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Rua 235, s/n, Setor Universitário, Goiânia, Goiás CEP 74605-050, Brazil.
School of Nursing, Federal University of Goiás, Rua 227, s/n, Setor Leste Universitário, Goiânia, Goiás CEP 74605-080, Brazil.
Vaccine. 2017 Apr 11;35(16):2025-2033. doi: 10.1016/j.vaccine.2017.03.010. Epub 2017 Mar 18.
Routine infant immunization with meningococcal C conjugate (MCC) vaccination started in Brazil in November 2010, scheduled at three and five months plus a booster at 12-15months of age. No catch-up was implemented. We assessed the impact of vaccination on meningococcal C disease (MenC) four years after vaccination start in the National Immunization Program.
We performed an ecological quasi-experimental design from 2008 to 2014 using a deterministic linkage between the National Notification and the National Reference Laboratory databases for meningitis. We conducted an interrupted time-series analysis considering Brazil except for Salvador municipality, because an epidemic of serogroup C disease occurred in this city, which prompted a mass vaccination campaign with catch-up for adolescents in 2010. Observed MenC rates in the post-vaccination period were compared to expected rates calculated from the pre-vaccination years. Results for Salvador were presented as descriptive data. An additional time-series analysis was performed for the state of São Paulo.
A total of 18,136 MenC cases were analyzed. The highest incidence rates were observed for infants aged <12months and no second incident peak was observed for adolescents. For Brazil, MenC rates were reduced by 67.2% (95%CI 43.0-91.4%) for infants <12months of age, 92.0% (77.3-106.8%) for the age-group 12-23months, and 64.6% (24.6-104.5%) for children aged 2-4years. For children 5-9years old, MenC rates reduced 19.2% (9.5-28.9%). Overall, 955 MenC cases were averted in Brazil in individuals aged <40years after MCC vaccination. Results from São Paulo State, mirror the patterns seen in Brazil.
After four years of infants and toddlers vaccination start, MenC invasive disease reduced in the target population. This investigation provide a robust baseline to ascertain how much the upcoming catch-up dose in 12-13years of age will accelerate the decrease in MenC incidence rates among youths in Brazil.
2010年11月，巴西开始对婴儿进行常规的脑膜炎球菌C结合疫苗（MCC）接种，接种计划为在3个月和5个月时各接种一剂，12至15个月时进行加强接种。未实施补种。我们评估了在国家免疫规划中开始接种疫苗四年后，接种疫苗对脑膜炎球菌C病（MenC）的影响。
我们在2008年至2014年期间进行了一项生态准实验设计，利用国家脑膜炎通知数据库和国家参考实验室数据库之间的确定性关联。我们进行了中断时间序列分析，分析范围包括除萨尔瓦多市之外的巴西地区，因为该市发生了C群疾病流行，这促使在2010年针对青少年开展了补种的大规模疫苗接种运动。将接种疫苗后时期的观察到的MenC发病率与根据接种疫苗前几年计算出的预期发病率进行比较。萨尔瓦多的结果以描述性数据呈现。对圣保罗州进行了额外的时间序列分析。
共分析了18136例MenC病例。观察到<12个月龄婴儿的发病率最高，青少年未观察到第二个发病高峰。对于巴西，<12个月龄婴儿的MenC发病率降低了67.2%（95%CI 43.0 - 91.4%），12至23个月龄年龄组降低了92.0%（77.3 - 106.8%），2至4岁儿童降低了64.6%（24.6 - 104.5%）。对于5至9岁儿童，MenC发病率降低了19.2%（9.5 - 28.9%）。总体而言，在巴西，MCC疫苗接种后，<40岁人群中避免了955例MenC病例。圣保罗州的结果反映了在巴西观察到的模式。
在开始对婴幼儿接种疫苗四年后，目标人群中的MenC侵袭性疾病有所减少。这项调查为确定即将在12至13岁进行的补种剂量将如何加速巴西青少年中MenC发病率的下降提供了有力的基线数据。
