a Department of National Immunization Program , Chinese Center for Disease Control and Prevention , Beijing , China.
b Department of Expanded Program on Immunization , Hangzhou Center for Disease Control and Prevention , Hangzhou , China.
Hum Vaccin Immunother. 2018 Jun 3;14(6):1392-1397. doi: 10.1080/21645515.2018.1428508. Epub 2018 Feb 15.
China has used 3 different mumps-containing vaccines (MuCV) since 1990: monovalent mumps vaccine, measles-mumps (MM) vaccine, and measles-mumps-rubella (MMR) vaccine, and one dose MuCV (using MMR at 18 months) has been included in the EPI since 2007. MuCV effectiveness has been of concern following large-scale mumps outbreaks. In 2015, an outbreak of mumps occurred in a primary school, which allow us assess vaccine effectiveness of different MuCVs.
All children in the school were studied as a retrospective cohort. Vaccination histories and case information were obtained from vaccination records and clinic/hospital logs. Parental questionnaires were used to confirm students' illnesses and calculate attack rate (AR). VE was assessed using the formula, VE = (AR in unvaccinated students- AR in the vaccinated students) / (AR in unvaccinated students). VEs of different type of MuCV were compared.
In total, 283 students were identified as clinical mumps among the 2370 students, and 1908 students were included for MuCV VE assessment. 213 (including 21 [8.9%] patients) were 2-dose MuCV recipients (AR: 9.9%), 1165 (including 123 [51.9%] patients) were 1-dose recipients (AR: 10.6%), and 530 (including 93 [39.2%] patients) were unvaccinated (AR: 17.5%). VE was 44% for 2 doses and 40% for one dose. For one-MuCV-dose students, estimated mumps VE was 63% for vaccinated within 3 years (between vaccination and this outbreak); 50% for vaccinated within 3 to 5 years; and 34% for vaccinated more than 5 years. Comparing VE by vaccine type and 5-year interval since vaccination, VE for MMR was 60%, which was consistently higher than VE for monovalent mumps vaccine (22%) and MM (2%).
This outbreak was associated with low and declining 1-dose MuCV effectiveness. China's immunization program should evaluate the potential of a 2-dose MMR schedule to adequately control mumps.
自 1990 年以来，中国使用了 3 种不同的含腮腺炎疫苗（MuCV）：单价腮腺炎疫苗、麻疹-腮腺炎（MM）疫苗和麻疹-腮腺炎-风疹（MMR）疫苗，自 2007 年以来，EPI 中已包含了一剂 MuCV（使用 MMR 在 18 个月时接种）。大规模腮腺炎暴发后，MuCV 的有效性引起了关注。2015 年，一所小学发生了腮腺炎暴发，这使我们能够评估不同 MuCV 的疫苗效力。
对学校内所有儿童进行回顾性队列研究。接种史和病例信息从接种记录和诊所/医院日志中获得。家长问卷用于确认学生的疾病并计算发病率（AR）。使用公式 VE =（未接种学生的 AR-接种学生的 AR）/（未接种学生的 AR）评估 VE。比较了不同类型 MuCV 的 VE。
在 2370 名学生中，共发现 283 名临床腮腺炎学生，其中 1908 名学生纳入 MuCV VE 评估。213 名（包括 21 名[8.9%]患者）为 2 剂 MuCV 接种者（AR：9.9%），1165 名（包括 123 名[51.9%]患者）为 1 剂接种者（AR：10.6%），530 名（包括 93 名[39.2%]患者）为未接种者（AR：17.5%）。2 剂的 VE 为 44%，1 剂的 VE 为 40%。对于接受 1 剂 MuCV 接种的学生，接种时间在 3 年内（接种至此次暴发期间）的估计腮腺炎 VE 为 63%；接种时间在 3 至 5 年之间的 VE 为 50%；接种时间超过 5 年的 VE 为 34%。按疫苗类型和接种后 5 年间隔比较 VE，MMR 的 VE 为 60%，明显高于单价腮腺炎疫苗（22%）和 MM（2%）的 VE。
此次暴发与 1 剂 MuCV 效力低且逐渐下降有关。中国免疫规划应评估采用 2 剂 MMR 方案来充分控制腮腺炎的可能性。
