From the Key Laboratory of Public Health Safety, Ministry of Education, China.
Tropical Disease Research Center, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.
Pediatr Infect Dis J. 2019 Mar;38(3):248-252. doi: 10.1097/INF.0000000000002132.
Use of Haemophilus influenzae type b conjugate vaccine is effective in reducing the disease burden, but its coverage in China is unclear. The aim of this meta-analysis is to assess the coverage of Hib conjugate vaccines in children in Mainland China.
We systematically searched Pubmed, Web of Science, Medline, CNKI and Wanfang to identify studies assessing the coverage of Hib vaccine in Chinese children. Random-effects models were used to obtain pooled estimates for Hib vaccine coverage and analyzed heterogeneity with meta-regression and subgroup analyses.
Thirty-three studies that included 7,227,480 subjects in 12 provinces met our inclusion criteria. The pooled overall coverage of Hib conjugate vaccine was 54.9% [95% confidence interval (CI): 52.9-57.0]. The pooled coverage for the nonlocal population (54.3%; 95% CI: 52.4-56.3) was lower than that for the local residents (62.0%; 95% CI: 58.4-65.6). The region-pooled coverage was higher in the east of China (59.7%; 95% CI: 57.3-62.1) than in the central and west parts of the country (48.5%; 95% CI: 40.6-56.4). Overall, 26.7% (95% CI: 20.1-33.2) had 1 dose only, 14.8% (95% CI: 10.0-19.6%) had 2 doses, 13.5% (95% CI: 9.1-17.8) had 3 doses and 14.3% (95% CI: 9.7-18.9) had 4 doses.
We found a low coverage of Hib conjugate vaccine, particularly for the nonlocal children and those living in the central and west parts of China. Including Hib vaccine into the national immunization program is recommended to reduce disparities in vaccination coverage.
使用乙型流感嗜血杆菌结合疫苗可有效降低疾病负担，但在中国的覆盖范围尚不清楚。本研究旨在评估中国内地儿童 Hib 结合疫苗的接种率。
我们系统地检索了 Pubmed、Web of Science、Medline、CNKI 和万方，以确定评估中国儿童 Hib 疫苗接种率的研究。采用随机效应模型获得 Hib 疫苗接种率的合并估计值，并通过 meta 回归和亚组分析来分析异质性。
共纳入 12 个省的 33 项研究，包含 7227480 名儿童。Hib 结合疫苗的总体接种率为 54.9%（95%置信区间：52.9-57.0）。非本地儿童（54.3%，95%置信区间：52.4-56.3）的接种率低于本地儿童（62.0%，95%置信区间：58.4-65.6）。按地区划分，东部地区的接种率较高（59.7%，95%置信区间：57.3-62.1），而中部和西部地区的接种率较低（48.5%，95%置信区间：40.6-56.4）。总体而言，26.7%（95%置信区间：20.1-33.2）仅接种 1 剂，14.8%（95%置信区间：10.0-19.6%）接种 2 剂，13.5%（95%置信区间：9.1-17.8%）接种 3 剂，14.3%（95%置信区间：9.7-18.9%）接种 4 剂。
我们发现 Hib 结合疫苗的接种率较低，特别是非本地儿童和中国中部及西部地区的儿童。建议将 Hib 疫苗纳入国家免疫规划，以减少接种率的差异。
