Ningbo Center for Disease Control and Prevention, China.
Ningbo Women's and Children's Hospital, China.
Vaccine. 2018 Sep 5;36(37):5665-5670. doi: 10.1016/j.vaccine.2018.05.025. Epub 2018 Aug 10.
2-dose varicella vaccination has been available in Ningbo city, China since 2014 in the private sector. This study aimed to evaluate the breakthrough varicella infection rate, and to examine overall and incremental effectiveness of 2-dose varicella vaccination among Chinese children.
A retrospective investigation was done among native children born from 2008 to 2013 in active surveillance area in Ningbo, China. Between 2009 and 2016, demographic information and data on varicella vaccination were collected by Ningbo's Immunization Information System, and information of varicella infections were obtained from China Information System for Disease Control and Prevention. The logistic regression was conducted to estimate varicella vaccine effectiveness (VE).
A total of 107,324 local children were enrolled in the cohort analysis and 95.11% of these children with no varicella disease history received at least 1-dose varicella vaccine from 2009 to 2016. The total breakthrough varicella infection rate (BVR) was 0.37% for all the vaccinated children and 0.04% for 2-dose vaccination. The annual BVR ranged from 0.01% to 0.49% for 1-dose of varicella vaccine and from 0.01% to 0.02% for 2-dose. The infection rates both in the unvaccinated children and the 1-dose children were decreasing after 2-dose vaccination implemented in 2014 (Unvaccinated: P < 0.001 for trend; 1-dose: P = 0.003 for trend). The VE against all varicella was 50.3% (95% CI: 39.8%-59.0%) for 1-dose (P < 0.001) and 98.7% (95% CI: 98.1%-99.1%) for 2-dose (P < 0.001), and the incremental VE was 97.4% (95% CI: 96.2%-98.2%) compared with 1-dose (P < 0.001).
The 2-dose regimen provided excellent protection to prevent all varicella, and the universal 2-dose regimen of varicella vaccine should be recommended to prevent the varicella disease among children in China.
自 2014 年以来，中国宁波市的私营部门已提供两剂水痘疫苗。本研究旨在评估突破性水痘感染率，并检查中国儿童两剂水痘疫苗接种的总体和增量有效性。
对中国宁波市主动监测地区 2008 年至 2013 年出生的本地儿童进行回顾性调查。2009 年至 2016 年，通过宁波市免疫信息系统收集人口统计学信息和水痘疫苗接种数据，并从中国疾病预防控制信息系统获取水痘感染信息。使用逻辑回归估计水痘疫苗效力（VE）。
共纳入 107324 名本地儿童进行队列分析，其中 95.11%的儿童无水痘病史，2009 年至 2016 年期间至少接种过 1 剂水痘疫苗。所有接种疫苗儿童的总突破性水痘感染率（BVR）为 0.37%，2 剂接种疫苗的 BVR 为 0.04%。1 剂水痘疫苗的年 BVR 范围为 0.01%至 0.49%，2 剂的年 BVR 范围为 0.01%至 0.02%。2014 年实施 2 剂疫苗接种后，未接种疫苗儿童和 1 剂疫苗接种儿童的感染率均呈下降趋势（未接种疫苗：趋势 P<0.001；1 剂：趋势 P=0.003）。1 剂接种的水痘总体 VE 为 50.3%（95%CI：39.8%-59.0%）（P<0.001），2 剂接种的 VE 为 98.7%（95%CI：98.1%-99.1%）（P<0.001），与 1 剂接种相比，增量 VE 为 97.4%（95%CI：96.2%-98.2%）（P<0.001）。
两剂方案为预防所有水痘提供了极好的保护，应推荐在中国儿童中普遍使用两剂水痘疫苗来预防水痘疾病。
