Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention , Lu'an , Anhui , China.
Chinese Field Epidemiology Training Program (CFETP), Chinese Center for Disease Control and Prevention , Beijing , China.
Hum Vaccin Immunother. 2019;15(9):2106-2111. doi: 10.1080/21645515.2019.1581526. Epub 2019 Mar 15.
In 2016, an outbreak of mumps occurred in a primary school in China with a student population having high vaccination coverage. An unmatched case-control study was performed to identify risk factors contributing to this outbreak, and a retrospective cohort study was conducted to evaluate the effectiveness of mumps-containing vaccine (MuCV). A total of 97 cases were identified during the outbreak, and the overall attack rate was 8.2%. Among students with confirmed vaccination status, 90% had received at least one dose of MuCV. Cases were more likely than non-cases to report taking the school bus during the epidemic period (adjusted OR = 2.3, 95% CI: 1.4-3.7). Vaccine effectiveness (VE) was higher for two-dose MuCV (76%, 95% CI:49â€"89%) than for one-dose MuCV (59%, 95% CI: 36â€"74%. The protection afforded by both one-dose and two-dose MuCV waned over time, from 82% among students vaccinated within 5 years to 41% among those vaccinated more than 10 years previously for one-dose VE, and from 90% to 25% over the same time period for two-dose VE. We found that outbreaks of mumps can occur in schools despite high coverage of one-dose MuCV vaccination. Although the VE of both two-dose and one-dose MuCV wanes over time, the overall VE for two-dose MuCV was superior than that of one-dose MuCV. Therefore, a two-dose MuCV schedule through routine services is likely needed in order to control mumps epidemics in China.
2016 年，中国一所小学发生了腮腺炎暴发疫情，学生人群的疫苗接种率很高。为了确定导致此次暴发的危险因素，我们开展了一项病例对照研究，并进行了一项回顾性队列研究来评估含腮腺炎成分疫苗（MuCV）的效果。暴发期间共发现 97 例病例，总发病率为 8.2%。在有明确接种状态的学生中，90%至少接种过一剂 MuCV。病例较对照更有可能在流行期间乘坐校车（校正 OR=2.3，95%CI：1.4-3.7）。两剂 MuCV 的疫苗效果（VE）高于一剂 MuCV（76%，95%CI：49%-89%）和 59%（95%CI：36%-74%）。一剂和两剂 MuCV 的保护作用随着时间的推移而减弱，一剂 VE 从接种后 5 年内的 82%降至 10 年以上的 41%，两剂 VE 从接种后 90%降至 5 年内的 25%。我们发现，尽管一剂 MuCV 的接种率很高，但腮腺炎仍可在学校暴发。虽然两剂和一剂 MuCV 的 VE 随时间推移而减弱，但两剂 MuCV 的总体 VE 优于一剂 MuCV。因此，为了控制中国的腮腺炎流行，可能需要通过常规服务接种两剂 MuCV。
