探讨 MMR 疫苗对马德里自治区流行性腮腺炎发病率的影响及评价 Jeryl-Lynn 株的有效性。1998-2016 年。

Impact of the MMR vaccine on the incidence of mumps in the Community of Madrid and evaluation of the effectiveness of the Jeryl-Lynn strain. Years 1998-2016.

机构信息

Subdirección General de Epidemiología, Dirección General de Salud Pública de la Comunidad de Madrid, Madrid, España.

出版信息

Med Clin (Barc). 2019 Oct 11;153(7):276-280. doi: 10.1016/j.medcli.2019.01.012. Epub 2019 Mar 8.

DOI:10.1016/j.medcli.2019.01.012

PMID:30857795

Abstract

INTRODUCTION

Mumps is characterised by parotid inflammation and fever and is preventable by vaccination with MMR vaccine. The objective of the study is to assess the impact and effectiveness of the vaccine.

MATERIAL AND METHODS

Cases notified to the Notifiable Disease System between 1998 and 2016 were used for the study. The vaccine effectiveness (VE) was calculated in cohorts vaccinated with two doses of Jeryl-Lynn, and the impact was calculated by comparing incidences by age and by Rubini (1995-1998) and Jeryl-Lynn (1999-2002) cohorts during the periods 1998-2004, 2005-2009 and 2010-2015. The incidences for age group and period were compared with the previous period and the incidences for cohorts were compared within a period with incidence ratios (IR) using Poisson models. The VE was estimated using the screening method using logistic regression models.

RESULTS

13,816 cases were reported. The incidence in 2005-2009 was higher than in 1998-2004 (IR: 1.46, 95% CI: 1.40-1.53), and it remained stable in 2010-2015 (IR: 0.99, 95% CI: 0.95-1.03). The average incidence rate of the Rubini cohort was 69.43 and the Jeryl-Lynn cohort was 32.24. The IR was 0.25 (95% CI: 0.22-0.29), 0.55 (95% CI: 0.49-0.61) and 0.88 (95% CI: 0.76-1.00) for each period respectively. 2,574 cases were included in the VE study. EV decreased over time reaching not significant values after seven years of follow-up (VE: 55%, 95% CI: 82 to -12%).

CONCLUSIONS

Parotiditis behavior is characterised by fluctuations, changes in presentation and a decrease in VE.

摘要

简介

流行性腮腺炎的特征是腮腺炎症和发热，可以通过接种麻疹腮腺炎风疹（MMR）疫苗来预防。本研究的目的是评估疫苗的效果和影响。

材料和方法

使用 1998 年至 2016 年向传染病报告系统报告的病例进行研究。使用两剂 Jeryl-Lynn 疫苗接种的队列计算疫苗有效性（VE），通过比较 1998-2004 年、2005-2009 年和 2010-2015 年期间按年龄和按 Rubini（1995-1998 年）和 Jeryl-Lynn（1999-2002 年）队列计算发病率，来评估疫苗的影响。使用泊松模型比较年龄组和时期的发病率，并在同一时期内使用发病率比（IR）比较队列的发病率。使用逻辑回归模型的筛选方法估计 VE。

结果

报告了 13816 例病例。2005-2009 年的发病率高于 1998-2004 年（IR：1.46，95%CI：1.40-1.53），2010-2015 年保持稳定（IR：0.99，95%CI：0.95-1.03）。Rubini 队列的平均发病率为 69.43，Jeryl-Lynn 队列的发病率为 32.24。IR 分别为 0.25（95%CI：0.22-0.29）、0.55（95%CI：0.49-0.61）和 0.88（95%CI：0.76-1.00）。VE 研究中纳入了 2574 例病例。VE 随时间推移而下降，随访 7 年后无显著意义（VE：55%，95%CI：82 至-12%）。