Zhu J L, Lyu M Z, Luo S Y, Chen G S, Pang Z F, Zhang G M, Wu X H
Division of Communicable Disease Prevention and Control, Jinhua Prefectural Center for Disease Control and Prevention, Jinhua 321002, China.
Division of Communicable Disease Prevention and Control, Yongkang County Center for Disease Control and Prevention, Yongkang 321300, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2020 May 10;41(5):747-752. doi: 10.3760/cma.j.cn112338-20190730-00563.
To assess the effectiveness of influenza vaccine in children aged 6-72 months. The cohort study was conducted based on community child vaccination clinics in Yiwu and Yongkang counties of Zhejiang province. From October 2017 to December 2017, a total of 1 752 children aged 6-72 months were enrolled from 10 child vaccination clinics. The questionnaire survey was conducted after the written consents were obtained from the parents or legal guardians of the children. Then, a follow up was conducted for enrolle children until 30 April 2018, the influenza vaccination status and the number of influenza-like illness (ILI) cases, hospital visit due to ILI, self-medication due to ILI were observed and recorded every month. Vaccine effectiveness (VE) was estimated by using the generalized linear model (GLM) where dependent variables were the number of ILI cases, hospital visit and self-medication respectively. Of the 1 752 children, 925 (52.80%) were boys and the median age was 30.00 months. The cumulative observation was 308 166 person days at the end of 2017-2018 season, with 5.27 ILI cases per 1 000 person days, 3.41 hospital visit due to ILI per 1 000 person days, 1.45 self-medication due to ILI per 1 000 person days. Of the 1 752 children, 643 received the influenza vaccination in 2017-2018 season. Compared with unvaccinated children, the VE was 23.5% against ILI case number (95%: 15.1%-31.1%), 19.3% against hospital visit due to ILI (95%: 8.2%-29.1%) and 25.8% against self-medication due to ILI (95%: 9.3%- 39.3%). Modeling splitting 643 children with 2017-2018 vaccination into those before and after vaccination, the influenza VE was 31.9% against ILI case number (95%: 12.7%-46.9%), 32.6% against hospital visit due to ILI (95%: 8.6%-50.3%) and 44.3% against self-medication due to ILI (95%: 11.9%-64.8%) in children aged 36-72 months. However, the children aged 6-35 months showed no significant VEs. For the VE analysis in children with different vaccination status, the VEs were significant if they received vaccination in both 2016-2017 season and 2017-2018 season or only in 2017-2018 seasons. The VE was not demonstrated among the children who were immunized only in 2016-2017 season. Influenza vaccination is moderate effective in preventing the incidence of ILI and hospital visit and self-medication in children in influenza season, the protection effect in children aged 36-72 months is better than that in children aged 6-35 months.
评估流感疫苗对6至72个月大儿童的有效性。该队列研究基于浙江省义乌市和永康县的社区儿童预防接种门诊开展。2017年10月至2017年12月，从10家儿童预防接种门诊共招募了1752名6至72个月大的儿童。在获得儿童家长或法定监护人的书面同意后进行问卷调查。然后，对入选儿童进行随访至2018年4月30日，每月观察并记录流感疫苗接种情况以及流感样病例（ILI）的数量、因ILI就诊的次数、因ILI自我用药的情况。采用广义线性模型（GLM）估计疫苗有效性（VE），其中因变量分别为ILI病例数、就诊次数和自我用药次数。1752名儿童中，925名（52.80%）为男孩，中位年龄为30.00个月。在2017 - 2018季节末累计观察308166人日，每1000人日有5.27例ILI病例、3.41次因ILI就诊、1.45次因ILI自我用药。1752名儿童中，643名在2017 - 2018季节接种了流感疫苗。与未接种疫苗的儿童相比，疫苗对ILI病例数的有效性为23.5%（95%：15.1% - 31.1%），对因ILI就诊的有效性为19.3%（95%：8.2% - 29.1%），对因ILI自我用药的有效性为25.8%（95%：9.3% - 39.3%）。将2017 - 2018年接种疫苗的643名儿童按接种前后进行建模划分，36至72个月大儿童中，疫苗对ILI病例数的有效性为31.9%（95%：12.7% - 46.9%），对因ILI就诊的有效性为32.6%（95%：8.6% - 50.3%），对因ILI自我用药的有效性为44.3%（95%：11.9% - 64. Eight%）。然而，6至35个月大的儿童未显示出显著的疫苗有效性。对于不同接种状态儿童的疫苗有效性分析，在2016 - 2017季节和2017 - 2018季节均接种或仅在2017 - 2018季节接种的儿童，疫苗有效性显著。仅在2016 - 2017季节接种疫苗的儿童未显示出疫苗有效性。流感疫苗在预防流感季节儿童ILI的发病、就诊及自我用药方面有中度效果，对36至72个月大儿童的保护效果优于6至35个月大的儿童。
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