Che Xinren, Liu Yan, Wang Jun, Xu Yuyang, Zhang Xuechao, Gu Wenwen, Jiang Wei, Du Jian, Zhang Xiaoping
Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
Hum Vaccin Immunother. 2021 Apr 3;17(4):1239-1243. doi: 10.1080/21645515.2020.1809264. Epub 2020 Sep 22.
Although China's Expanded Program on Immunization (EPI) provides two doses of group A meningococcal polysaccharide vaccine (MPV-A) for children younger than 2 y, more self-paying group A and group C meningococcal polysaccharide conjugate vaccine (MCV-AC) has been used as an alternative to MPV-A, to prevent Neisseria meningitidis serogroup C (Men-C) earlier. We evaluated the pattern of MPV-A and MCV-AC utilization to provide evidence for China to upgrade the national meningococcal meningitis vaccination strategy.
Children born between 2008 and 2017 registered in Hangzhou's Immunization Information System (HZIIS) were included. Descriptive epidemiological methods were used to characterize the data. Adverse event following immunization (AEFI) was collected from Chinese national adverse event following immunization information system (CNAEFIIS) to compare the safety of MPV-A and MCV-AC.
Data of 1149,027 children from HZIIS were analyzed. The average immunization rate of meningococcal meningitis vaccine (MenV) was 97.50%. Percentages of children using MPV-A-only, MCV-AC-only, and MPV-A/MCV-AC sequential schedules were 68.20%, 29.73%, and 2.07%, respectively. The vaccination rate of MCV-AC-only increased by age and it was higher in resident children than migration children. The incidence rate of AEFI of MPV-A and MCV-AC was 53.36 per 100,000 and 62.13 per 100,000, respectively.
Children in Hangzhou had high MenV coverage. MCV-AC-only schedule use increased by year and was higher in urban areas among locally born children. Both MPV-A and MCV-AC were safe for children, while MCV-AC could protect against Men-C more effectively. This supports the rationale to introduce MCV-AC into China's EPI system for free instead of MPV-A.
尽管中国扩大免疫规划（EPI）为2岁以下儿童提供两剂A群脑膜炎球菌多糖疫苗（MPV-A），但越来越多自费的A群和C群脑膜炎球菌多糖结合疫苗（MCV-AC）被用作MPV-A的替代疫苗，以便更早预防C群脑膜炎奈瑟菌（Men-C）。我们评估了MPV-A和MCV-AC的使用模式，为中国升级国家脑膜炎球菌性脑膜炎疫苗接种策略提供依据。
纳入2008年至2017年在杭州免疫信息系统（HZIIS）登记的儿童。采用描述性流行病学方法对数据进行特征分析。从中国国家免疫后不良事件信息系统（CNAEFIIS）收集免疫后不良事件（AEFI），以比较MPV-A和MCV-AC的安全性。
分析了HZIIS中1149027名儿童的数据。脑膜炎球菌性脑膜炎疫苗（MenV）的平均接种率为97.50%。仅使用MPV-A、仅使用MCV-AC以及采用MPV-A/MCV-AC序贯接种程序的儿童比例分别为68.20%、29.73%和2.07%。仅使用MCV-AC的接种率随年龄增长而升高，常住儿童高于流动儿童。MPV-A和MCV-AC的AEFI发生率分别为每10万人53.36例和每10万人62.13例。
杭州儿童的MenV覆盖率较高。仅使用MCV-AC的接种程序逐年增加，在本地出生儿童的城市地区更高。MPV-A和MCV-AC对儿童均安全，而MCV-AC能更有效地预防Men-C。这支持了将MCV-AC免费纳入中国EPI系统以替代MPV-A的理由。
