Pan Jinhua, Wang Yesheng, Cao Lingsheng, Wang Ying, Zhao Qi, Tang Shenglan, Gong Wenfeng, Guo Lei, Liu Zhixi, Wen Zexuan, Zheng Bo, Wang Weibing
Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China.
National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
Innovation (Camb). 2021 May 5;2(2):100113. doi: 10.1016/j.xinn.2021.100113. eCollection 2021 May 28.
To evaluate the achievements of China's immunization program between 1950 and 2018, we chose 11 vaccine-preventable diseases (VPDs) as representative notifiable diseases and used annual surveillance data obtained between 1950 and 2018 to derive disease incidence and mortality trends. Quasi-Poisson and polynomial regression models were used to estimate the impacts of specific vaccine programs, and life-table methods were used to calculate the loss of life expectancy, years of life lost, and loss of working years. The total notification number for the 11 VPDs was 211,866,000 from 1950 to 2018. The greatest number occurred in 1959, with a total incidence of 1,723 per million persons. From 1978 to 2018, a substantial decline was observed in the incidence of major infectious diseases. The incidence of pertussis fell 98% from 126.35 to 1.58 per million, and the incidences of measles, meningococcal meningitis, and Japanese encephalitis fell 99%, 99%, and 98%, respectively. The regression models showed that most of the 11 diseases exhibited dramatic declines in morbidity after their integration into the Expanded Program on Immunization (EPI), while varicella and paratyphoid fever, which were not integrated into the EPI, showed increased morbidity. From 1978 to 2018, the total life expectancy for the 11 VPDs increased by 0.79 years, and similar results were obtained for different age groups. China has had great success in controlling VPDs in recent decades, and improving vaccination coverage is a key aspect of controlling VPDs in China.
为评估1950年至2018年间中国免疫规划的成就，我们选取了11种疫苗可预防疾病（VPD）作为具有代表性的法定报告疾病，并利用1950年至2018年期间获得的年度监测数据来推导疾病发病率和死亡率趋势。采用准泊松和多项式回归模型来估计特定疫苗计划的影响，并使用生命表方法来计算预期寿命损失、生命年损失和工作年损失。1950年至2018年期间，11种VPD的总报告数为2.11866亿例。数量最多的年份是1959年，总发病率为每百万人1723例。1978年至2018年期间，主要传染病的发病率大幅下降。百日咳发病率从每百万126.35例降至1.58例，下降了98%；麻疹、流行性脑脊髓膜炎和乙型脑炎的发病率分别下降了99%、99%和98%。回归模型显示，11种疾病中的大多数在纳入扩大免疫规划（EPI）后发病率显著下降，而未纳入EPI的水痘和副伤寒发病率则有所上升。1978年至2018年期间，11种VPD导致的总预期寿命增加了0.79岁，不同年龄组也得到了类似结果。近几十年来，中国在控制VPD方面取得了巨大成功，提高疫苗接种覆盖率是中国控制VPD的一个关键方面。
