澳大利亚麻疹控制活动如何促进风疹消除。
How Australia's measles control activities have catalyzed rubella elimination.
机构信息
Epidemiologist and independent investigator, Canberra, Australian Capital Territory, 2604, Australia.
Global Immunization Division, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Clifton Rd, Atlanta, GA, 30333, USA.
出版信息
Int J Infect Dis. 2022 Jan;114:72-78. doi: 10.1016/j.ijid.2021.11.003. Epub 2021 Nov 5.
BACKGROUND
By 2017, rubella had been officially eliminated in Australia. This success was attributed to Australia's longstanding national immunization programme and two enhanced measles immunization activities using measles, mumps, and rubella (MMR) vaccines - the Measles Control Campaign (MCC) and the Young Adult MMR Campaign (YAC). Our study describes the impact of these activities on rubella incidence, and its elimination in Australia.
METHODS
Aggregate national serological survey data were assigned to birth cohorts, and mean, median, and age-group estimates calculated and analyzed against MMR immunization coverage estimates (1998-2018) and rubella notifications (1993-2018). Three-year cumulative incidences were calculated by birth cohort.
RESULTS
The serological surveys revealed high and stable levels of rubella immunity among females, but estimates for three male cohorts were lower. Since 2007, MMR immunization coverage among children aged 24-27 months has remained above 90% for both doses. The 3-year cumulative incidence of rubella declined across all birth cohorts following the MCC and the YAC.
DISCUSSION
Using MMR vaccines to address measles immunity gaps had the additional benefit of controlling rubella in Australia. Both the MCC and YAC shifted rubella epidemiology, accelerating the interruption of endemic transmission. Countries should consider combined measles and rubella vaccines for all catch-up activities.
背景
到 2017 年，风疹已在澳大利亚被正式消灭。这一成功归因于澳大利亚长期以来的国家免疫计划以及两次使用麻疹、腮腺炎和风疹（MMR）疫苗的强化麻疹免疫活动——麻疹控制运动（MCC）和青年 MMR 运动（YAC）。我们的研究描述了这些活动对风疹发病率的影响及其在澳大利亚的消除情况。
方法
将汇总的全国血清学调查数据分配给出生队列，并根据 MMR 免疫覆盖率估计值（1998-2018 年）和风疹报告病例数（1993-2018 年）计算和分析均值、中位数和年龄组估计值。通过出生队列计算三年累积发病率。
结果
血清学调查显示女性风疹免疫力高且稳定，但三个男性队列的估计值较低。自 2007 年以来，24-27 月龄儿童的两剂 MMR 免疫覆盖率均保持在 90%以上。在 MCC 和 YAC 之后，所有出生队列的风疹三年累积发病率均下降。
讨论
使用 MMR 疫苗解决麻疹免疫差距还有助于控制澳大利亚的风疹。MCC 和 YAC 都改变了风疹的流行病学，加速了地方性传播的中断。各国应考虑为所有补种活动使用麻疹和风疹联合疫苗。
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