Department of Immunization Program, Hongkou District Center for Disease Control and Prevention, Shanghai, China.
Department of Immunization Program, Xuhui District Center for Disease Control and Prevention, Shanghai, China.
Hum Vaccin Immunother. 2021 Dec 2;17(12):5316-5324. doi: 10.1080/21645515.2021.2009729. Epub 2021 Dec 10.
To evaluate the effectiveness of varicella vaccine (VarV) as post-exposure prophylaxis (PEP) among children during varicella outbreaks.
A comprehensive literature search was performed in PubMed, Embase, Web of Science, SinoMed, Wanfang and CNKI. Relevant outcomes included the incidence of varicella. Pooled estimates were calculated using a fixed-effects or random-effects model according to the heterogeneity among studies.
A total of 15 studies with 7,474 children that received one or two dosages of VarV as PEP and 183,827 children who received no VarV were included in the meta-analysis. In total, one-dose and two-dose VarV as PEP had 43% (95% confidence interval (CI):27%, 55%) and 60% (95%CI: 35%, 75%) efficacy, respectively. When PEP was applied within 3 days, the pooled VarV as PEP for prevention of varicella was 80% (95%CI: 68%, 88%); when PEP was administered beyond 3 days, the pooled VarV as PEP for the prevention of varicella was 50% (95%CI: 11%, 72%). If the PEP was implemented with a coverage of more than 80%, the VarV could prevent 82% of varicella cases from occurring (95%CI: 15%, 96%); if the PEP covered a maximum of 80% of the susceptible cases, the VarV could prevent 65% of varicella cases from occurring (95%CI: 50%, 76%).
The two-dose VarV had better efficacy than one-dose VarV in the control of varicella outbreaks, especially if PEP was applied within 3 days of an outbreak and in conjunction with a high coverage rate ≥80%.
评估水痘疫苗（VarV）作为水痘疫情爆发时儿童暴露后预防（PEP）的有效性。
在 PubMed、Embase、Web of Science、SinoMed、万方和中国知网进行了全面的文献检索。相关结局包括水痘发病率。根据研究间的异质性，使用固定效应或随机效应模型计算汇总估计值。
共有 15 项研究纳入了 7474 名接受一剂或两剂 VarV 作为 PEP 的儿童和 183827 名未接受 VarV 的儿童。总的来说，一剂和两剂 VarV 作为 PEP 的疗效分别为 43%（95%置信区间（CI）：27%，55%）和 60%（95%CI：35%，75%）。当 PEP 在 3 天内使用时，VarV 作为 PEP 预防水痘的总有效率为 80%（95%CI：68%，88%）；当 PEP 在 3 天之后使用时，VarV 作为 PEP 预防水痘的总有效率为 50%（95%CI：11%，72%）。如果 PEP 的覆盖率超过 80%，VarV 可以预防 82%的水痘病例发生（95%CI：15%，96%）；如果 PEP 覆盖最多 80%的易感病例，VarV 可以预防 65%的水痘病例发生（95%CI：50%，76%）。
两剂 VarV 比一剂 VarV 更能有效控制水痘疫情，尤其是在疫情爆发后 3 天内应用，并与 80%以上的高覆盖率相结合。
