2018-2020 年拉脱维亚 tick-borne encephalitis 疫苗接种的有效性：一项观察性研究。
Effectiveness of tick-borne encephalitis vaccination in Latvia, 2018-2020: an observational study.
机构信息
Department of Pediatrics, Children's Clinical University Hospital, Rīga Stradinš University, Riga, Latvia.
Department of Neurology and Neurosurgery, Riga East University Hospital, Rīga Stradinš University, Riga, Latvia.
出版信息
Clin Microbiol Infect. 2023 Nov;29(11):1443-1448. doi: 10.1016/j.cmi.2023.06.028. Epub 2023 Jul 6.
OBJECTIVES
Tick-borne encephalitis (TBE) is an infection by the tick-borne encephalitis virus (TBEV) that results in symptoms of central nervous system inflammation. TBE is endemic in Latvia and other European countries. TBE vaccines are commonly used in Latvia, but vaccine effectiveness estimates are limited.
METHODS
Study staff at Rīga Stradinš University conducted nationwide active surveillance for TBEV infections. Serum and cerebrospinal fluid were ELISA-tested for TBEV-specific IgG and IgM antibodies. Vaccination history was collected by interview and medical record review. Utilizing data from surveillance and population surveys, vaccine effectiveness (with 95% CIs) and cases averted were estimated using the screening method.
RESULTS
There were 587 laboratory-identified TBE cases from 2018 to 2020; 98.1% (576/587) were unvaccinated, 1.5% (9/587) were unknown or partially vaccinated, and 0.3% (2/587) were fully vaccinated (three-dose primary series and appropriately timed boosters). TBE resulted in the death of 1.7% (10/587) of TBE cases. TBE vaccine history was ascertained from 92.0% (13 247/14 399) people from the general population: 38.6% (5113/13 247) were unvaccinated, 26.3% (3484/13 247) were fully vaccinated, and 35.1% (4650/13 247) were partially vaccinated. TBE vaccine effectiveness was 99.5% (98.0-99.9) against TBE, 99.5% (97.9-99.9) against TBE hospitalization, 99.3% (94.8-99.9) against moderate/severe TBE, and 99.2% (94.4-99.9) against TBE hospitalization >12 days. From 2018 to 2020, vaccination averted 906 TBE cases, including 20 deaths.
DISCUSSION
TBE vaccine was highly effective in preventing TBE, moderate and severe disease, and prolonged hospitalization. To prevent life-threatening TBE, TBE vaccine uptake and compliance should be increased in Latvia and other European regions where TBE is endemic.
目的
蜱传脑炎（TBE）是一种由蜱传脑炎病毒（TBEV）引起的感染，导致中枢神经系统炎症的症状。TBE 在拉脱维亚和其他欧洲国家流行。TBE 疫苗在拉脱维亚通常使用，但疫苗效力估计有限。
方法
里加斯特拉丁什大学的研究人员对 TBEV 感染进行了全国性的主动监测。采用 ELISA 法检测血清和脑脊液中 TBEV 特异性 IgG 和 IgM 抗体。通过访谈和病历回顾收集疫苗接种史。利用监测和人群调查数据，采用筛查法估计疫苗效力（95%CI）和预防病例数。
结果
2018 年至 2020 年期间，实验室共确诊 587 例 TBE 病例；98.1%（576/587）未接种疫苗，1.5%（9/587）接种情况不详或部分接种，0.3%（2/587）完全接种（三剂基础系列和适时加强剂）。TBE 导致 1.7%（10/587）的 TBE 病例死亡。从普通人群中确定了 92.0%（13247/14399）的 TBE 疫苗接种史：38.6%（5113/13247）未接种疫苗，26.3%（3484/13247）完全接种疫苗，35.1%（4650/13247）部分接种疫苗。TBE 疫苗效力对 TBE 为 99.5%（98.0-99.9），对 TBE 住院为 99.5%（97.9-99.9），对中度/重度 TBE 为 99.3%（94.8-99.9），对 TBE 住院>12 天为 99.2%（94.4-99.9）。2018 年至 2020 年，疫苗接种预防了 906 例 TBE 病例，包括 20 例死亡。
讨论
TBE 疫苗对预防 TBE、中度和重度疾病以及延长住院时间非常有效。为了预防危及生命的 TBE，应在拉脱维亚和其他 TBE 流行的欧洲地区增加 TBE 疫苗接种率和依从性。
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