Liu Fang, Li Zhen, Wang Hongyu, Cao Yang, Zhang Nan, Wang Fang, Wei Rui, Zhang Jian, Zhao Yuqian
Beijing Chaoyang District Center for Disease Control and Prevention, Beijing, China.
Beijing Chaoyang District Center for Disease Control and Prevention, Beijing, China.
Vaccine. 2024 Jul 25;42(19):3968-3973. doi: 10.1016/j.vaccine.2024.05.006. Epub 2024 May 11.
Universal varicella vaccination has been introduced in many countries, but there are a number of important differences in their vaccination strategies. It is essential to establish a vaccination program that can maximize the benefits of varicella vaccine, but there is a lack of comprehensive research on the effectiveness of varicella vaccine in different vaccination status.
Using data from population-based surveillance platforms we conducted a 1:2 matched case-control study. The cases were clinically diagnosed varicella with onset from 2017 to 2021, 1-14 years old in Chaoyang District, Beijing. The controls were matched according to date of birth (±1 month), sex and residence. The vaccination data of the subjects were obtained from the Childhood Immunization Information Management System in Beijing. Using conditional logistic regression models with or without interaction terms, we evaluated the effectiveness of varicella vaccine in different vaccination status.
A total of 2528 cases and 5056 controls were enrolled. This study found that whether the time since last vaccination was adjusted had a substantial effect on the comparing vaccine effectiveness (VE) between subgroups. After adjustment for the time since last vaccination, 1) the incremental VE of 2-dose was 49.6 % (95 % Confidence Interval [CI], 38.8-58.6) compared with 1-dose (93.9 % vs. 88.0 %); 2) Among children who received one dose, the risk of chickenpox in children vaccinated at 18-23 months was 1.382 (95 %CI, 1.084-1.762) times that in children vaccinated at 12-17 months. 3) the VE with less than one, two, and three year intervals is higher than that with six-year-intervals (P < 0.05), respectively.
When comparing VE between subgroups of different vaccination status, the time since last vaccination should be adjusted. The first dose of varicella vaccine should be given as early as the second year of life, and the second dose can improve vaccine effectiveness.
许多国家已推行水痘普遍接种疫苗，但各国的疫苗接种策略存在一些重要差异。制定一个能使水痘疫苗效益最大化的接种计划至关重要，然而，对于水痘疫苗在不同接种状态下的有效性缺乏全面研究。
利用基于人群监测平台的数据，我们开展了一项1:2匹配病例对照研究。病例为2017年至2021年期间临床诊断为水痘且年龄在1至14岁的北京市朝阳区患者。对照根据出生日期（±1个月）、性别和居住地进行匹配。受试者的疫苗接种数据来自北京市儿童免疫信息管理系统。使用带有或不带有交互项的条件逻辑回归模型，我们评估了水痘疫苗在不同接种状态下的有效性。
共纳入2528例病例和5056例对照。本研究发现，是否调整上次接种后的时间对不同亚组间疫苗有效性（VE）的比较有实质性影响。在调整上次接种后的时间后，1）与1剂次相比，2剂次的增量VE为49.6%（95%置信区间[CI]，38.8 - 58.6）（93.9%对88.0%）；2）在接种1剂次的儿童中，18至23个月接种水痘疫苗的儿童患水痘的风险是12至17个月接种儿童的1.382倍（95%CI，1.084 - 1.762）。3）间隔时间小于1年、2年和3年的VE分别高于间隔6年的VE（P < 0.05）。
在比较不同接种状态亚组间的VE时，应调整上次接种后的时间。水痘疫苗首剂应在生命的第二年尽早接种，第二剂可提高疫苗有效性。
