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评估德国成年人免疫状况的挑战——基于人群的 VACCELERATE 脊髓灰质炎疫苗接种调查的经验教训。

Challenges in assessing the immunization status of adults in Germany-lessons from a population-based VACCELERATE survey on polio vaccination.

机构信息

Faculty of Medicine, Institute of Translational Research, University of CologneUniversity Hospital CologneCologne Excellence Cluster On Cellular Stress Responses in Aging-Associated Diseases (CECAD), Herderstr. 52-54, 50931, Cologne, Germany.

Faculty of Medicine, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), University of Cologne, and University Hospital Cologne, Cologne, Germany.

出版信息

Infection. 2024 Aug;52(4):1563-1574. doi: 10.1007/s15010-024-02296-9. Epub 2024 May 28.

Abstract

PURPOSE

Considering the re-emergence of poliomyelitis (PM) in non-endemic regions, it becomes apparent that vaccine preventable diseases can rapidly develop epi- or even pandemic potential. Evaluation of the current vaccination status is required to inform patients, health care providers and policy makers about vaccination gaps.

METHODS

Between October 28 2022 and November 23 2022, 5,989 adults from the VACCELEREATE Volunteer Registry completed an electronic case report form on their previous PM vaccine doses including number, types/-valencies and the time of administration based on their vaccination records. A uni-/multivariable regression analysis was performed to assess associations in participant characteristics and immunization status.

RESULTS

Among German volunteers (n = 5,449), complete PM immunization schedule was found in 1,981 (36%) participants. Uncertain immunization, due to unknown previous PM vaccination (n = 313, 6%), number of doses (n = 497, 9%), types/-valencies (n = 1,233, 23%) or incoherent immunization schedule (n = 149, 3%) was found in 40% (n = 2,192). Out of 1,276 (23%) participants who reported an incomplete immunization schedule, 62 (1%) never received any PM vaccine. A total of 5,074 (93%) volunteers reported having been vaccinated at least once and 2,087 (38%) indicated that they received vaccination within the last ten years. Female sex, younger age, as well as availability of first vaccination record were characteristics significantly associated with complete immunization (p < 0.001).

CONCLUSION

Full PM immunization schedule was low and status frequently classified as uncertain due to lack of details on administered doses. There is an obviousneed for improved recording to enable long-term access to detailed vaccination history in the absence of a centralized immunization register.

摘要

目的

鉴于脊髓灰质炎(PM)在非流行地区再次出现,显然疫苗可预防的疾病可能迅速发展为爆发或甚至大流行的潜力。评估当前的疫苗接种状况对于向患者、医疗保健提供者和决策者通报疫苗接种差距是必要的。

方法

2022 年 10 月 28 日至 11 月 23 日,5989 名来自 VACCELEREATE 志愿者登记处的成年人根据他们的疫苗接种记录,填写了一份关于他们以前的 PM 疫苗剂量的电子病例报告表,包括剂量数量、类型/效价和接种时间。进行了单变量/多变量回归分析,以评估参与者特征和免疫状况的关联。

结果

在德国志愿者中(n=5449),1981 名(36%)参与者完成了完整的 PM 免疫接种计划。由于以前的 PM 疫苗接种情况未知(n=313,6%)、剂量数量(n=497,9%)、类型/效价(n=1233,23%)或免疫接种计划不一致(n=149,3%),40%(n=2192)的免疫接种情况不确定。在 1276 名(23%)报告不完全免疫接种计划的参与者中,有 62 名(1%)从未接种过任何 PM 疫苗。共有 5074 名(93%)志愿者报告至少接种过一次疫苗,2087 名(38%)表示他们在过去十年内接种过疫苗。女性性别、年轻年龄以及第一次接种记录的可用性是与完全免疫显著相关的特征(p<0.001)。

结论

完整的 PM 免疫接种计划很低,由于缺乏关于接种剂量的详细信息,接种情况经常被归类为不确定。在没有集中免疫登记的情况下,为了能够长期获得详细的疫苗接种史,显然需要改进记录。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3482/11289296/b4606b0fd361/15010_2024_2296_Fig1_HTML.jpg

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