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含麻疹成分疫苗纳入免疫规划后 15 年流行性腮腺炎的流行病学特征及血清学调查

Epidemiological characteristics and serological survey of mumps 15 years after MMR vaccine was included in the immunization program.

机构信息

Department of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang, China.

Department of Anorectal, Quzhou Hospital of Traditional Chinese Medicine, Quzhou, Zhejiang, China.

出版信息

J Med Virol. 2024 Aug;96(8):e29856. doi: 10.1002/jmv.29856.

Abstract

Mumps is a vaccine-preventable acute viral infectious disease. To understand the incidence of mumps and population immunity in Quzhou City after measles mumps rubella vaccine (MMR) was included in the immunization program, we analyzed the epidemiological characteristics of mumps cases from 2009 to 2023 and a cross-sectional serosurvey of IgG antibodies to mumps conducted in 2024. We found that 15 years after the MMR vaccine was included in the immunization program, the incidence of mumps was significantly reduced in all populations, but the incidence remained highest in vaccinated children aged 0-12 years. Vaccine escape may explain the high incidence of mumps in highly vaccinated populations. Updating vaccines or developing a new vaccine that targets multiple viral genotypes may be necessary to improve the effectiveness of the vaccine against infection and fully control infections and outbreaks. The positive rate and concentration of mumps IgG antibody were inconsistent with the incidence data. mumps IgG antibody is not an ideal substitute for immunity and cannot be used to accurately predict whether a target population is susceptible or protected. Natural infections may provide longer-lasting immunity than vaccination.

摘要

流行性腮腺炎是一种可通过疫苗预防的急性病毒性传染病。为了解含麻疹、腮腺炎、风疹成分疫苗(MMR)纳入免疫规划后衢州市流行性腮腺炎发病情况及人群免疫水平,我们分析了 2009 年至 2023 年流行性腮腺炎病例的流行病学特征,并于 2024 年开展了横断面血清流行性腮腺炎 IgG 抗体检测。结果发现,MMR 疫苗纳入免疫规划 15 年后,各人群流行性腮腺炎发病率均显著降低,但疫苗接种儿童(0~12 岁)仍是发病率最高的人群,疫苗突破感染可能是高接种率人群流行性腮腺炎高发的原因。更新疫苗或开发针对多种病毒基因型的新疫苗可能是提高疫苗对感染的有效性并全面控制感染和暴发的必要措施。流行性腮腺炎 IgG 抗体的阳性率和浓度与发病率数据不一致。流行性腮腺炎 IgG 抗体不是免疫的理想替代物,不能用于准确预测目标人群的易感性或保护状态。自然感染可能提供比疫苗接种更持久的免疫力。

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