Liu Siyu, Xu Xia, Liu Qianqian, Tang Lin, Wang Xiaoqi, Huang Aodi, Li Jiuhong, Xiu Yuexin, Yang Hong, Wen Ning, Rodewald Lance E, Yin Zundong, Wang Fuzhen
National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing, China.
China CDC Wkly. 2024 Dec 13;6(50):1319-1324. doi: 10.46234/ccdcw2024.262.
Since rubella was incorporated into the national disease surveillance system in 2004, rubella incidence has changed dramatically. This study analyzed the impact of immunization strategies on the age-specific and sex-specific incidence of rubella in China from 2004 to 2023 to inform efforts to accelerate rubella elimination.
Annual rubella-containing vaccine (RCV) coverage levels, reported rubella cases and incidence, and vaccination status of cases were obtained from the National Immunization Program Information Management System, the National Notifiable Diseases Reporting System, and the Measles Surveillance System, and used to describe temporal trends. Incidence trends and annual percent changes (APC) by age group and sex were estimated using joinpoint regression.
In 2008, RCV coverage was 51.5% for the first dose and 39.0% for the second dose, increasing to and stabilizing at 95% or above for both doses by 2012. There were 584,758 cases of rubella reported in China during 2004-2023. Joinpoint regression showed that rubella incidence initially increased, peaked in 2008, and then decreased (APC=47.12%, APC=-18.95%, <0.05). Adolescents, aged 10-19 years, accounted for 67.8% of cases at a peak incidence in 2019 (APC=103.70%, APC=-89.76%, <0.05); 77.8% of cases had no or unknown RCV history.
The decrease in rubella incidence is closely associated with vaccination. Nationwide inclusion of RCV significantly impacted on the prevention and control of rubella. Targeted measures to address immunization gaps and maintain high surveillance sensitivity are necessary to promote rubella elimination.
自2004年风疹纳入国家疾病监测系统以来，风疹发病率发生了显著变化。本研究分析了2004年至2023年免疫策略对中国风疹年龄别和性别别发病率的影响，为加速消除风疹的努力提供信息。
从国家免疫规划信息管理系统、国家法定传染病报告系统和麻疹监测系统获取含风疹疫苗（RCV）年度接种覆盖率、报告的风疹病例数和发病率以及病例的疫苗接种状况，并用于描述时间趋势。采用Joinpoint回归估计年龄组和性别的发病率趋势及年度变化百分比（APC）。
2008年，第一剂RCV接种覆盖率为51.5%，第二剂为39.0%，到2012年两剂接种覆盖率均升至95%及以上并稳定下来。2004年至2023年期间，中国共报告风疹病例584,758例。Joinpoint回归显示，风疹发病率最初上升，2008年达到峰值，随后下降（APC=47.12%，APC=-18.95%，P<0.05）。2019年发病率峰值时，10至19岁青少年占病例的67.8%（APC=103.70%，APC=-89.76%，P<0.05）；77.8%的病例无RCV接种史或接种史不明。
风疹发病率的下降与疫苗接种密切相关。全国范围内纳入RCV对风疹的防控产生了重大影响。采取针对性措施解决免疫空白并保持高监测敏感性对于促进消除风疹是必要的。
