Jiang Yuxin, Luo Yinsong, Xiao Xi, Li Xiaorui, Hu Yiyao, Liu Chenye, Zhao Dian, Kong Tianqi, Liu Jiaye
School of Public Health, Shenzhen University Medical School, Shenzhen, China.
School of Public Health, Shenzhen University Medical School, Shenzhen, China.
Vaccine. 2025 Mar 7;49:126786. doi: 10.1016/j.vaccine.2025.126786. Epub 2025 Jan 30.
To evaluate the global, regional, and national burden of four vaccine preventable infectious diseases (VPDs) among adults aged 55-89 years from 1990 to 2021, in the context of an aging population.
Data from the Global Burden of Disease Study 2021 on acute hepatitis A, B, E, and varicella and herpes zoster were analysed for incidence rates and disability-adjusted life years (DALYs), stratified by sex, age, Social Development Index (SDI), and region. Joinpoint regression analysis was used to assess trends.
In 2021, the global incidence of four VPDs among adults aged 55-89 years was 1698.8 cases per 100,000 population, with a total of 25,243,776 (95 % UI 17301929-34,959,277) new cases and 719,888 (95 % UI 534782-992,800) DALYs. From 1990 to 2021, the incidence rates of acute hepatitis A and acute hepatitis B consistently declined, whereas those of acute hepatitis E, varicella and herpes zoster moderately increased, with EAPCs of 0.13 (95 % UI 0.12-0.15) and 0.14 (95 % UI 0.09-0.19), respectively. In 2021, sub-Saharan Africa had the highest overall burden of the four diseases, whereas high-income Asia Pacific (945.7 per 100,000 population) and Western Europe (840.7 per 100,000 population) had the highest incidence rates of varicella and herpes zoster. Acute hepatitis A and acute hepatitis B were more prevalent in low- and middle-SDI regions, whereas increasing trends for acute hepatitis E and varicella and herpes zoster were observed in higher-SDI regions. The incidence rates of acute hepatitis A and acute hepatitis B were higher in males than in females and decreased with age.
Despite overall declines in VPDs among older adults, disparities remain. Public health efforts must focus on improving vaccine access and targeting at-risk populations, especially older adults, to address the burden of VPDs.
在人口老龄化背景下，评估1990年至2021年55 - 89岁成年人中四种疫苗可预防传染病（VPDs）的全球、区域和国家负担。
分析了全球疾病负担研究2021中关于甲型、乙型、戊型急性肝炎以及水痘和带状疱疹的数据，以获取发病率和伤残调整生命年（DALYs），并按性别、年龄、社会发展指数（SDI）和地区进行分层。采用Joinpoint回归分析评估趋势。
2021年，55 - 89岁成年人中四种VPDs的全球发病率为每10万人1698.8例，共有25,243,776例（95% UI 17301929 - 34,959,277）新发病例和719,888例（95% UI 534782 - 992,800）伤残调整生命年。1990年至2021年，甲型急性肝炎和乙型急性肝炎的发病率持续下降，而戊型急性肝炎、水痘和带状疱疹的发病率适度上升，其年度变化百分比分别为0.13（95% UI 0.12 - 0.15）和0.14（95% UI 0.09 - 0.19）。2021年，撒哈拉以南非洲地区这四种疾病的总体负担最高，而高收入亚太地区（每10万人945.7例）和西欧（每10万人840.7例）的水痘和带状疱疹发病率最高。甲型急性肝炎和乙型急性肝炎在低和中等SDI地区更为普遍，而在高SDI地区观察到戊型急性肝炎、水痘和带状疱疹呈上升趋势。甲型急性肝炎和乙型急性肝炎的发病率男性高于女性，并随年龄下降。
尽管老年人中VPDs总体有所下降，但差异仍然存在。公共卫生工作必须专注于改善疫苗可及性并针对高危人群，尤其是老年人，以应对VPDs的负担。
