Sulik-Wakulińska Magdalena, Toczyłowski Kacper, Grygorczuk Sambor
Department of Infectious Diseases and Neuroinfections, Medical University in Białystok, Żurawia 14, 15-540 Białystok, Poland.
Department of Pediatric Infectious Diseases, Medical University in Białystok, Waszyngtona 17, 15-274 Białystok, Poland.
Vaccines (Basel). 2025 Jun 20;13(7):665. doi: 10.3390/vaccines13070665.
: Tick-borne encephalitis (TBE) is a notifiable disease in Poland, with the highest incidence in the northeastern region. Although vaccination is highly effective, breakthrough infections occasionally occur. This study aimed to describe the clinical features of vaccinated and unvaccinated TBE cases, assess long-term hospitalization trends, and estimate vaccine effectiveness (VE) in a highly endemic region. : We retrospectively analyzed 1518 laboratory-confirmed TBE cases hospitalized at the University Clinical Hospital in Białystok, Poland, from 1988 to 2020. Clinical and cerebrospinal fluid (CSF) parameters were compared between vaccinated and unvaccinated individuals. Vaccine effectiveness was estimated using the screening method, based on aggregated regional vaccine uptake data from 1999 to 2020. : Among all cases, 13 (0.9%) occurred in individuals who had received at least one dose of vaccine, including 4 who had completed the full primary vaccination schedule. Hospitalized vaccinated patients showed similar demographic and clinical characteristics compared to unvaccinated patients, though CSF findings suggested an earlier and more dynamic immune response. Seasonal analysis revealed a sustained increase in TBE hospitalizations and a possible extension of the transmission season into late summer and autumn. Estimated VE was 94.4% (95% CI 85.2-97.9%), though this should be interpreted with caution due to the small number of vaccinated cases and assumptions regarding population-level coverage. : This study provides detailed clinical data on breakthrough TBE cases and long-term epidemiological insights from an endemic region in Poland. While vaccine effectiveness appears high, low uptake remains a public health concern. These findings underscore the need for improved vaccination coverage and ongoing surveillance to monitor evolving transmission patterns.
蜱传脑炎（TBE）在波兰是一种应报告的疾病，东北地区发病率最高。尽管疫苗接种非常有效，但仍偶尔会出现突破性感染。本研究旨在描述接种疫苗和未接种疫苗的TBE病例的临床特征，评估长期住院趋势，并估计高度流行地区的疫苗效力（VE）。
我们回顾性分析了1988年至2020年在波兰比亚韦斯托克大学临床医院住院的1518例实验室确诊的TBE病例。比较了接种疫苗和未接种疫苗个体的临床和脑脊液（CSF）参数。基于1999年至2020年汇总的区域疫苗接种数据，采用筛查方法估计疫苗效力。
在所有病例中，13例（0.9%）发生在至少接种过一剂疫苗的个体中，其中4例完成了完整的基础疫苗接种程序。与未接种疫苗的患者相比，住院的接种疫苗患者表现出相似的人口统计学和临床特征，不过脑脊液检查结果表明免疫反应更早且更活跃。季节性分析显示TBE住院病例持续增加，传播季节可能延长至夏末和秋季。估计的疫苗效力为94.4%（95%置信区间85.2 - 97.9%），不过由于接种疫苗的病例数量较少以及关于人群水平覆盖率的假设，对此应谨慎解读。
本研究提供了关于突破性TBE病例的详细临床数据以及来自波兰一个流行地区的长期流行病学见解。虽然疫苗效力似乎很高，但接种率低仍然是一个公共卫生问题。这些发现强调了提高疫苗接种覆盖率和持续监测以监测不断演变的传播模式的必要性。
