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2016 - 2024年金华市水痘突破性病例特征

Characteristics of Varicella Breakthrough Cases in Jinhua City, 2016-2024.

作者信息

Du Zhi-Ping, Long Zhi-Ping, Chen Meng-An, Sheng Wei, He Yao, Zhang Guang-Ming, Wu Xiao-Hong, Pang Zhi-Feng

机构信息

Department of Infectious Disease Prevention and Control, Jinhua Center for Disease Control and Prevention, Jinhua 321000, China.

出版信息

Vaccines (Basel). 2025 Aug 7;13(8):842. doi: 10.3390/vaccines13080842.

Abstract

: Varicella remains a prevalent vaccine-preventable disease, but breakthrough infections are increasingly reported. However, long-term, population-based studies investigating the temporal and demographic characteristics of breakthrough varicella remain limited. : This retrospective study analyzed surveillance data from Jinhua City, China, from 2016 to 2024. Varicella case records were obtained from the China Information System for Disease Control and Prevention (CISDCP), while vaccination data were retrieved from the Zhejiang Provincial Immunization Program Information System (ISIS). Breakthrough cases were defined as infections occurring more than 42 days after administration of the varicella vaccine. Differences in breakthrough interval were analyzed across subgroups defined by dose, sex, age, population category, and vaccination type. A bivariate cubic regression model was used to assess the combined effect of initial vaccination age and dose interval on the breakthrough interval. : Among 28,778 reported varicella cases, 7373 (25.62%) were classified as breakthrough infections, with a significant upward trend over the 9-year period ( < 0.001). Most cases occurred in school-aged children, especially those aged 6-15 years. One-dose recipients consistently showed shorter breakthrough intervals than two-dose recipients ( = 62.10 vs. 120.10 months, < 0.001). Breakthrough intervals also differed significantly by sex, age group, population category, and vaccination type ( < 0.05). Regression analysis revealed a negative correlation between the initial vaccination age, the dose interval, and the breakthrough interval ( = 0.964, < 0.001), with earlier and closely spaced vaccinations associated with longer protection. : The present study demonstrates that a two-dose varicella vaccination schedule, when initiated at an earlier age and administered with a shorter interval between doses, provides more robust and longer-lasting protection. These results offer strong support for incorporating varicella vaccination into China's National Immunization Program to enhance vaccine coverage and reduce the public health burden associated with breakthrough infections.

摘要

水痘仍然是一种常见的可通过疫苗预防的疾病,但突破性感染的报告越来越多。然而,针对突破性水痘的时间和人口统计学特征的长期、基于人群的研究仍然有限。

这项回顾性研究分析了中国金华市2016年至2024年的监测数据。水痘病例记录来自中国疾病预防控制信息系统(CISDCP),而疫苗接种数据则从浙江省免疫规划信息系统(ISIS)中获取。突破性病例定义为在接种水痘疫苗42天以上发生的感染。对按剂量、性别、年龄、人群类别和疫苗接种类型定义的亚组的突破性间隔差异进行了分析。使用双变量三次回归模型评估初始接种年龄和剂量间隔对突破性间隔的综合影响。

在报告的28778例水痘病例中,7373例(25.62%)被归类为突破性感染,在9年期间呈显著上升趋势(<0.001)。大多数病例发生在学龄儿童中,尤其是6至15岁的儿童。单剂量接种者的突破性间隔始终比双剂量接种者短(分别为62.10个月和120.10个月,<0.001)。突破性间隔在性别、年龄组、人群类别和疫苗接种类型方面也存在显著差异(<0.05)。回归分析显示初始接种年龄、剂量间隔与突破性间隔之间呈负相关(=0.964,<0.001),早期且剂量间隔紧密的接种与更长的保护期相关。

本研究表明,两剂水痘疫苗接种方案在较早年龄开始并在剂量之间间隔较短时间接种时,可提供更强有力和更持久的保护。这些结果为将水痘疫苗纳入中国国家免疫规划以提高疫苗覆盖率和减轻与突破性感染相关的公共卫生负担提供了有力支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83d5/12390572/65387ea1dcd3/vaccines-13-00842-g001.jpg

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