摘要
目的评价水痘减毒活疫苗(VarV)接种后水痘突破病例(BV)发病率,为优化VarV免疫策略提供依据.方法电子检索中国生物医学文献库(CBMd)、中国期刊全文数据库(CNKI)和万方全文数据库、美国国家医学图书馆数据库(NCBI)等数据库,将有关接种1剂次或2剂次VarV后发生BV的文献纳入分析,合并计算BV的发病率,采用亚组分析或Meta回归模型分析文献间异质性.结果共纳入20篇文献.接种1剂次VarV后BV发病率为12.4/1 000人年(95%CI:9.0~15.9),首剂接种后3年内BV的发病率为11.0/1000人年(95CI%:5.8~16.1),而5年以后BV的发病率则提高至15.7/1000人年(95CI%:8.3~23.0).接种2剂次VarV后BV发病率是0.2/1 000人年(95%CI:-0.2~0.6).Meta回归模型显示,合并接种1剂次VarV后BV发病率中75.3%的异质性来源于研究设计、接种年龄及随访时间.结论接种2剂次VarV后BV发病率低于接种1剂次VarV,建议第2剂VarV在首剂接种后3~4年内接种.
Objective To evaluate the incidence of breakthrough varicella (BV) after the vaccination of live attenuated varicella vaccine (VarV),so as to optimize the strategy of VarV vaccination.Methods By searching data bases of China Biology Medicine disc,China National Knowledge Infrastructure,Wanfang Database,National Center for Biotechnology Information,random control trials (RCT) and cohort studies on the incidence of BV after 1 dose or 2 doses of VarV were included.Pooled estimate of the incidence of BV was calculated.Subgroup analyses and meta-regression were used to detect the risk factors of the heterogeneity.Results A total of 20 original articles were included.The pooled average BV incidence after 1 dose of VarV was 12.4/1 000 person years (PY)(95%CI:9.0-15.9) and was 0.2/1 000PY (95%CI:-0.2-0.6) in the individuals after 2 doses.The incidence of BV was 11.0/1000 PY (95CI%:5.8-16.1) within 3 years after the first dose,and increased to 15.7/1000 PY(95CI%:8.3-23.0) after 5 years.The meta-regression showed that design type,age at vaccination and the follow-up time accounted for approximately 75.3% of the heterogeneity in the average BV incidence rate after 1 dose.Conclusions The incidence of BV is lower among individuals after 2 doses than those after 1 dose of VarV.The interval of 3-4 years between the first and second vaccinations is recommended.
作者
胡昱
陈雅萍
汪颖
梁辉
Hu Yu;Chen Yaping;Wang Ying;Liang Hui(Department of Immunization Planning,Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou 310051, China)
出处
《国际流行病学传染病学杂志》
CAS
2019年第2期160-165,共6页
International Journal of Epidemiology and Infectious Disease
关键词
水痘
疫苗
减毒
突破
META分析
Chickenpox
Vaccines,attenuated
Breakthrough
Meta-analysis
