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首页> 外文期刊>The Pediatric infectious disease journal >Vaccine effectiveness and severity of varicella among previously vaccinated children during outbreaks in day-care centers with low vaccination coverage.
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Vaccine effectiveness and severity of varicella among previously vaccinated children during outbreaks in day-care centers with low vaccination coverage.

机译:在疫苗接种率较低的日托中心,暴发期间先前接种过疫苗的儿童的水痘疫苗有效性和严重性。

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摘要

BACKGROUND: Varicella vaccine effectiveness (VE) during outbreaks has been reported to be 71-100% against any disease and >90% against moderate/severe disease even in day-care centers (DCCs) and schools with low vaccination rates. A recent report suggested an effectiveness rate of 44% during a DCC outbreak despite a high vaccination rate. AIMS: To reassess vaccination coverage, VE and severity of disease among previously vaccinated children after exposure during DCC outbreaks in northern Israel, where vaccination rates are low. METHODS: During January to June 2003, active surveillance for varicella among children in northern Israel revealed outbreaks in 8 DCCs with children 3-6 years of age. Data concerning symptoms of the disease and the age at vaccination (for previously vaccinated children) were obtained from parents and health care providers for children who contracted the disease. Analysis of VE was limited to children who were continuously enrolled in DCCs during the outbreaks. RESULTS: The overall vaccination rate was 37%. The incidences of natural varicella and breakthrough varicella (BV) were 79 of 153 [52%; 95% confidence interval (CI) 44-60%] and 37 of 89 (41.5%; 95% CI 31-52%), respectively. VE was 20% (95% CI 0-40%) against disease of any severity and 93.4% (95% CI 75-98%) against moderate/severe disease. Ninety-four percent and 14% of children with BV and natural varicella, respectively, had mild disease (P < 0.001). The odds ratio for BV was 17 (95% CI 2.18-118) for children vaccinated >2 years before the outbreak. CONCLUSIONS: During varicella outbreaks in DCCs with low vaccine coverage, previous vaccination provided poor protection against chickenpox, mostly among children who had been vaccinated >2 years earlier, but the disease appeared to be much milder among children with BV than among nonvaccinated children.
机译:背景:据报道,即使在日托中心(DCC)和疫苗接种率较低的学校中,暴发期间的水痘疫苗有效性(VE)对抗任何疾病的比例都为71-100%,针对中度/重度疾病的> 90%。最近的一份报告显示,尽管疫苗接种率很高,但在DCC爆发期间的有效率为44%。目的:在疫苗接种率低的以色列北部DCC暴发期间,在接触过疫苗的儿童中重新评估疫苗接种率,VE和疾病严重性。方法:在2003年1月至2003年6月期间,对以色列北部儿童的水痘进行了主动监测,发现8例DCC中3-6岁的儿童暴发。有关疾病症状和接种年龄的数据(以前接种过疫苗的儿童)是从父母和医疗保健提供者那里获得的。 VE的分析仅限于在暴发期间不断加入DCC的儿童。结果:总体疫苗接种率为37%。天然水痘和突破性水痘(BV)的发生率为153的79 [52%; 95%置信区间(CI)为44-60%]和37中的37(41.5%; 95%CI为31-52%)。对于任何严重程度的疾病,VE均为20%(95%CI 0-40%),对于中度/重度疾病,VE为93.4%(95%CI 75-98%)。 BV和自然水痘患儿分别有94%和14%患有轻度疾病(P <0.001)。爆发前2年以上接种疫苗的儿童BV的优势比为17(95%CI 2.18-118)。结论:在疫苗接种率较低的DCC中,水痘暴发期间,以前的疫苗接种对水痘的保护作用较差,主要是在> 2岁之前接种疫苗的儿童中,但该病似乎比未接种疫苗的儿童轻得多。

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