【摘要】 目的在消灭脊髓灰质炎(脊灰)后期,分析用Sabin株脊灰灭活疫苗(IPV)替代首剂脊灰减毒活疫苗(OPV)的"1剂Sabin株IPV+3剂OPV序贯程序"的有效性、安全性。方法采用描述流行病学方法,对梅州市2008—2017年急性弛缓性麻痹(AFP)病例、2015年12月—2017年11月Sabin株IPV替代首剂OPV免疫后疑似预防接种异常反应(AEFI)病例监测结果进行分析。结果免疫策略调整前8年梅州市发生4例疫苗相关麻痹型脊灰(VAPP),发病率为0.21/10万。Sabin株IPV替代首剂OPV后,可获得较好的脊灰中和抗体保护率,2年未发生VAPP、疫苗衍生脊灰病毒(VDPV)病例。主动、被动监测结果显示,AEFI发生率分别为542.51/10万、65.52/10万,以一般反应为主,异常反应发生率和同期接种的第一、二类疫苗性差异无统计学意义。结论梅州市采用"1剂次Sabin株IPV+3剂次OPV"的序贯免疫程序2年来,保持高水平脊灰免疫屏障,消除脊灰野毒株传入的风险,并且防止了VAPP、VDPV病例的发生。更多还原

【Abstract】 [Objective]To analyze the effectiveness and safety of 1 agent Sabin strain IPV+3 agents OPV sequential program,that is Sabin strain inactivated poliovirus vaccine(IPV) instead of the first dose oral poliovirus vaccine(OPV),at the late stage of poliomyelitis elimination.[Methods] The descriptive epidemiological method was used to analyze the monitoring results of acute flaccid paralysis(AFP) cases from 2008 to 2017 and adverse events following immunization(AEFI) cases from December 2015 to November 2017 in Meizhou City,which occurred after the immunization of Sabin strain IPV instead of the first dose OPV.[Results] There were 4 cases of vaccine-associated paralytic polio(VAPP) in eight years before immunization strategy adjustment,and the incidence rate was 0.21/lakh.Sabin strain IPV instead of the first dose OPV could obtain the better polio neutralizing antibody protection rate,and there were no cases of VAPP and VDPV in two years.The results of active and passive monitoring showed that the incidence rate of AEFI was 542.51/lakh and 65.52/lakh respectively,which were mainly general reaction.There was no significant difference in the inci-dence rate of adverse reaction between that and the first,second types of vaccines in same period.[Conclusion] The sequential immunization program of 1 agent Sabin strain IPV +3 agents OPV has adopted in Meizhou City for two years,and it maintains a poliomyelitis immune barrier at high level,eliminates the risk of introduction of poliovirus and prevent the occurrence of VAPP and VDPV.更多还原