【摘要】 目的 分析广元市14岁以下儿童水痘突破病例流行特征，为水痘防控提供科学依据。方法 收集2017—2022年广元市14岁以下儿童水痘突破病例信息，采用描述性流行病学方法分析水痘突破病例流行特征，使用Pearson相关分析法分析突破病例疫苗接种时年龄与接种至发病时间间隔相关关系。结果 2017—2022年广元市共报告14岁以下儿童突破病例957例，占水痘总病例的25.30%，突破病例比例呈现上升趋势(χ²_趋势=130.283,P<0.01)，不同月份、县区、职业、年龄突破病例在水痘总病例中的比例差异均有统计学意义（均P<0.01）。突破病例以5—7、10—12月为双高峰，利州区（53.29%）、学生（82.76%）为主，男女性别比1.10∶1。1、2剂突破病例分别报告852、105例，1剂突破病例首次接种至发病时间中位数为8.00（5.84,9.85）年，2剂疫苗接种至发病时间间隔中位数为4.15（2.30,6.06）年，1剂和2剂突破病例接种至发病时间分布差异有统计学意义（χ²=14.737,P<0.01）。突破病例首剂接种时年龄与接种至发病时间间隔呈现显著负相关（r=-0.236,P<0.01）。原发病例发病率963.29/10万，突破率为316.74/10万，水痘疫苗整体保护率为69.01%,1、2剂保护率分别为63.96%、85.51%。结论 广元市14岁以下儿童水痘突破病例在水痘总病例中比例呈现上升趋势，接种疫苗可有效降低水痘发病率，接种2剂次疫苗比接种1剂次更能有效防控水痘。更多还原

【Abstract】 Objective To investigate the epidemiological characteristics of varicella breakthrough cases among children under 14 years of age in Guangyuan City from 2017 to 2022, with the aim of providing a scientific foundation for the prevention and control of varicella. Methods Data on varicella breakthrough cases in children under 14 were collected for the period 2017-2022 in Guangyuan City. Descriptive epidemiological methods were employed to analyze the characteristics of these cases. Pearson correlation analysis was utilized to assess the relationship between the age at initial vaccination and the interval from vaccination to disease onset. Results From 2017 to 2022, a total of 957 breakthrough cases were reported in Guangyuan City among children under 14, constituting 25.30% of all reported varicella cases. The proportion of breakthrough cases demonstrated a significant increase(χ²_{for trend}=130.283, P<0.01). Statistically significant variations in the proportion of breakthrough cases were identified across different months, districts, occupations, and age cohorts（all P<0.01）. The incidence exhibited a bimodal distribution with peaks from May to July and from October to December. The majority of cases were reported in Lizhou District（53.29%） and among students（82.76%）, with a male-to-female ratio of 1.10: 1. A total of 852 and 105 breakthrough cases were reported in recipients of one and two vaccine doses, respectively. The median interval from vaccination to onset was 8.00（IQR: 5.84, 9.85） years for single-dose recipients and 4.15（IQR: 2.30, 6.06） years for two-dose recipients. The difference in the temporal distribution of onset post-vaccination between the one-dose and two-dose groups was statistically significant（χ²=14.737, P<0.01）. A significant negative correlation was observed between the age at first-dose vaccination and the interval to disease onset（r=-0.236, P<0.01）. The incidence rate among unvaccinated individuals was 963.29 per 100 000, whereas the breakthrough infection rate among vaccinated individuals was 316.74 per 100 000. The overall vaccine effectiveness（VE） was calculated to be 69.01%. The VE for the one-dose and two-dose schedules was 63.96% and 85.51%, respectively. Conclusions The proportion of varicella breakthrough cases relative to total varicella incidence among children under 14 in Guangyuan City is on an upward trend. Varicella vaccination is effective in reducing disease incidence, with a two-dose vaccination schedule affording substantially greater protection against varicella than a single-dose regimen.更多还原