【作者】 庄昉成； 姜器； 龚岳平； 莫世华； 忻亚娟； 钱汶； 陈念良； 张淑雅； 柴少爱； 毛江森；

【Author】 Zhuang Fang-cheng,Jiang Qi,Gong Yue-ping,et al (Institute of Viral Diseases,Zhejiang Academy of Medical Sciences,Hangzhou,310013)

【机构】 浙江省医学科学院病毒病研究所； 台州市椒江区卫生防疫站； 嵊泗县卫生防疫站； 浙江省卫生防疫站；

【摘要】 目的观察在甲型肝炎(甲肝)高发县、区用甲肝减毒活疫苗(H2株)大面积接种后长期的流行病学保护效果。方法选择浙江省嵊泗县和椒江区二个试点。二组小学生定群研究,观察4年。试点内1-15岁儿童普遍接种甲肝活疫苗。部分研究对象作血清中和试验、免疫回忆反应及免后10年抗体检测。结果接种组与未接种组甲肝发病率差别具有显著性(P<0．01),疫苗保护率为100％。疫苗接种率与甲肝发病率二者具有明显负相关。全人口甲肝发病率分别下降了94．5％和90．3％,1—15岁儿童组发病专率分别下降了96．9％和97．9％,10年期间没有发生甲肝流行。血清学检测结果:免后阴性血清,用体外中和法验证有63．8％仍有中和作用,加强免疫 1针后回忆反应明显。免后10年抗-HAV—IgG的阳性率为80．2％。结论甲肝减毒活疫苗(H2株)长期的流行病学效果明显。通过普遍接种甲肝减毒活疫苗,第一次在甲肝高发地区和高发年龄组消除了甲肝的发生与流行。更多还原

【Abstract】 Objective To assess the long-term epidemiological effects after a mass vaccination programming live attenuated hepatitis A vaccine (H2-strain). Methods Shengsi county and jiao-jiang city in Zhejiang province were chosen where high incidence rate of hepatitis A was observed. Mass vaccination program of H2-strain vaccine was carried out on 1~15 year olds.Cohort studies included two groups were carried out in Shengsi. Cases reported program on hepatitis A was under the national standard on clinical diagnosis and partly through laboratory monitor of anti-HAV IgM and IgG,ELISA and Abbott EIA.Population size was estimated by the yearly reports of census bureau of the county and the city. Serum tests including neutralization test, immune-recall responses, and anti-HAV IgG were performed 10 years after the initial immunization.Results The morbidity of hepatitis A was significantly different between vaccinated groups and non-vaccinated groups (P< 0.01)in the cohort study.The protective efficacy in the site was 100 percent.There was a significantly negative correlation of regression between vaccine coverage and hepatitis A morbidity.In- both sites ,hepatitis A incidence rate showed decrease of 94.5%and 90.3%in whole population,with 96.9% and 97.9% in 1~15 year olds respectively. Neutralization test showed that 63.8% of the serum negative to ELISA after vaccination could still neutralize certain HAV.Immune-recall response after the booster was seen in vaccine group with 80.2% positive rate of anti HAV-IgG, 10years after immunization among vaccinees in both sites.Not a single hepatitis A case was identified.Conclusion Lave attenuated hepatitis A vaccine seemed to have obviously long-term epidemi-ological effects.更多还原