在14个高负担国家的例行麻疹疫苗接种和补充免疫活动的健康影响:动态麻疹免疫计算引擎 (DynaMICE) 建模研究
Megan Auzenbergs1, Han Fu1, Kaja Abbas2
1Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
The Lancet. Global health
|July 20, 2023
概括
含麻疹疫苗第一剂 (MCV1) 预防了数百万病例和死亡. 虽然补充免疫活动 (SIAs) 减少了比单独的MCV2更多的麻疹负担,但常规的MCV2提供了更高的效率.
科学领域:
- 流行病学 流行病学
- 免疫接种计划 免疫接种计划
- 公共卫生 公共卫生
背景情况:
- 世界卫生组织 (WHO) 建议至少95%的人口接种两剂含麻疹疫苗 (MCV).
- 常规免疫服务通常提供第一剂 (MCV1) 和第二剂 (MCV2).
- 补充免疫活动 (SIA) 提供针对特定年龄组的疫苗接种,无论先前的疫苗接种情况如何,在麻疹负担较高的国家.
研究的目的:
- 估计不同麻疹疫苗接种策略的相对效果和效率.
- 分析MCV1,MCV2和SIAs对14个高发病率国家的麻疹负担的影响.
主要方法:
- 使用了动态麻疹免疫计算引擎 (DynaMICE),这是一个年龄结构的隔间动态模型.
- 评估了疫苗接种战略对2000年至2020年麻疹易感性和麻疹负担的影响.
- 纳入了国家特定的常规MCV1和MCV2覆盖率数据 (1980-2020年) 和世卫组织的SIA数据.
主要成果:
- 据估计,MCV1的实施防止了8.24亿例麻疹病例和960万例死亡 (NNV: 1.41).
- 将常规的MCV2添加到MCV1中,可以预防1.08亿例病例和404,270例死亡.
- 将SIA添加到MCV1中可以防止2.56亿例病例和440万例死亡,但与MCV2 (NNV:5.41) 相比,效率较低 (NNV:6.02).
结论:
- 疫苗接种计划可以接触到更多未接种疫苗的儿童,并比单独的MCV2减少麻疹负担,但由于针对年龄范围广泛,其效率较低.
- 在规划未来有效的麻疹疫苗接种策略方面,MCV1,MCV2和SIA之间的相互作用至关重要.
- 这项分析提供了洞察力,以提高全球麻疹疫苗接种工作的健康影响和效率.
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