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在中国国家免疫计划中增加新的儿童疫苗:证据,好处和优先事项

Haijun Zhang¹, Xiaozhen Lai², Bryan N Patenaude³

¹Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China; International Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Immunization, Vaccines and Biologicals, WHO, Geneva, Switzerland.

The Lancet. Public health

|November 24, 2023

概括

将四种关键的儿童疫苗引入中国的国家免疫计划可以防止数千人死亡. 肺炎球菌合疫苗 (PCV13) 提供了最重要的影响,其次是轮状病毒,Hib和水疫苗.

科学领域:

儿童传染病儿童传染病
公共卫生政策公共卫生政策
疫苗学疫苗学疫苗学

背景情况:

中国国家免疫计划 (NIP) 在儿童必需疫苗方面存在差距.
肺炎球菌结合疫苗 (PCV),轮状病毒,血清型b (Hib) 的Haemophilus influenzae和疹疫苗都在私人提供,但不在NIP上.
这些疫苗解决了幼儿的重大疾病负担.

研究的目的:

评估中国四种非NIP疫苗的疾病负担,覆盖率,不平等和成本效益.
建议优先接种疫苗,将其纳入中国的NIP.
评估引入这些疫苗的潜在影响.

主要方法:

关于疾病负担,覆盖率和成本效益的文献综述.
2019年疫苗引入的死亡率影响计算.
对2023年新生儿队伍的预算分析.
优先考虑的多标准决策分析.

主要成果:

在2019年将这四种疫苗纳入2019年可能会避免11,761名5岁以下儿童的死亡,降低死亡率10.29%.
肺炎球菌合疫苗 (PCV13) 显示覆盖率最低,不平等率最高,但预防死亡的潜力最大.
预计2023年队列PCV13,轮状病毒,Hib和水疫苗的政府成本是相当大的.

结论:

建议优先引入PCV13,轮状病毒疫苗,Hib疫苗和天花疫苗到中国的NIP中.
包括这些疫苗可以显著降低儿童死亡率,并解决现有的覆盖不平等.
战略性疫苗引入对于提高中国儿童健康状况至关重要.

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