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血清型特异性肺炎球菌疫苗在患有状细胞疾病的儿童中的有效性:二十年分析

Ziyu Zhang¹, Melike Yildirim², Pinar Keskinocak¹

¹H. Milton Stewart School of Industrial and Systems Engineering, Atlanta, GA, USA; Center for Health and Humanitarian Systems, Georgia Institute of Technology, Atlanta, GA, USA.

|May 3, 2025

概括

患有状细胞疾病 (SCD) 的儿童在接种疫苗后仍然面临更高的侵入性肺炎球菌病 (IPD) 率. 剩余的IPD病例与目前疫苗未覆盖的血清型有关,这表明需要更广泛的疫苗策略.

科学领域:

儿科血液学儿科血液学
传染性疾病传染性疾病
疫苗学疫苗学疫苗学

背景情况:

状细胞病 (SCD) 是一种普遍存在的全球遗传血液疾病.
患有SCD的儿童患入侵性肺炎球菌病 (IPD) 的风险显著增加.

研究的目的:

评估肺炎球菌合疫苗 (PCV13) 对SCD儿童IPD发病率的影响.
评估疫苗的有效性,并确定负责这一群体突破性IPD的血清型.

主要方法:

利用基于人口的IPD监测数据,用于马萨诸塞州的18岁以下儿童 (2002-2020年).
在PCV13之前和之后期间计算的发病率 (IR) 和发病率比率 (IRR).
使用随机森林模型确定疫苗有效性 (VE) 和预测PCV13疫苗失败.

主要成果:

患有SCD的儿童在PCV13前后两个时期都比健康儿童呈现出明显更高的IPDIR.
PCV13显示SCD儿童整体IPD的适度降低 (28.1%),而健康儿童的IPD降低了59.5%.
在患有SCD的儿童中,很大一部分 (61.1%) 的IPD病例是由非PCV13血清型引起的,这表明扩展性疫苗的潜力.

结论:

尽管接种了疫苗,但患有SCD的儿童仍然面临IPD的更高风险.
不被PCV13覆盖的血清型是该队列中大多数正在进行的IPD的原因.
扩大价值的疫苗和风险分层的疫苗接种方法对于保护患有SCD的儿童至关重要.

关键词:

发生率 (IR) 发生率 (IR)发生率比率 (IRR)侵入性肺炎球菌病 (IPD) 是一种侵袭性肺炎球菌病.基于风险的疫苗接种.状细胞疾病 (SCD) 是一种状细胞疾病.疫苗的有效性 (VE)

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