上海市闸北区老年人接种23价肺炎球菌多糖疫苗流行病学效果评价

黄瑾; 张小娟; 蒋懿; 华瑞珏; 敖建军

doi:10.11847/zgggws1118849

上海市闸北区老年人接种23价肺炎球菌多糖疫苗流行病学效果评价

Effects of 23-valent pneumococcal polysaccharide vaccine inoculation on respiratory diseases among elderly people in Zhabei district of Shanghai: a follow-up study

摘要

摘要:
目的评价上海市闸北区≥60岁老年人接种23价肺炎球菌多糖疫苗（PPV23）的流行病学效果，为有效降低老年人肺炎链球菌性肺炎发病率，减少因罹患该病导致的疾病负担提供参考依据。
方法采用前瞻性队列研究方法，于2014年在上海市闸北区9个街道选取接种组和对照组≥60岁老年人各1 800人，每季度随访1次，为期3年，比较2组老年人肺炎、支气管炎和上呼吸道感染等疾病的发病情况。
结果上海市闸北区接种组老年人肺炎发病密度为0.62/百人年，低于对照组老年人的1.29/百人年（RR = 0.477，95 % CI = 0.305～0.734，P < 0.001），疫苗保护率为52.3 %；接种组老年人上呼吸道感染发病密度为4.95/百人年，低于对照组老年人的6.66/百人年（RR = 0.742，95 % CI = 0.630～0.873，P < 0.001），疫苗保护率为25.8 %。不同年龄组接种组与对照组老年人比较，60～69岁接种组老年人肺炎和上呼吸道感染发病密度均低于对照组老年人，≥80岁接种组老年人上呼吸道感染发病密度低于对照组老年人，差异均有统计学意义（均P < 0.05）。
结论接种PPV23对老年人肺炎和上呼吸道感染发病具有保护作用。

Abstract:
Objective To evaluate the effect of 23-valent pneumococcal polysaccharide vaccine (PPV23) inoculation on incidents of respiratory diseases among community residents aged≥60 years in Zhabei district of Shanghai city and to provide references for reducing pneumococcal pneumonia incidence in the elderly.
Methods We conducted a prospective cohort study among 3 600 residents randomly recruited from 9 communities in Zhabei district of Shanghai city in 2014. We carried out quarterly follow-ups continuously for 3 years to collected information on occurrences of pneumonia, bronchitis, and upper respiratory infection among the participants and compared incidences of the diseases among the participants with and without PPV23 inoculation.
Results The participants with PPV23 inoculation had significantly lower incidence density (0.62/100 vs. 1.29/100 person-years) and risk (relative risk RR = 0.477, 95% confidence interval 95% CI: 0.305 – 0.734; P < 0.001) of pneumonia compared to those without PPV23 inoculation; the protective rate of PPV23 inoculation against pneumonia was 52.3%. In comparison to those among the participants not having PPV23 inoculation, significantly lower incidence density (4.95/100 vs. 6.66/100 person-years) and risk (RR = 0.742, 95% CI: 0.630 – 0.873; P < 0.001) of upper respiratory infections were observed among the participants having PPV23 inoculation; the protective rate of PPV23 inoculation against upper respiratory infections was 25.8%. The incidence density of pneumonia and upper respiratory infections were significantly lower among the 60 – 69 years old participants with PPV23 inoculation than those without PPV23 inoculation (P < 0.05); for the participants aged≥80 years, the incidence density of upper respiratory infections was significantly lower among the inoculated with PPV23 than those uninoculated (P < 0.05).
Conclusion Inoculation of 23-valent pneumococcal polysaccharide vaccine has protective effect against pneumonia and upper respiratory infections among community elderly people.

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