PCV13对苏州地区儿童社区获得性肺炎保护效果评价

李赵进; 陈庆会; 栾琳; 陶云珍; 冯爽; 张优仪; 田健美; 邵雪君; 赵根明; 张钧; 张涛

doi:10.11847/zgggws1137785

PCV13对苏州地区儿童社区获得性肺炎保护效果评价

Effectiveness of 13-valent pneumococcal polysaccharide conjugate vaccine on community-acquired pneumonia: a retrospective cohort study among young children in Suzhou city

摘要

摘要:
目的评价13价肺炎球菌结合疫苗（13-valent pneumococcal conjugate vaccine, PCV13）对苏州地区儿童社区获得性肺炎（community-acquired pneumonia，CAP）的保护效果。
方法采用队列研究，以2017年12月1日 — 2019年6月30日到苏州大学附属儿童医院（SCH）就诊或住院治疗的苏州地区0～18月龄儿童为研究对象，通过苏州市疾病预防控制中心的免疫信息系统查询儿童疫苗接种信息建立队列，从SCH信息系统收集研究对象的门诊和住院信息进行随访，采用Cox比例风险模型估计接种不同剂次PCV13的保护率。
结果 2017年12月1日 — 2019年6月30日，共59927名苏州地区儿童纳入研究，其中接种组共7459人（12.4 %）。对于第一次门诊或住院诊断CAP，至少接种1、2和3剂次PCV13的保护率分别为10.1 %（95 % CI = 3.3 %～18.1 %）、15.7 %（95 % CI = 7.6 %～23.1 %）和20.3 %（95 % CI = 11.5 %～28.3 %），对于所有门诊或住院诊断全CAP，至少接种1、2和3剂次PCV13的保护率分别为13.1 %（95 % CI = 6.0 %～20.0 %）、17.5 %（95 % CI = 10.0 %～24.5 %）和22.2 %（95 % CI = 14.0 %～30.0 %）。
结论 PCV13对苏州地区儿童社区获得性肺炎具有保护效果，接种满3剂次效果最好。

Abstract:
Objective To evaluate protective effectiveness of 13-valent pneumococcal polysaccharide conjugate vaccine (PCV13) on community-acquired pneumonia (CAP) among young children in Suzhou city.
Methods A retrospective cohort study was carried out among 59 927 children aged 0 − 18 months and having outpatient visit or hospitalization at Children's Hospital of Soochow University (SCH) from December 1, 2017 to June 30, 2019. The participants' information on outpatient visit or hospitalization were collected from the information system of SCH and that on PCV13 vaccination were extracted from the Immunization Information System of Suzhou Municipal Center for Disease Control and Prevention. Cox proportional hazard model was used to estimate the vaccine effectiveness (VE) of different doses of PCV13.
Results Of all the children followed-up, 12.4% (n = 7 459) were vaccinated with PCV13. Among the children having at least one dose, two doses, and three doses of PCV13 vaccination, the VE of PCV13 against CAP diagnosed at first outpatient visit or hospitalization during the follow-up period were 10.1% (95% confidence interval 95% CI: 3.3% − 18.1%), 15.7% (95% CI: 7.6% − 23.1%), and 20.3% (95% CI: 11.5% − 28.3%); while, the VE of PCV13 against CAP diagnosed during the whole follow-up period were 13.1% (95% CI: 6.0% − 20.0%), 17.5% (95% CI: 10.0% − 24.5%), and 22.2% (95% CI: 14.0% − 30.0%), respectively.
Conclusion PCV13 is of protective effectiveness against CAP in young children and the PCV13 vaccination of 3 doses is the most effective.

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