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不同免疫剂次和免疫间隔对含流行性腮腺炎成分疫苗突破病例发病年龄影响

Impacts of different vaccination doses and intervals on the age of onset in mumps-containing vaccine breakthrough cases

    摘要
  • 摘要:
    目的 了解不同免疫剂次和免疫间隔对含流行性腮腺炎成分疫苗（MuCV）突破病例发病年龄的影响，为优化MuCV的免疫策略提供参考依据。
    方法 通过中国疾病预防控制信息系统和重庆市免疫规划信息管理系统进行数据匹配，纳入重庆市沙坪坝区2008年1月1日—2023年12月31日出生儿童接种MuCV后截至2023年12月31日诊断为流行性腮腺炎（流腮）的突破病例，采用多元线性回归模型分析不同免疫剂次和免疫间隔对突破病例发病年龄的影响。
    结果 2008—2023年重庆市沙坪坝区MuCV突破病例累计1 204例，发病年龄集中于1～9岁，其中5～9岁639例（53.07%）；接种1剂次、2剂次和3剂次MuCV突破病例分别为782例（64.95%）、418例（34.72%）和4例（0.33%）；平均发病年龄分别为（5.25±2.12）、（6.52±2.07）和（7.81±2.51）岁；第2剂次MuCV免疫间隔<2、2～4和>4年的突破病例分别为97例（23.21%）、193例（46.17%）和128例（30.62%）；平均发病年龄分别为（4.92±2.08）、（6.27±1.53）和（8.10±1.64）岁。不同特征MuCV突破病例比较，不同免疫剂次和免疫间隔MuCV突破病例平均发病年龄差异均有统计学意义（均P<0.001）。在调整性别、居住地和户籍等混杂因素后，多元线性回归分析结果显示，接种2剂次MuCV（β=1.275，95%CI=1.024～1.525）和接种3剂次MuCV（β=2.581，95%CI=0.510～4.652）突破病例发病年龄均较接种1剂次MuCV突破病例明显推迟；免疫剂次增加与MuCV突破病例发病年龄推迟呈线性趋势（β=1.275，P<0.001）；第2剂次MuCV免疫间隔为2～4年（β=1.324，95%CI=0.909～1.738）和>4年（β=3.175，95%CI=2.726～3.624），突破病例发病年龄均较第2剂次MuCV免疫间隔<2年突破病例明显推迟，免疫间隔延长与MuCV突破病例发病年龄推迟呈线性趋势（β=1.605，P<0.001）。
    结论 重庆市沙坪坝区2008—2023年MuCV突破病例以5～9岁儿童为主，增加免疫剂次和延长第2剂次免疫间隔均可明显推迟MuCV突破病例的发病年龄。

     

    Abstract:
    Objective To investigate the impacts of different vaccination doses and intervals on the age of onset in mumps-containing vaccine (MuCV) breakthrough cases, providing evidence for optimizing MuCV immunization strategies.
    Methods Data were matched from the China Disease Prevention and Control Information System and the Chongqing Immunization Planning Information Management System. MuCV breakthrough cases in children born in Shapingba district between January 1, 2008 and December 31, 2023, who received MuCV and were diagnosed with mumps by December 31, 2023, were included. A multivariate linear regression model was employed to analyze the effects of vaccination doses and intervals on the age of onset in breakthrough cases.
    Results From 2008 to 2023, 1 204 MuCV breakthrough cases were identified in Shapingba district, with disease onset primarily occurring in children aged 1–9 years (5–9 years: 639 cases, 53.07%). Breakthrough cases occurred in 782 (64.95%), 418 (34.72%), and 4 (0.33%) children who had received 1, 2, and 3 doses of MuCV, respectively, with mean onset ages of (5.25 ± 2.12), (6.52 ± 2.07), and (7.81 ± 2.51) years. Among children receiving 2 doses, those with intervals of < 2 years (97 cases, 23.21%), 2–4 years (193 cases, 46.17%), and > 4 years (128 cases, 30.62%) between doses had mean onset ages of (4.92 ± 2.08), (6.27 ± 1.53), and (8.10 ± 1.64) years, respectively. Significant differences in mean age of onset were observed across different vaccination doses and intervals (all P < 0.001). After adjusting for gender, residence, and household registration, multivariate regression showed that 2-dose (β = 1.275, 95%CI: 1.024–1.525) and 3-dose (β = 2.581, 95%CI: 0.510–4.652) recipients had delayed ages of onset compared with 1-dose recipients, with a linear trend between increasing doses and delayed onset (β = 1.275, P < 0.001). For the second dose, intervals of 2–4 years (β = 1.324, 95%CI: 0.909–1.738) and > 4 years (β = 3.175, 95%CI: 2.726–3.624) delayed onset compared with intervals < 2 years, with a linear trend between prolonged intervals and delayed onset (β = 1.605, P < 0.001).
    Conclusions MuCV breakthrough cases in Shapingba district from 2008 to 2023 predominantly occurred in children aged 5–9 years. Increasing vaccination doses and extending the interval to the second dose significantly delayed the age of onset.

     

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