Objective The objective of our study was to evaluate the vaccine effectiveness(VE)of the pentavalent rotavirus vaccine(RV5)among<5-year-old children in three provinces of China during 2020-2024 via a propensity sco...Objective The objective of our study was to evaluate the vaccine effectiveness(VE)of the pentavalent rotavirus vaccine(RV5)among<5-year-old children in three provinces of China during 2020-2024 via a propensity score-matched test-negative case-control study.Methods Electronic health records and immunization information systems were used to obtain data on acute gastroenteritis(AGE)cases tested for rotavirus(RV)infection.RV-positive cases were propensity score matched with RV-negative controls for age,visit month,and province.Results The study included 27,472 children with AGE aged 8 weeks to 4 years at the time of AGE diagnosis;7.98%(2,192)were RV-positive.The VE(95%confidence interval,CI)of 1-2 and 3 doses of RV5 against any medically attended RV infection(inpatient or outpatient)was 57.6%(39.8%,70.2%)and 67.2%(60.3%,72.9%),respectively.Among children who received the 3rd dose before turning 5 months of age,3-dose VE decreased from 70.4%(53.9%,81.1%)(<5 months since the 3rd dose)to 63.0%(49.1%,73.0%)(≥1 year since the 3rd dose).The three-dose VE rate was 69.4%(41.3%,84.0%)for RVGE hospitalization and 57.5%(38.9%,70.5%)for outpatient-only medically attended RVGE.Conclusion Three-dose RV5 VE against rotavirus gastroenteritis(RVGE)in children aged<5 years was higher than 1-2-dose VE.Three-dose VE decreased with time since the 3rd dose in children who received the 3rd dose before turning five months of age,but remained above 60%for at least one year.VE was higher for RVGE hospitalizations than for medically attended outpatient visits.展开更多
Fifteen pediatric cases of suspected Japanese encephalitis （JE） were reported in Beijing Children＇s Hospital during the late summer of 2013. The clinical manifestations in most cases included high fever, seizures, ...Fifteen pediatric cases of suspected Japanese encephalitis （JE） were reported in Beijing Children＇s Hospital during the late summer of 2013. The clinical manifestations in most cases included high fever, seizures, and abnormal magnetic resonance imaging findings. Twelve of 15 cases were laboratory-confirmed as JE cases by pathogen identification. Epidemiological investigations showed that five of the 12 laboratory-confirmed patients had an incomplete JE vaccination history. Follow-up investigations after discharge indicated that seven laboratory-confirmed JE patients without JE vaccinations had relatively poor prognoses, with an average Modified Rankin Scale （MRS） score of 2.6 when compared with the other five laboratory-confirmed, JE-vaccinated patients with an average MRS score of 0.5. The observation of pediatric JE cases among those with a history of JE vaccination warrants further attention.展开更多
Introduction The Haemophilus influenzae type b(Hib)conjugate vaccine is widely administered in China.Methods We extracted data on Hib vaccine doses administered and adverse events following immunization(AEFI)reported ...Introduction The Haemophilus influenzae type b(Hib)conjugate vaccine is widely administered in China.Methods We extracted data on Hib vaccine doses administered and adverse events following immunization(AEFI)reported between 2010 and 2021 from the Chinese National Immunization Information System(CNIIS).A descriptive analysis was conducted to examine the characteristics and incidence rates of AEFI with the Hib vaccine.Results In China,between 2010 and 2021,a total of 52,910 AEFIs with the Hib vaccine were reported,resulting in an overall AEFI reporting rate of 38.10 per 100,000 doses.Common(typically minor)and rare(potentially serious)vaccine reactions occurred at rates of 34.71 and 2.78 per 100,000 doses,respectively.Among the common vaccine reactions,the incidences of fever(axillary temperature≥38.6℃),injection site redness and swelling(>2.5 cm in diameter),and injection site induration(>2.5 cm in diameter)were 11.93,9.69,and 3.38 per 100,000 doses,respectively.Rare vaccine reactions included anaphylactic rash,angioedema,and febrile convulsion with reported incidences of 2.42,0.10,and 0.05 per 100,000 doses,respectively.The incidence of serious rare vaccine reactions was 0.16 per 100,000 doses.Conclusions The reported incidence of AEFI with the Hib vaccine was low,with the occurrence of serious rare adverse reactions also being markedly low throughout the period 2010–2021 in China.展开更多
Introduction:Domestic Sabin-strain inactivated poliovirus vaccine(sIPV)was approved for use in China in 2015 and introduced into the national immunization schedule in a sequential schedule with oral poliovirus vaccine...Introduction:Domestic Sabin-strain inactivated poliovirus vaccine(sIPV)was approved for use in China in 2015 and introduced into the national immunization schedule in a sequential schedule with oral poliovirus vaccine(OPV)in May 2016.However,a comprehensive analysis describing the characteristics,occurrences,and incidences of adverse events following immunization(AEFI)with sIPV in China is lacking.Methods:Data on sIPV doses administered and AEFI reported from 2015 to 2022 were obtained from the Chinese National Immunization Information System(CNIIS).Descriptive epidemiological methods and statistics were used to analyze and describe the characteristics,occurrences,and incidences of AEFI following sIPV in China from 2015 to 2022.Results:From 2015 to 2022,over 110,000,000 sIPV doses were administered,and 46,748 sIPV AEFIs were reported,resulting in an AEFI reporting rate of 42.44/100,000.Most AEFIs(46,333,99.11%)were non-serious.Causality assessment determined 46,061(98.53%)AEFIs were vaccine product-related reactions,including 44,001(94.12%)common and 2,060(4.41%)rare vaccine reactions.Among common vaccine reactions,reporting rates for fever>38.5°C,local redness and swelling≥2.6 cm,and local induration≥2.6 cm were 12.02/100,000,5.13/100,000,and 1.67/100,000,respectively.Among rare vaccine reactions,reporting rates for anaphylactic rash,thrombocytopenic purpura,and febrile convulsion were 1.56/100,000,0.09/100,000,and 0.03/100,000,respectively.Conclusions:Most reported sIPV AEFIs were non-serious,and the reporting rate of rare vaccine reactions has been very low since sIPV was approved for use in China.As sIPV remains in use in China,surveillance of AEFIs associated with this vaccine needs to be maintained.展开更多
Background:Since rubella was incorporated into the national disease surveillance system in 2004,rubella incidence has changed dramatically.This study analyzed the impact of immunization strategies on the age-specific ...Background:Since rubella was incorporated into the national disease surveillance system in 2004,rubella incidence has changed dramatically.This study analyzed the impact of immunization strategies on the age-specific and sex-specific incidence of rubella in China from 2004 to 2023 to inform efforts to accelerate rubella elimination.Methods:Annual rubella-containing vaccine(RCV)coverage levels,reported rubella cases and incidence,and vaccination status of cases were obtained from the National Immunization Program Information Management System,the National Notifiable Diseases Reporting System,and the Measles Surveillance System,and used to describe temporal trends.Incidence trends and annual percent changes(APC)by age group and sex were estimated using joinpoint regression.Results:In 2008,RCV coverage was 51.5%for the first dose and 39.0%for the second dose,increasing to and stabilizing at 95%or above for both doses by 2012.There were 584,758 cases of rubella reported in China during 2004–2023.Joinpoint regression showed that rubella incidence initially increased,peaked in 2008,and then decreased(APC2004–2008=47.12%,APC2008–2023=–18.95%,P<0.05).Adolescents,aged 10–19 years,accounted for 67.8%of cases at a peak incidence in 2019(APC2016–2019=103.70%,APC2016–2019=–89.76%,P<0.05);77.8%of cases had no or unknown RCV history.Conclusions:The decrease in rubella incidence is closely associated with vaccination.Nationwide inclusion of RCV significantly impacted on the prevention and control of rubella.Targeted measures to address immunization gaps and maintain high surveillance sensitivity are necessary to promote rubella elimination.展开更多
What is already known about this topic?The inclusion of meningococcal vaccines in the National Immunization Program(NIP)over several years has significantly reduced the incidence of meningococcal meningitis in China t...What is already known about this topic?The inclusion of meningococcal vaccines in the National Immunization Program(NIP)over several years has significantly reduced the incidence of meningococcal meningitis in China to historic lows.Worldwide,there has been a diversification of meningococcal serogroups,leading to a shift in dominant serogroups in China from serogroup A to serogroups C and B,accompanied by a rise in reports of serogroups Y and W.What is added by this report?An outbreak of serogroup Y Neisseria meningitidis(Nm)in a secondary vocational school involved a single confirmed severe case and 24 individuals with laboratory-confirmed Nm carriage.Epidemiological investigation revealed that the outbreak was localized to the classroom of the confirmed case.Prolonged close contact within a confined space was identified as a significant risk factor for Nm transmission.The genotype sequence identified was type 1655(ST-1655),which is categorized under clonal complex 23(CC-23)and bears resemblance to 8 previously confirmed cases of serogroup Y meningococcal meningitis within Guangdong Province.This suggests that serogroup Y infections continue to sporadically emerge and have become prevalent strains.What are the implications for public health practice?This outbreak underscores the critical need to enhance surveillance of meningococcal serogroups and population carrier,and advocate for vaccination with MenY-containing vaccines.展开更多
Background:Hepatitis A(HepA)vaccination and economic transitions can change the epidemiology of HepA.China's Gross Domestic Product(GDP)per capita was known to be inversely associated with the incidence of HepA,bu...Background:Hepatitis A(HepA)vaccination and economic transitions can change the epidemiology of HepA.China's Gross Domestic Product(GDP)per capita was known to be inversely associated with the incidence of HepA,but a deeper understanding of the epidemiology of HepA in different socio-economic regions is lacking.We compare the changing epidemiology of HepA in three socioeconomic-geographic regions of China.Methods:We obtained data on all HepA cases reported through the National Notifiable Disease Reporting System and assessed trends and changes in age-specific incidence rates by age quartile and season.We categorized the country into three regions,the sequential years into five era,compared the incidence,quartile age;seasonal intensity and coverage of HepA of the three regions.Linear regression was peiformed to analyse trends in incidence of HepA and to analyse the association between coverage and incidence.Results:The annual mean incidences of HepA in the eastern,central,and western regions decreased from 63.52/100000,50.57/100000 and 46.39/100000 in 1990-1992 to 1.18/100000,1.05/100000 and 3.14/100000 in 2012-2017,respectively.Decreases in incidence were seen in all age groups in the three regions;the incidence was highest(9.3/100000)in the youngest age group(0-4 years)of the western region,while in the central region,the age group with the highest incidence changed from 0 to 9 years to adults>60 years old.In 2017,the median age of HepA cases was 43 years(Q-Q3:33-55),47 years(Q1-Q3:32-60)and 33 years(Q1-Q3:9-52)in the eastern,central,and western provinces,respectively.Seasonal peaks became smaller or were nearly elimination nationwide,but seasonality persisted in some provinces.After the Expanded Program on Immunization(EPI)included HepA vaccine into the routine schedule in 2007,HepA coverage increased to>80%in the three regions and was negatively association with the HepA incidence.Conclusion:The incidence of HepA decreased markedly between 1990 and 2017.A socioeconomic inequity in coverage of HepA vaccine was almost eliminated after HepA vaccine was introduced into China's EPI system,but inequity in incidence still existed in lower socio-economic developed region.展开更多
Background:Mother to child transmission of hepatitis B virus(HBV)remains the most common form of HBV infection in China.Prevention of HBV vertical transmission involves timely administration of the complete hepatitis ...Background:Mother to child transmission of hepatitis B virus(HBV)remains the most common form of HBV infection in China.Prevention of HBV vertical transmission involves timely administration of the complete hepatitis B vaccine(HepB)series and hepatitis B immunoglobulin.Post-vaccination serological testing(PVST)is utilized to determine an infant's outcome after HBV exposure and completion of HepB series.We aim to determine the frequency of compliance with a PVST testing cascade for HBV infected mothers and analyze factors associated with infant lost to follow up(LTFU).Methods:We conducted a retrospeaive cohort review of previously collected data in Fujian,Jiangxi,Zhejiang and Chongqing provinces in China from 1 June 2016-31 December 2017.The study population included all HBV-exposed infants and their mothers.SAS software was used for statistical analyses.Bivariate and multivariate regression analyses(presented in odds ratio[OR]with 95%confidence intervals[CI])were used to compare the proportional differences of factors associated with PVST not being completed.Results:Among enrolled 8474 target infants,40%of them transferred out of the study provinces without further information and 4988 were eligible for PVST.We found 20%(994)of infants were not compliant with the testing cascade:55%of LTFU occurred because parents refused venous blood sample collection or failure of sample collection in the field,16%transferred out after 6 months of age,and 10%of families chose to have independent,confidential PVST completed without reporting results.High PVST noncompliance rates were more likely to be from Fujian(aOR=17.0,95%CI:9.7-29.9),Zhejiang(aOR=5.7,95%Cl:3.2-10.1)and Jiangxi(aOR=1.9,95%CI:1.0-3.4),and from HBV e antigen positive mother(aOR=1.2,95%CI:1.1-1.4).Conclusions:This study found that the LTFU rate reached 20%in PVST program,which was a significant problem.We recommend implementing a national elearonic information system for tracking HBV at risk mother-infant pairs;encourage further research in developing a less invasive means of completing PVST,and take effective measures nationally to reduce HBV stigma.Without reducing the loss to follow up rate among infants eligible for PVST,elimination of vertical HBV transmission will be impossible.展开更多
Vaccination is one of the most cost-effective interventions for saving lives and promoting public health.The coronavirus disease 2019(COVID-19)pandemic is providing a stark reminder of the importance and power of vacc...Vaccination is one of the most cost-effective interventions for saving lives and promoting public health.The coronavirus disease 2019(COVID-19)pandemic is providing a stark reminder of the importance and power of vaccines(1).However,vaccines can cause harm,and their rare safety concerns have increased in relative visibility as successful control and prevention of vaccine preventable diseases has diminished awareness of these diseases.展开更多
Importance.The great success in vaccine-preventable diseases has been accompanied by vaccine safety concerns.This has caused vaccine hesitancy to be the top 10 in threats to global health.The comprehensive understandi...Importance.The great success in vaccine-preventable diseases has been accompanied by vaccine safety concerns.This has caused vaccine hesitancy to be the top 10 in threats to global health.The comprehensive understanding of adverse events following immunization should be entirely based on clinical trials and postapproval surveillance.It has increasingly been recognized worldwide that the active surveillance of vaccine safety should be an essential part of immunization programs due to its complementary advantages to passive surveillance and clinical trials.Highlights.In the present study,the framework of vaccine safety surveillance was summarized to illustrate the importance of active surveillance and address vaccine hesitancy or safety concerns.Then,the global progress of active surveillance systems was reviewed,mainly focusing on population-based or hospital-based active surveillance.With these successful paradigms,the practical and reliable ways to create robust and similar systems in China were discussed and presented from the perspective of available databases,methodology challenges,policy supports,and ethical considerations.Conclusion.In the inevitable trend of the global vaccine safety ecosystem,the establishment of an active surveillance system for vaccine safety in China is urgent and feasible.This process can be accelerated with the consensus and cooperation of regulatory departments,research institutions,and data owners.展开更多
Viral hepatitis represents one of the most serious public health threats in the world today.World Hepatitis Day takes place on July 28 every year and is an opportunity to step up national and international efforts to ...Viral hepatitis represents one of the most serious public health threats in the world today.World Hepatitis Day takes place on July 28 every year and is an opportunity to step up national and international efforts to control and prevent viral hepatitis and to encourage action and engagement by individuals,partners,and the general public.July 28 was chosen for the World Hepatitis Day because it is the birthday of Nobel-prize-winning scientist Dr.展开更多
基金the Study on Vaccine Application Evaluation Strategies and Capacity Building (INV-006373)the National Key R&D Program of China(2024YFC2310604)
文摘Objective The objective of our study was to evaluate the vaccine effectiveness(VE)of the pentavalent rotavirus vaccine(RV5)among<5-year-old children in three provinces of China during 2020-2024 via a propensity score-matched test-negative case-control study.Methods Electronic health records and immunization information systems were used to obtain data on acute gastroenteritis(AGE)cases tested for rotavirus(RV)infection.RV-positive cases were propensity score matched with RV-negative controls for age,visit month,and province.Results The study included 27,472 children with AGE aged 8 weeks to 4 years at the time of AGE diagnosis;7.98%(2,192)were RV-positive.The VE(95%confidence interval,CI)of 1-2 and 3 doses of RV5 against any medically attended RV infection(inpatient or outpatient)was 57.6%(39.8%,70.2%)and 67.2%(60.3%,72.9%),respectively.Among children who received the 3rd dose before turning 5 months of age,3-dose VE decreased from 70.4%(53.9%,81.1%)(<5 months since the 3rd dose)to 63.0%(49.1%,73.0%)(≥1 year since the 3rd dose).The three-dose VE rate was 69.4%(41.3%,84.0%)for RVGE hospitalization and 57.5%(38.9%,70.5%)for outpatient-only medically attended RVGE.Conclusion Three-dose RV5 VE against rotavirus gastroenteritis(RVGE)in children aged<5 years was higher than 1-2-dose VE.Three-dose VE decreased with time since the 3rd dose in children who received the 3rd dose before turning five months of age,but remained above 60%for at least one year.VE was higher for RVGE hospitalizations than for medically attended outpatient visits.
基金grants from the National Key Research and Development Program(2016YFD0500401)a clinical technological innovation project supervised by the Beijing Hospital Authority(XMLX201401)+3 种基金a Development Grant of the State Key Laboratory of Infectious Disease Prevention and Control(2015SKLID505,2014SKLID03)Ministry of Science and Technology of the People’s Republic of China(No.2013ZX10004202,No.2013ZX10004101,No.2012ZX10004215)the National Natural Science Foundation of China(81290342 and 81501757)the Special National Project on Research and Development of Key Biosafety Technologies(2016YFC1201900)
文摘Fifteen pediatric cases of suspected Japanese encephalitis （JE） were reported in Beijing Children＇s Hospital during the late summer of 2013. The clinical manifestations in most cases included high fever, seizures, and abnormal magnetic resonance imaging findings. Twelve of 15 cases were laboratory-confirmed as JE cases by pathogen identification. Epidemiological investigations showed that five of the 12 laboratory-confirmed patients had an incomplete JE vaccination history. Follow-up investigations after discharge indicated that seven laboratory-confirmed JE patients without JE vaccinations had relatively poor prognoses, with an average Modified Rankin Scale （MRS） score of 2.6 when compared with the other five laboratory-confirmed, JE-vaccinated patients with an average MRS score of 0.5. The observation of pediatric JE cases among those with a history of JE vaccination warrants further attention.
基金Supported by the Emergency Response Mechanism Operation Programme of China CDC(102393220020010000017)。
文摘Introduction The Haemophilus influenzae type b(Hib)conjugate vaccine is widely administered in China.Methods We extracted data on Hib vaccine doses administered and adverse events following immunization(AEFI)reported between 2010 and 2021 from the Chinese National Immunization Information System(CNIIS).A descriptive analysis was conducted to examine the characteristics and incidence rates of AEFI with the Hib vaccine.Results In China,between 2010 and 2021,a total of 52,910 AEFIs with the Hib vaccine were reported,resulting in an overall AEFI reporting rate of 38.10 per 100,000 doses.Common(typically minor)and rare(potentially serious)vaccine reactions occurred at rates of 34.71 and 2.78 per 100,000 doses,respectively.Among the common vaccine reactions,the incidences of fever(axillary temperature≥38.6℃),injection site redness and swelling(>2.5 cm in diameter),and injection site induration(>2.5 cm in diameter)were 11.93,9.69,and 3.38 per 100,000 doses,respectively.Rare vaccine reactions included anaphylactic rash,angioedema,and febrile convulsion with reported incidences of 2.42,0.10,and 0.05 per 100,000 doses,respectively.The incidence of serious rare vaccine reactions was 0.16 per 100,000 doses.Conclusions The reported incidence of AEFI with the Hib vaccine was low,with the occurrence of serious rare adverse reactions also being markedly low throughout the period 2010–2021 in China.
基金Supported by grants from the Operation of the Public Health Emergency Response Mechanism in China CDC(102393220020010000017).
文摘Introduction:Domestic Sabin-strain inactivated poliovirus vaccine(sIPV)was approved for use in China in 2015 and introduced into the national immunization schedule in a sequential schedule with oral poliovirus vaccine(OPV)in May 2016.However,a comprehensive analysis describing the characteristics,occurrences,and incidences of adverse events following immunization(AEFI)with sIPV in China is lacking.Methods:Data on sIPV doses administered and AEFI reported from 2015 to 2022 were obtained from the Chinese National Immunization Information System(CNIIS).Descriptive epidemiological methods and statistics were used to analyze and describe the characteristics,occurrences,and incidences of AEFI following sIPV in China from 2015 to 2022.Results:From 2015 to 2022,over 110,000,000 sIPV doses were administered,and 46,748 sIPV AEFIs were reported,resulting in an AEFI reporting rate of 42.44/100,000.Most AEFIs(46,333,99.11%)were non-serious.Causality assessment determined 46,061(98.53%)AEFIs were vaccine product-related reactions,including 44,001(94.12%)common and 2,060(4.41%)rare vaccine reactions.Among common vaccine reactions,reporting rates for fever>38.5°C,local redness and swelling≥2.6 cm,and local induration≥2.6 cm were 12.02/100,000,5.13/100,000,and 1.67/100,000,respectively.Among rare vaccine reactions,reporting rates for anaphylactic rash,thrombocytopenic purpura,and febrile convulsion were 1.56/100,000,0.09/100,000,and 0.03/100,000,respectively.Conclusions:Most reported sIPV AEFIs were non-serious,and the reporting rate of rare vaccine reactions has been very low since sIPV was approved for use in China.As sIPV remains in use in China,surveillance of AEFIs associated with this vaccine needs to be maintained.
基金Supported by the operation of the public health emergency response mechanism of the Chinese Center for Disease Control and Prevention(No.102393220020010000017)the World Health Organization Rubella and Congenital Rubella Syndrome Surveillance Program(No.601007).
文摘Background:Since rubella was incorporated into the national disease surveillance system in 2004,rubella incidence has changed dramatically.This study analyzed the impact of immunization strategies on the age-specific and sex-specific incidence of rubella in China from 2004 to 2023 to inform efforts to accelerate rubella elimination.Methods:Annual rubella-containing vaccine(RCV)coverage levels,reported rubella cases and incidence,and vaccination status of cases were obtained from the National Immunization Program Information Management System,the National Notifiable Diseases Reporting System,and the Measles Surveillance System,and used to describe temporal trends.Incidence trends and annual percent changes(APC)by age group and sex were estimated using joinpoint regression.Results:In 2008,RCV coverage was 51.5%for the first dose and 39.0%for the second dose,increasing to and stabilizing at 95%or above for both doses by 2012.There were 584,758 cases of rubella reported in China during 2004–2023.Joinpoint regression showed that rubella incidence initially increased,peaked in 2008,and then decreased(APC2004–2008=47.12%,APC2008–2023=–18.95%,P<0.05).Adolescents,aged 10–19 years,accounted for 67.8%of cases at a peak incidence in 2019(APC2016–2019=103.70%,APC2016–2019=–89.76%,P<0.05);77.8%of cases had no or unknown RCV history.Conclusions:The decrease in rubella incidence is closely associated with vaccination.Nationwide inclusion of RCV significantly impacted on the prevention and control of rubella.Targeted measures to address immunization gaps and maintain high surveillance sensitivity are necessary to promote rubella elimination.
文摘What is already known about this topic?The inclusion of meningococcal vaccines in the National Immunization Program(NIP)over several years has significantly reduced the incidence of meningococcal meningitis in China to historic lows.Worldwide,there has been a diversification of meningococcal serogroups,leading to a shift in dominant serogroups in China from serogroup A to serogroups C and B,accompanied by a rise in reports of serogroups Y and W.What is added by this report?An outbreak of serogroup Y Neisseria meningitidis(Nm)in a secondary vocational school involved a single confirmed severe case and 24 individuals with laboratory-confirmed Nm carriage.Epidemiological investigation revealed that the outbreak was localized to the classroom of the confirmed case.Prolonged close contact within a confined space was identified as a significant risk factor for Nm transmission.The genotype sequence identified was type 1655(ST-1655),which is categorized under clonal complex 23(CC-23)and bears resemblance to 8 previously confirmed cases of serogroup Y meningococcal meningitis within Guangdong Province.This suggests that serogroup Y infections continue to sporadically emerge and have become prevalent strains.What are the implications for public health practice?This outbreak underscores the critical need to enhance surveillance of meningococcal serogroups and population carrier,and advocate for vaccination with MenY-containing vaccines.
基金operating system for public health preparedness and response of Chinese Center for Disease Control and Prevention(131031001000150001)Major Science and Technology Special Project(grant no.2017ZX10105015).
文摘Background:Hepatitis A(HepA)vaccination and economic transitions can change the epidemiology of HepA.China's Gross Domestic Product(GDP)per capita was known to be inversely associated with the incidence of HepA,but a deeper understanding of the epidemiology of HepA in different socio-economic regions is lacking.We compare the changing epidemiology of HepA in three socioeconomic-geographic regions of China.Methods:We obtained data on all HepA cases reported through the National Notifiable Disease Reporting System and assessed trends and changes in age-specific incidence rates by age quartile and season.We categorized the country into three regions,the sequential years into five era,compared the incidence,quartile age;seasonal intensity and coverage of HepA of the three regions.Linear regression was peiformed to analyse trends in incidence of HepA and to analyse the association between coverage and incidence.Results:The annual mean incidences of HepA in the eastern,central,and western regions decreased from 63.52/100000,50.57/100000 and 46.39/100000 in 1990-1992 to 1.18/100000,1.05/100000 and 3.14/100000 in 2012-2017,respectively.Decreases in incidence were seen in all age groups in the three regions;the incidence was highest(9.3/100000)in the youngest age group(0-4 years)of the western region,while in the central region,the age group with the highest incidence changed from 0 to 9 years to adults>60 years old.In 2017,the median age of HepA cases was 43 years(Q-Q3:33-55),47 years(Q1-Q3:32-60)and 33 years(Q1-Q3:9-52)in the eastern,central,and western provinces,respectively.Seasonal peaks became smaller or were nearly elimination nationwide,but seasonality persisted in some provinces.After the Expanded Program on Immunization(EPI)included HepA vaccine into the routine schedule in 2007,HepA coverage increased to>80%in the three regions and was negatively association with the HepA incidence.Conclusion:The incidence of HepA decreased markedly between 1990 and 2017.A socioeconomic inequity in coverage of HepA vaccine was almost eliminated after HepA vaccine was introduced into China's EPI system,but inequity in incidence still existed in lower socio-economic developed region.
文摘Background:Mother to child transmission of hepatitis B virus(HBV)remains the most common form of HBV infection in China.Prevention of HBV vertical transmission involves timely administration of the complete hepatitis B vaccine(HepB)series and hepatitis B immunoglobulin.Post-vaccination serological testing(PVST)is utilized to determine an infant's outcome after HBV exposure and completion of HepB series.We aim to determine the frequency of compliance with a PVST testing cascade for HBV infected mothers and analyze factors associated with infant lost to follow up(LTFU).Methods:We conducted a retrospeaive cohort review of previously collected data in Fujian,Jiangxi,Zhejiang and Chongqing provinces in China from 1 June 2016-31 December 2017.The study population included all HBV-exposed infants and their mothers.SAS software was used for statistical analyses.Bivariate and multivariate regression analyses(presented in odds ratio[OR]with 95%confidence intervals[CI])were used to compare the proportional differences of factors associated with PVST not being completed.Results:Among enrolled 8474 target infants,40%of them transferred out of the study provinces without further information and 4988 were eligible for PVST.We found 20%(994)of infants were not compliant with the testing cascade:55%of LTFU occurred because parents refused venous blood sample collection or failure of sample collection in the field,16%transferred out after 6 months of age,and 10%of families chose to have independent,confidential PVST completed without reporting results.High PVST noncompliance rates were more likely to be from Fujian(aOR=17.0,95%CI:9.7-29.9),Zhejiang(aOR=5.7,95%Cl:3.2-10.1)and Jiangxi(aOR=1.9,95%CI:1.0-3.4),and from HBV e antigen positive mother(aOR=1.2,95%CI:1.1-1.4).Conclusions:This study found that the LTFU rate reached 20%in PVST program,which was a significant problem.We recommend implementing a national elearonic information system for tracking HBV at risk mother-infant pairs;encourage further research in developing a less invasive means of completing PVST,and take effective measures nationally to reduce HBV stigma.Without reducing the loss to follow up rate among infants eligible for PVST,elimination of vertical HBV transmission will be impossible.
基金The National Natural Science Foundation of China(Grant No.81973146)the Advanced Project of Beijing Natural Science Foundation(Grant No.BMU2019GJJXK003).
文摘Vaccination is one of the most cost-effective interventions for saving lives and promoting public health.The coronavirus disease 2019(COVID-19)pandemic is providing a stark reminder of the importance and power of vaccines(1).However,vaccines can cause harm,and their rare safety concerns have increased in relative visibility as successful control and prevention of vaccine preventable diseases has diminished awareness of these diseases.
基金This work was supported by the National Natural Science Foundation of China(Grant no.81973146)the advanced project of the Beijing Natural Science Foundation(Grant no.BMU2019GJJXK003).
文摘Importance.The great success in vaccine-preventable diseases has been accompanied by vaccine safety concerns.This has caused vaccine hesitancy to be the top 10 in threats to global health.The comprehensive understanding of adverse events following immunization should be entirely based on clinical trials and postapproval surveillance.It has increasingly been recognized worldwide that the active surveillance of vaccine safety should be an essential part of immunization programs due to its complementary advantages to passive surveillance and clinical trials.Highlights.In the present study,the framework of vaccine safety surveillance was summarized to illustrate the importance of active surveillance and address vaccine hesitancy or safety concerns.Then,the global progress of active surveillance systems was reviewed,mainly focusing on population-based or hospital-based active surveillance.With these successful paradigms,the practical and reliable ways to create robust and similar systems in China were discussed and presented from the perspective of available databases,methodology challenges,policy supports,and ethical considerations.Conclusion.In the inevitable trend of the global vaccine safety ecosystem,the establishment of an active surveillance system for vaccine safety in China is urgent and feasible.This process can be accelerated with the consensus and cooperation of regulatory departments,research institutions,and data owners.
文摘Viral hepatitis represents one of the most serious public health threats in the world today.World Hepatitis Day takes place on July 28 every year and is an opportunity to step up national and international efforts to control and prevent viral hepatitis and to encourage action and engagement by individuals,partners,and the general public.July 28 was chosen for the World Hepatitis Day because it is the birthday of Nobel-prize-winning scientist Dr.
