Background:Routinely, the first measles, mumps, and rubella (MMR) vaccine dose is given at 14 months of age in the Netherlands. However, during a measles epidemic in 2013-2014, MMR vaccination was also offered to 6-14-month-olds in municipalities with <90% MMR vaccination coverage. We studied the effectiveness of the early MMR vaccination schedule.
Methods:Parents of all infants targeted for early MMR vaccination were asked to participate. When parent(s) suspected measles, their infant's saliva was tested for measles-specific antibodies. The vaccine effectiveness (VE) against laboratory-confirmed and self-reported measles was estimated using Cox regression, with VE calculated as 1 minus the hazard ratio.
Results:Three vaccinated and 10 unvaccinated laboratory-confirmed cases occurred over observation times of 106631 and 23769 days, respectively. The unadjusted VE against laboratory-confirmed measles was 94% (95% confidence interval [CI], 79%-98%). After adjustment for religion and sibling's vaccination status, the VE decreased to 71% (-72%-95%). For self-reported measles, the unadjusted and adjusted VE was 67% (40%-82%) and 43% (-12%-71%), respectively.
Conclusions:Infants vaccinated between 6 and 14 months of age had a lower risk of measles than unvaccinated infants. However, part of the effect was caused by herd immunity, since vaccinated infants were more likely to be surrounded by other vaccinated individuals.
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【Effectiveness of Early Measles, Mumps, and Rubella Vaccination Among 6-14-Month-Old Infants During an Epidemic in the Netherlands: An Observational Cohort Study.].
【在荷兰流行期间6-14个月大的婴儿中进行早期麻疹，腮腺炎和风疹疫苗接种的有效性：一项观察性队列研究。】
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DOI：10.1093/infdis/jiw586文章类型：杂志文章
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背景：在荷兰，常规的第一个麻疹，腮腺炎和风疹（MMR）疫苗剂量是在14个月大时接种的。然而，在2013-2014年的麻疹流行期间，还向市镇6-14个月大的婴儿提供了MMR疫苗接种，接种率不到90％。我们研究了早期MMR疫苗接种计划的有效性。
方法：要求所有接受早期MMR疫苗接种的婴儿的父母参加。当父母怀疑麻疹时，对婴儿的唾液进行麻疹特异性抗体检测。使用Cox回归评估了针对实验室确诊和自行报告的麻疹的疫苗效力（VE），计算得出的VE为1减去危险比。
结果：分别在106631和23769天的观察时间内发生了3例疫苗接种和10例未经实验室确认的疫苗接种病例。针对实验室确认的麻疹的未经调整的VE为94％（95％置信区间[CI]，79％-98％）。在对宗教和兄弟姐妹的疫苗接种状况进行调整之后，VE降至71％（-72％-95％）。对于自我报告的麻疹，未经调整和调整的VE分别为67％（40％-82％）和43％（-12％-71％）。
结论：在6至14个月大的年龄中接种疫苗的婴儿比未接种疫苗的婴儿患麻疹的风险更低。但是，部分影响是由于牛群免疫引起的，因为接种疫苗的婴儿更有可能被其他接种疫苗的个体包围。
方法：要求所有接受早期MMR疫苗接种的婴儿的父母参加。当父母怀疑麻疹时，对婴儿的唾液进行麻疹特异性抗体检测。使用Cox回归评估了针对实验室确诊和自行报告的麻疹的疫苗效力（VE），计算得出的VE为1减去危险比。
结果：分别在106631和23769天的观察时间内发生了3例疫苗接种和10例未经实验室确认的疫苗接种病例。针对实验室确认的麻疹的未经调整的VE为94％（95％置信区间[CI]，79％-98％）。在对宗教和兄弟姐妹的疫苗接种状况进行调整之后，VE降至71％（-72％-95％）。对于自我报告的麻疹，未经调整和调整的VE分别为67％（40％-82％）和43％（-12％-71％）。
结论：在6至14个月大的年龄中接种疫苗的婴儿比未接种疫苗的婴儿患麻疹的风险更低。但是，部分影响是由于牛群免疫引起的，因为接种疫苗的婴儿更有可能被其他接种疫苗的个体包围。
