BACKGROUND:Little is known about the impact of the recent varicella vaccine shortage. To assess the temporal trend in varicella vaccine administration before 18 and 24 months of age in a community cohort of children prior to, during and after the recent varicella vaccine shortage. And to compare the temporal trends in varicella vaccinations to trends of an older, more widely accepted vaccine, the MMR. METHODS:Community population-based birth cohorts were identified who were eligible for the varicella vaccination before, during and after the 2001 to 2002 varicella vaccine shortage. Only children (84% of all) who remained in the community through their second birthday were included. For each child in the cohort, the medical records and immunization registry records from both medical facilities in the county were reviewed to identify the dates and sites for all varicella immunizations given. In addition to varicella immunizations, the dates of all MMR vaccinations were recorded. Additional data abstracted included the child's birth date, gender and dates of any recognized cases of chickenpox up through age 24 months. RESULTS:Of the 2,512 children in the birth cohorts, 50.8% were boys. In the three cohorts combined, 81.1% of the boys and 79.3% of the girls (p = 0.30) received the varicella vaccine by age 24 months. The pre-shortage community rate of varicella immunization was 79.7% by 24 months of age. During the varicella vaccine shortage, the rate of varicella immunization by 24 months fell to 77.2%. Only 6 additional children received a "catch-up" immunization by 36 months of age. In the post shortage period the community 24-month immunization rate rebounded to a level higher than the pre-shortage rate 84.0%. During the almost three years of observation, the MMR immunization rate by age 24 months was constant (87%). CONCLUSION:The varicella shortage was associated with an immediate drop in the 24-month varicella immunizations rate but rebounded quickly to above pre-shortage rates. In this community the only long term impact of the varicella vaccine shortage may be on the small number of children who still had not received catch-up varicella immunizations by 36 months of age.

译文

背景:对最近水痘疫苗短缺的影响知之甚少。在最近的水痘疫苗短缺之前,期间和之后,评估社区队列中儿童在18和24个月大之前接种水痘疫苗的时间趋势。并将水痘疫苗接种的时间趋势与较旧的,被更广泛接受的疫苗MMR的趋势进行比较。
方法:确定2001年至2002年水痘疫苗短缺之前,之中和之后有水痘疫苗接种资格的以社区人群为基础的出生队列。仅包括直到第二个生日仍留在社区中的儿童(占总数的84%)。对于该队列中的每个孩子,都检查了县内两个医疗机构的病历和免疫登记记录,以确定所有水痘疫苗接种的日期和地点。除水痘疫苗接种外,还记录了所有MMR疫苗接种的日期。提取的其他数据包括孩子的出生日期,性别以及直至24个月的任何公认的水痘病例的日期。
结果:在出生队列的2,512名儿童中,男孩占50.8%。在这三个队列中,到24个月大时,有81.1%的男孩和79.3%的女孩(p = 0.30)接受了水痘疫苗。到24个月大时,水痘疫苗的短缺前社区接种率为79.7%。在水痘疫苗短缺期间,水痘疫苗的免疫率在24个月内下降到77.2%。到36个月大时,仅再有6名儿童接受了“追赶”免疫。在短缺后时期,社区24个月的免疫接种率反弹到高于短缺前84.0%的水平。在将近三年的观察中,到24个月大时的MMR免疫率是恒定的(87%)。
结论:水痘短缺与24个月水痘疫苗接种率立即下降有关,但迅速反弹至短缺前水平。在这个社区中,水痘疫苗短缺的唯一长期影响可能是对仍在36个月大时仍未接受追赶水痘免疫接种的少数儿童。

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