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The Delta variant of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has caused a new global wave of the Coronavirus Disease 2019 (COVID-19) pandemic. COVID-19 vaccines currently available in China show high effectiveness against severe illness and death. However, transmission of the virus is not fully stopped by vaccination alone, therefore, integrated vaccination and non-pharmacological interventions is necessary to prevent and control the epidemic in the near future. Further expanded vaccine coverage of primary doses as well as booster shots in China's domestic population are needed to reduce severe illness and death. In order to provide evidence necessary for adjusting and optimizing immunization strategies and pandemic control measures, it is essential to conduct research on vaccine effectiveness against emerging variants, persistence of vaccine-induced protection, surveillance of adverse event following immunization with large-scale vaccine use, and modelling studies on strategic combinations of vaccination and non-pharmacological interventions.
Subject(s)
Humans , COVID-19 , COVID-19 Vaccines , China , Immunization, Secondary , SARS-CoV-2 , Vaccination , Vaccine EfficacyABSTRACT
In December 2019, novel coronavirus pneumonia epidemic occurred in Wuhan, Hubei Province, and spread rapidly across the country. In the early stages of the epidemic, China adopted the containment strategy and implemented a series of core measures around this strategic point, including social mobilization, strengthening case isolation and close contacts tracking management, blocking epidemic areas and traffic control to reduce personnel movements and increase social distance, environmental measures and personal protection, with a view to controlling the epidemic as soon as possible in limited areas such as Wuhan. This article summarizes the background, key points and core measures in the country and provinces. It sent prospects for future prevention and control strategies.
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@#In December 2019, novel coronavirus pneumonia epidemic occurred in Wuhan, Hubei Province, and spread rapidly across the country. In the early stages of the epidemic, China adopted the containment strategy and implemented a series of core measures around this strategic point, including social mobilization, strengthening case isolation and close contacts tracking management, blocking epidemic areas and traffic control to reduce personnel movements and increase social distance, environmental measures and personal protection, with a view to controlling the epidemic as soon as possible in limited areas such as Wuhan. This article summarizes the background, key points and core measures in the country and provinces. It sent prospects for future prevention and control strategies.
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Objectives@#To explore acute meningitis and encephalitis syndrome (AMES) surveillance in 4 China prefectures, to understand the epidemiological features and disease burden of neisseria meningitides (Nm) meningitis, streptococcus pneumoniae (Sp) meningitis, haemophilus influenza type b (Hib) meningitis and Japanese encephalitis and provide evidence for related disease prevention and control.@*Methods@#AMES surveillance were conducted in Jinan, Shandong Province and Yichang, Hubei Province in September 2006, and in 13 districts of Shijiazhuang, Hebei Province and Guigang City, Guangxi Zhuang Autonomous Region in April 2007. Six hospitals in each city were selected as monitoring pilot hospitals to carry out reports of suspected cases of acute meningitis and encephalitis, case investigation, blood specimens and cerebrospinal fluid specimen collection, anti-JEV IgM antibody enzyme-linked immunosorbent assay, Nm, Sp and Hib culture and polymerase chain reaction detection, etc. According to the age group, the incidence of bacterial meningitis and Japanese encephalitis in local residents <20 years old was estimated.@*Results@#From 2006 to 2013, a total of 19 423 surveillance cases were reported in four cities, of which 11 071 (56.99%) were reported in the pilot hospitals. Of the 11 071 cases, 5 315 were tested for bacteriology and 9 180 were tested for anti-JEV IgM antibodies. Among the bacteriological tests, 176 cases were positive, including 75 cases of Nm positive, 91 cases of Sp positive and 10 cases of Hib positive. The incidence of three bacterial meningitis is estimated for people under 20 years old, with estimated incidence of Nm, Sp and Hib meningitis in children <5 years old was 0.46/100 000-0.71/100 000, 0.34/100 000-0.83/100 000 and 0.32/100 000-0.57/100 000 respectively; the estimated incidence of Nm and Sp meningitis in children aged 5-9 years was 0.59/100 000-1.14/100 000 and 0.50/100 000-1.66/100 000 respectively. In 732 cases of positive JE cases, the positive detection rates of <5 years old, 40-49 years old and ≥50 years old were 9.51% (95/999), 28.09% (66/235) and 33.85% (130/384), respectively. The estimated annual incidence rate of JE was 0.12/100 000-0.79/100 000.ratio of cases 1.19∶1. Most of cases (27.30%) were children and adolescents aged 5-14 years and those (26.84%) aged over 45 year.@*Conclusion@#The study found that primary and secondary school students are the key population of Nm meningitis, suggesting that it is necessary to explore the enhanced immunization study of meningococcal vaccine in this population; Sp has the possibility of occurrence in all age groups; <5 years old children are the main population of Hib meningitis.
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Objective@#To analyze the characteristics of epidemiology and neisseria meningitidis (Nm) serogroups distribution for meningococcal meningitis (MM) cases in China from 2015 to 2017.@*Methods@#The data of MM cases were collected from National Notifiable Diseases Registry System (NNDRS) and case-based MM surveillance system (MMSS) from 2015 to 2017; Demographic data are from the National Bureau of statistics. Inclusion criteria: the date of onset was January 1, 2015 to December 31, 2017, the status of infectious disease report card was "final examination card", the cases are classified as "laboratory confirmed cases" and "clinical diagnostic cases", and the card data information of disease name was "Meningococcal meningitis". According to the Diagnostic Criteria for Meningococcal meningitis (WS295-2008), laboratory confirm was made for reported cases or clinically diagnosed cases of meningococcal meningitis.@*Results@#From 2015 to 2017, a total of 325 MM cases were reported in China, with an average annual incidence of 0.007 9 per 100 000 population. And 148 cases were laboratory confirmed. There were 3, 15, 12, 5, 2 and 18 provinces which were reported serogroup A, B, C, W, Y, Others and NG MM Cases, respectively. Except for Tibet and Hainan, other provinces have reported group A cases; The provinces reporting group B, C, W and Y cases increased by 9, 11, 13 and 2 provinces in 2007, respectively compared with 2005. Serogroup B was the primary reason causing the cases of <1 year old and 1-6 years old children; and in this age group, 51.43% (18 cases) and 68.18% (15 cases) of group B were accounted for in laboratory confirmed, respectively; Serogroup C, others and NG was the major reason in the cases of 7-12 and >12 years old students and adults: 33.33% (5 cases) and 26.32% (20 cases) of group C were accounted for in laboratory confirmed respectively, then 26.67% (4 cases) and 34.21% (26 cases) of group others and NG were accounted for respectively; 2 cases of serogroup Y were all >12 years old.@*Conclusion@#The epidemic serogroup of Nm caused MM cases showed a diversifying trend. To develop and provide new vaccines for serogroup B and other bacteria groups should be one of the important tasks for MM control and prevention in the future.
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Objective@#To analyze the changing epidemiological characteristics of hepatitis E cases in China, in order to promote in preventing and controlling hepatitis E.@*Methods@#Data of hepatitis E and outbreaks reported through national notifiable diseases reporting system were analyzed from 2004 to 2017, but data of Hongkong, Macau and Taiwan were not included. Data of hepatitis E were divided into three phases as 2004-2007, 2008-2011 and 2012-2017, representing eight years before, four years before and years after the postmarketing of hepatitis E vaccine. Linear regression was used for analyzing the trend of hepatitis E, improved muster method was used for analyzing the seasonal intensity.@*Results@#From 2004 to 2017, 329 519 hepatitis E cases were reported and the annual incidence were increasing from 1.27/100 000 to 2.10/100 000 (t=6.87, P<0.001). The concentrations of hepatitis E during 2004-2007, 2008-2011 and 2012-2017 were 17.43, 16.06, 11.17, respectively, with low seasonal intensity. Number of cases reported by Jiangsu, Guangdong and Zhejiang accounted for 31.54% of national cases. The incidence were lower in central (1.45/100 000) and western (1.11/100 000) region than that in eastern region (2.67/100 000), but were increasing continuously. There was an increasing trend of incidence with growing ages (t=7.85, P<0.001). The incidence was higher than 2/100 000 among cases aged ≥40, and was the highest (5.22/100 000) in the age group of 65-69 years old. Farmers, retired persons, houseworkers and unemployees accounted for 67.46% of total cases. A total of 7 outbreaks were reported, among which 3 were in nursing homes.@*Conclusion@#The incidence of hepatitis E in central and western regions were increasing continuously and the surveillance should be strengthened. There was higher risk among middle-aged population, farmers and nursing homes, so strategy for immunization among those population was in great need.
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Post-traumatic tetanus is the main type of non-neonatal tetanus. To reduce the incidence and mortality rate of tetanus and guide the primary medical institutions to prevent and control tetanus after trauma, National Immunization Planning Technical Working Group of the Chinese Center for Disease Control and Prevention has compiled this document in the reference with Position Paper by World Health Organization, the latest research progress from home and abroad. The guidelines focus on the basic procedures for the prevention and disposition of post-traumatic tetanus, the application of tetanus vaccines and immune preparation, and the pre-exposure immunization in high-risk populations of trauma.
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Objective Through analyzing the epidemiological characteristics of hepatitis A and E and the situation of vaccination,to promote the recommendation profile on Hepatitis E vaccination program,in China.Methods Three phases of time span were divided as 2004-2007,2008-2011 and 2012-2015,with age groups divided as ＜20,20-29,30-39 and ≥40.Incidence rates in both different phases and age groups were compared.Numbers of Hepatitis A and E vaccines released and used,were described.Results Between 2004 and 2015,a declining trend in the reported incidence of hepatitis A (t=-12.15,P＜0.001),but an increasing trend in hepatitis E (t=6.63,P＜0.00l) were noticed.The mean number of hepatitis A cases declined from 6 515 to 1 986 between 2004 and 2007 while the number of hepatitis E cases increased from 1 491 to 2 277 between 2012 and 2015.The peaks of hepatitis E appeared persistent annually,in March.The incidence of hepatitis A declined in three regions,with the western region (3.46/100 000) much higher than the eastern (1.13/100 000) or central regions (1.14/100 000) (x2=32 630,P＜0.01).The incidence of hepatitis E increased both in the central (1.74/100 000) and western regions (1.58/100 000),but more in the eastern region (2.66/100 000) (x2=6 009,P ＜ 0.01).Incidence of hepatitis A declined in all age groups and declined by 84.36％ among the 0-19 group.However,the incidence of hepatitis E showed an increasing trend among the ≥20 group.Incidence rates appeared higher in the older age groups.The coverage of hepatitis A vaccine increased from 62.05％ to 93.54％,but with a negative association seen between the coverage of Hepatitis A vaccine and the incidence (F=10.69,x2＜0.05).Conclusion The incidence of Hepatitis A declined sharply in China while hepatitis E was still increasing from 2004to 2015,calling for the expansion on the coverage of Hepatitis E vaccine in the whole population.
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Objective Through analyzing the epidemiological characteristics of hepatitis A and E and the situation of vaccination,to promote the recommendation profile on Hepatitis E vaccination program,in China.Methods Three phases of time span were divided as 2004-2007,2008-2011 and 2012-2015,with age groups divided as ＜20,20-29,30-39 and ≥40.Incidence rates in both different phases and age groups were compared.Numbers of Hepatitis A and E vaccines released and used,were described.Results Between 2004 and 2015,a declining trend in the reported incidence of hepatitis A (t=-12.15,P＜0.001),but an increasing trend in hepatitis E (t=6.63,P＜0.00l) were noticed.The mean number of hepatitis A cases declined from 6 515 to 1 986 between 2004 and 2007 while the number of hepatitis E cases increased from 1 491 to 2 277 between 2012 and 2015.The peaks of hepatitis E appeared persistent annually,in March.The incidence of hepatitis A declined in three regions,with the western region (3.46/100 000) much higher than the eastern (1.13/100 000) or central regions (1.14/100 000) (x2=32 630,P＜0.01).The incidence of hepatitis E increased both in the central (1.74/100 000) and western regions (1.58/100 000),but more in the eastern region (2.66/100 000) (x2=6 009,P ＜ 0.01).Incidence of hepatitis A declined in all age groups and declined by 84.36％ among the 0-19 group.However,the incidence of hepatitis E showed an increasing trend among the ≥20 group.Incidence rates appeared higher in the older age groups.The coverage of hepatitis A vaccine increased from 62.05％ to 93.54％,but with a negative association seen between the coverage of Hepatitis A vaccine and the incidence (F=10.69,x2＜0.05).Conclusion The incidence of Hepatitis A declined sharply in China while hepatitis E was still increasing from 2004to 2015,calling for the expansion on the coverage of Hepatitis E vaccine in the whole population.
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Objective@#To analyze the epidemiological characteristics of hepatitis A cases in China from 2004 to 2015.@*Methods@#Data of hepatitis A were reported through national notifiable disease information reporting system, which covered the 31 provinces (Hong Kong, Macau and Taiwan excluded). The inclusion criteria was: date of illness onset was between January 1st 2004 and December 31st 2015, the status of reported card was confirmed, the case was classified as laboratory confirmed or clinical diagnosed, the disease was Hepatitis A. The information such as sex, date of birth, date of illness onset, place of residence was collected. The data was divided into three phases, 2004-2007, 2008-2011, 2012-2015, which represented the phase before expanded program on immunization (EPI), first 4 years after EPI, second 4 years after EPI.@*Results@#From 2004 to 2015, there were totally 574 697 hepatitis A cases in China, the mean annual incidence was 3.62/100 000. The risk ratio of hepatitis A in 2015 was 0.23 when compared with 2004. Sichuan, Xinjiang and Yunnan contributed to 27.27% of the total cases in China. In 2012-2015, the incidence of western (3.46/100 000) region was significantly higher than that in central (1.21/100 000) and eastern (1.08/100 000) regions. From 2004-2015, number of cases in each age group declined greatly, with number of cases declining from 43 711 to 5 938 in the age group of 5-9 years, from 29 722 to 3 438 in 10-14, from 23 212 to 3 646 in 15-19. The number of cases declined from 24 079 to 10 304 in the age group of 0-4 (declined by 57.21%), but in 2012-2015, the incidence of 0-4 age group was still the highest, with 77.72% cases in Xinjiang and Sichuan. Famers, students and scattered children accounted for 69.95% of total cases, with student cases declined from 24.08% (2004-2007) to 8.67% (2012-2015).@*Conclusion@#The incidence of hepatitis A in China is decreasing year by year, the risk has been decreasing to a relatively low level. However, in western regions and children under age five, the risk is still high. Precision intervention is needed for further prevention and control of hepatitis A.
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Objectives To summary and compare the different seroconversion rates after the primary vaccination for the Japanese encephalitis (JE),and to evaluate the serological effect of 3 kinds of JE vaccines.Method Searching "CHKD","Wanfang" database and "EMCC" databases,the studies of the immunogenicity after the primary JEV vaccination,all randomized controlled trials or non-randomized controlled trials were included,and statistical analysis were made by RevMan 4.2.10 software.Results A total of 12 literatures were included,7 studies had control groups.The seroconversion rates after the primary vaccination,JEV-L,JEV-I (Vero) and JEV-I(PHK),were 86% (95% CI:80% ～ 91%),83% (95% CI:72% ～ 94%) and 64% (95% CI:58% ～ 69%) respectively.Comparing the seroconversion rates of the 3 kinds of vaccines after primary immunization,the rate of JEV-I (Vero) was significantly higher than the rate of JEVI(PHK),other comparisons were no significant difference.Conclusion The serological effects of JEV-L and JEV-I (Vero) after the primary vaccination were higher than that of JEV-I (PHK).
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Objective To analyze the prevalence season and trend of meningococcal disease in China by epidemic years from 2004 to 2008 in order to provide scientific basis for making strategies of meningococcal disease prevention and control.Methods The incidence numbers of meningococcal disease were calculated by weeks,epidemic years and areas.The seasonality and prevalence trends of meningococcal disease were analyzed by circular distribution.Results The incidence trend of meningococcal disease had obvious seasonality in China (P