Analysis of the direct economic burden of measles cases and its influencing factors in Shanghai from 2017 to 2019 / 中华预防医学杂志

Objective: To analyze the direct economic burden caused by measles cases in Shanghai from 2017 to 2019 and its influencing factors. Methods: A total of 161 laboratory-confirmed measles cases reported from January 1, 2017, to December 31, 2019, in Shanghai were included in the study through the "Measles Surveillance Information Reporting and Management System" of the "China Disease Surveillance Information Reporting and Management System". Through telephone follow-up and consulting hospital data, the basic information of population, medical treatment situation, medical treatment costs and other information were collected, and the direct economic burden of cases was calculated, including registration fees, examination fees, hospitalization fees, medical fees and other disease treatment expenses, as well as transportation and other expenses of cases. The multiple linear regression model was used to analyze the main influencing factors of the direct economic burden. Results: The age of 161 measles cases M (Q1, Q3) was 28.21 (13.33, 37.00) years. Male cases (56.52%) were more than female cases (43.48%). The largest number of cases was≥18 years old (70.81%). The total direct economic burden of 161 measles cases was 540 851.14 yuan, and the per capita direct economic burden was 3 359.32 yuan. The direct economic burden M (Q1, Q3) was 873.00 (245.01, 4 014.79) yuan per person. The results of multiple linear regression model analysis showed that compared with other and unknown occupations, central areas and non-hospitalized cases, the direct economic burden of measles cases was higher in scattered children, childcare children, students, and cadre staff in the occupational distribution, suburban areas and hospitalized, with the coefficient of β (95%CI) values of 0.388 (0.150-0.627), 0.297 (0.025-0.569), 0.327 (0.148-0.506) and 1.031 (0.853-1.209), respectively (all P values<0.05). Conclusion: The direct economic burden of some measles cases in Shanghai is relatively high. Occupation, area of residence and hospitalization are the main factors influencing the direct economic burden of measles cases.

Proportion and rate: connotation and understanding route / 中华流行病学杂志

Proportion and rate have multiple and overlapping meanings, which blur their concepts. Based on the existence of the states and the occurrence of the events and their measuring process, we first put forward the concept of "cumulative number of states in point time". Considering the general meaning of "rate" in mathematics and the units of the elements in indexes, this paper puts forward the concept of "the change of cumulative number of states in point time", which is equal to the commonly acknowledged concept "number of incident event within observation period" or "absolute rate", and further constructs relative rate and proportion. Proportions can be classified into three types: time-point (or rate-type) constitutional proportion, time-period incidence proportion and their synthesis, time-period constitutional proportion. The essential difference between relative rate and time-period proportions is whether the observation period is regarded as a one-unit-length fixed period which would be further moved to the description of the indexes. Furthermore, the sources populations of relative rate and proportions are exclusively those at the beginning of the observation period. Thus, we established a unified identification route about ratios, proportions, and rates, the basic indicators of categorical data in populations. These are applicable to both fixed and dynamic populations. The paper aims to clarify the connotation of the indexes and the feasible understanding route and provide some reference for the population researchers.

Consideration on implementation of co-administration of Seasonal Influenza and COVID-19 vaccines during pandemic in China / 中华预防医学杂志

Influenza is an infectious respiratory disease caused by the influenza viruses. Older people, infants and people with underlying medical conditions could have a higher risk of severe influenza symptoms and complications. The co-infection of Coronavirus Diseases 2019 (COVID-19) with influenza viruses could lead to the complication of prevention, diagnosis, control, treatment, and recovery of COVID-19. Influenza vaccine and COVID-19 vaccine overlapped in target populations, vaccination time, and inoculation units. Although there was insufficient evidence on the immunogenicity and safety of co-administration of influenza vaccine and COVID-19 vaccine, World Health Organization and some countries recommended co-administration of inactivated influenza vaccine and COVID-19 vaccine. This review summarized domestic and international vaccination policies and research progress, and put forward corresponding suggestions in order to provide scientific support for the formulation of vaccination strategy on seasonal influenza vaccine and COVID-19 vaccine.

Pneumonia vaccination followed by death due to Guillain-Barré syndrome: a case report / 上海预防医学

A case report of pneumonia vaccination followed by death due to Guillain-Barré syndrome was fully presented and discussed. The association between the vaccination and Guillain-Barré syndrome could not be completely ruled out; however, the diagnosis of coincidental event was preferred, which may provide a reference for future similar case investigation.

Analysis on the suspected adverse events following immunization surveillance reports of pneumonia vaccine in Shanghai， 2010‒2020 / 上海预防医学

Objective:To analyze the collected data of adverse events （AEFI） of pneumonia vaccine in Shanghai from 2010 to 2020，， so as to provide the appropriate immunization strategy and popularization of science for pneumonia vaccine . Methods:the data of suspected adverse events were collected from National AEFI Surveillance System during 2010 to 2020， and the vaccination information of pneumonia vaccine was obtained from Shanghai Vaccination Information System. Descriptive epidemiological method was used to analysis. Results:The total 18 446 AEFI cases were reported in Shanghai from 2010 to 2020， and the incidence rate was 425.0/100 000 doses. The general reactions were reported as 18 003 cases （97.6%）， with 393 cases of abnormal reactions （2.0%）， 57 cases of coincidences （0.3%）， 2 cases of psychogenic reactions （<0.1%） and no vaccine quality accident or vaccination accident was reported. There was no significant difference in the incidence rate between male and female； The incidence rate of AEFI decreased with the age of the old. The incidence rate of 23 valent pneumococcal polysaccharide vaccine （PPV23） AEFI was 476.5/100 000 doses， which was significantly lower than that of other kinds of pneumonia vaccine. The first dose was also significantly higher than that of non-first dose. Conclusion:The various types of pneumonia vaccines being used in Shanghai have high safety.

Epidemiological characteristics of measles complicated with pneumonia cases in Shanghai， 2015‒2020 / 上海预防医学

Objective:To investigate the epidemiological characteristics of measles complicated with pneumonia cases in Shanghai in 2015-2020. Methods:Case information was acquired from the measles surveillance information reporting and management system. Data of complications was recorded according to the medical information of the measles cases. The measles complicated with pneumonia cases were then characterized. Results:From 2015 through 2020， a total of 1 402 measles cases were notified in Shanghai， with an incidence rate of 0.96/100 000. Among them， 104 cases were complicated with pneumonia， with a complication proportion of 7.42%. The annual incidence of measles complicated with pneumonia was determined to be 0.07/100 000. There was no significant difference in the proportion of measles cases complicated with pneumonia across years （P=0.871）. Among the measles cases complicated with pneumonia， 62.5% were children aged 3 years or younger， which differed significantly with those without pneumonia （20.0%） （P<0.001）. Moreover， 64.4% had been to hospital 7-21 days prior to the onset of measles， compared to those without pneumonia （41.8%） （P<0.001）. Highest body temperature and the proportions of coughing， catarrhus， conjunctivitis， Koplik spot and other complications in the measles cases complicated with pneumonia were significantly higher than those in non-complicated cases （P<0.05）. Conclusion:Incidence of measles complicated with pneumonia is positively correlated with the overall incidence of measles. Measles cases complicated with pneumonia are mainly young children， with underlying diseases， and more severe symptoms. Therefore， it is necessary to reduce the overall incidence of measles， and pay attention to the vaccination and routine protection of young children with specific health conditions.

Polio antibody levels in infants during 2015-2016 in Shanghai before and after polio vaccination strategy adjustment / 上海预防医学

Objective To investigate the neutralized antibody level of poliomyelitis among healthy children before and after implementation of the new immunization strategy in Shanghai. Methods The poliomyelitis levels of healthy children were detected by neutralization test of the micro cells. Results The neutralizing antibody positive rates were 100% for polioⅠand polioⅢ before and after implementation of the new immunization strategy.GMTs (geometric mean titers) for polioⅠwere 1:1 047.46 before it, and 1:254.70 after it; those for polio Ⅲ were 1:513.52 before it and 1:185.49 after it. Conclusion The neutralized antibody levels of the poliomyelitis among healthy infants maintain a high level before and after implementing the new immunization strategy in Shanghai.

Status quo analysis on non-immunization program vaccination among children in Shanghai / 上海预防医学

Objective To investigate the status of non-immunization program vaccination among children in Shanghai. Methods Three districts were randomly selected for investigation in Shanghai.In the survey area, probability proportional to size sampling method was used to investigate the vaccination situation of non-immunization program and willingness to accept vaccination service in children aged 0-6 years old. Results A total of 416 children aged 0-6 years and their parents were investigated, 93.27%(388) of children received 1 dose or more of non-immunization program vaccines and 36.54% of children received 5 or more non-immunization program vaccines.The coverage of haemophilus influenzae type b conjugate vaccine, 13-valent pneumococcal conjugate vaccine, enterovirus 71 inactivated vaccine, oral rotavirus vaccine and influenza vaccine were 25.00%, 20.91%, 57.45%, 53.37% and 14.42%, respectively.64.95% of parents decided to vaccinate their children with non-immunization program vaccines because of the recommendation of vaccination staff.And 85.58% of parents requested vaccination staff to inform them or make appointments with non-immunization program vaccination.84.62% of parents could accept the charge for vaccination service. Conclusion In Shanghai, the proportion of children receiving multiple non-immunization program vaccination is relatively low and their parents′ demand for vaccination notification services is high.Vaccination staff should be encouraged to actively provide non-immunization program vaccination services, meeting the diverse needs of the public.

Immunization program vaccination rates compared between field investigation and information system sample survey / 上海预防医学

Objective To assess the accuracy of immunization program vaccination rates through the immunization program information system by comparing immunization program vaccination rates among children between field investigation and information system sample survey in Shanghai. Methods From three districts in Shanghai， samples were stratified and randomly selected.The PPS sampling method (probability proportional to size) was used for 634 children aged 0-6 years for field investigation and 630 children aged 0-6 years were randomly selected for information system sample survey.The immunization program vaccination rates of children surveyed were investigated， statistically analyzed and compared. Results Statistically significant differences (P < 0.05) were found in the age composition and household registration composition of children sampled by the field investigation and information system sample survey.The national immunization program vaccination rate was 99.91% and timely vaccination rate was 94.29% by the field investigation.The national immunization program vaccination rate was 97.49% and timely vaccination rate was 87.90% by the information system sample survey.All 26 doses of immunization program vaccine surveyed had lower rates of coverage and timely vaccination in the information system sample survey than in the field investigation.Eighteen doses of vaccination rates by information system sample survey data were statistically significantly (P < 0.05) lower than those by field investigation and 20 doses of timely vaccination rates by information system sample survey data were statistically significantly (P < 0.05) lower than those by field investigation. Conclusion There are advantages and disadvantages to both field investigation and information system sample survey of immunization program vaccination rates.Field investigation and information system sample survey should be used in combination to evaluate the vaccination rate in future.