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Article(id=1321169855848497483, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321169839390053177, articleNumber=null, orderNo=null, doi=10.11847/zgggws1145734, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1723996800000, receivedDateStr=2024-08-19, revisedDate=1734278400000, revisedDateStr=2024-12-16, acceptedDate=1744732800000, acceptedDateStr=2025-04-16, onlineDate=1792921039783, onlineDateStr=2026-10-25, pubDate=1749484800000, pubDateStr=2025-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792921039783, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792921039783, creator=13701087609, updateTime=1792921039783, updator=13701087609, issue=Issue{id=1321169839390053177, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='6', pageStart='641', pageEnd='768', issueExtLink='null', onlineDate='null', pubDate='1749484800000', pubDateStr='2025-06-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792921035859, creator='13701087609', updateTime=1792921035859, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=661, endPage=665, ext={EN=ArticleExt(id=1321169856121127244, articleId=1321169855848497483, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=The timely vaccination rate of pertussis-containing vaccines among children born in Henan province from 2012 to 2021: a surveillance data analysis, columnId=1321169841071969084, journalTitle=Chinese Journal of Public Health, columnName=Special Report – Focusing on Child Health and Development, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the timeliness of pertussis-containing vaccine (PCV) uptake among children born in Henan province from 2012 to 2021 and to provide a basis for pertussis prevention and control.

Methods

PCV uptake information from 2012 to 2021 was collected through the Henan Provincial Immunization Program Information Management System, and the timely vaccination rate of PCVs in Henan province was descriptively analyzed.

Results

A total of 14 890 226 children were born in Henan province from 2012 to 2021. The average PCV uptake rate gradually increased from 93.92% in 2012 to 98.82% in 2021, and has remained above 98% since 2016. The overall PCV uptake rate from 2012 to 2021 decreased with increasing doses, with rates of 97.32%, 96.82%, 96.46%, and 94.62% for the first to fourth doses, respectively. The timely PCV uptake rate within one month from 2012 to 2021 also gradually decreased with increasing doses, with rates of 81.26%, 68.43%, 54.83%, and 42.74% for the first to fourth doses, respectively. The non-National Immunization Program (NIP) vaccine replacement rate for PCV doses 1 to 4 ranged from 0.60% to 21.95%, 0.50% to 21.80%, 0.57% to 21.48%, and 0.47% to 20.77%, respectively.

Conclusions

The PCV uptake rate in Henan province has remained stable at a high level for a long time, but the timely vaccination rate, especially for the third and fourth doses, needs to be further improved. Increasing the timely PCV uptake rate will be an important measure for effective pertussis control.

, authors=Changshuang WANG, Yiran BAI, Yan WANG, Jun LI, Zhanpei XIAO, Yating MA, Mingyu ZHANG, Mingxia LU, Yanyang ZHANG, authorsList=Changshuang WANG, Yiran BAI, Yan WANG, Jun LI, Zhanpei XIAO, Yating MA, Mingyu ZHANG, Mingxia LU, Yanyang ZHANG, authorCompany=null, correspAuthors=Yanyang ZHANG, authorNote=null, correspAuthorsNote=
ZHANG Yanyang, E-mail:
, copyrightStatement=Copyright © 2025 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1321169856913850703, articleId=1321169855848497483, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=河南省2012—2021年出生儿童含百日咳成分疫苗预防接种及时率分析, columnId=1321169841432679230, journalTitle=中国公共卫生, columnName=专题报道 —— 关注儿童健康成长, runingTitle=null, highlight=null, articleAbstract=
目的

分析河南省2012—2021年出生儿童含百日咳成分疫苗接种的及时性，为百日咳疫情防控提供依据。

方法

通过河南省免疫规划信息管理系统收集2012—2021年含百日咳成分的疫苗接种信息，描述性分析河南省含百日咳成分疫苗的及时接种率。

结果

2012—2021年河南省共出生14 890 226名儿童，2012—2021年含百日咳成分疫苗平均接种率逐步提高，从2012年的93.92%上升到2021年的98.82%，从2016年开始平均接种率持续维持在98%以上。2012—2021年含百日咳成分疫苗的合计接种率随着接种剂次的增加而下降，第1至第4剂次的接种率分别为97.32%、96.82%、96.46%和94.62%。2012—2021年含百日咳成分疫苗1个月内及时接种率随着接种剂次的增加逐渐下降，第1至第4剂次的1个月内及时接种率分别为81.26%、68.43%、54.83%和42.74%。2012—2021年含百日咳成分疫苗第1剂次非免疫规划疫苗替代率为0.60%～21.95%；第2剂次为0.50%～21.80%；第3剂次为0.57%～21.48%；第4剂次为0.47%～20.77%。

结论

河南省含百日咳成分疫苗接种率长期稳定维持在较高水平，但及时接种率尤其是第3剂次与第4剂次亟待进一步提升；提升含百日咳成分疫苗的及时接种率将是实现百日咳有效控制的重要手段。

, authors=王长双, 白祎然, 王燕, 李军, 肖占沛, 马雅婷, 张明瑜, 路明霞, 张延炀*, *, authorsList=王长双, 白祎然, 王燕, 李军, 肖占沛, 马雅婷, 张明瑜, 路明霞, 张延炀, authorCompany=null, correspAuthors=张延炀, authorNote=

王长双（1984—），副主任医师，研究方向：疫苗免疫预防与规划

, correspAuthorsNote=
张延炀，E-mail：
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Vaccine, 2017, 35(1): 177-183., articleTitle=null, refAbstract=null), Reference(id=1321169862727156135, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169855848497483, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=22, rfOrder=21, authorNames=null, journalName=null, refType=null, unstructuredReference=谢超, 赖智维, 刘雨阳, 等. 基于湖南省免疫规划综合信息平台分析2020—2022年出生儿童部分国家免疫规划疫苗接种率[J]. 中国疫苗和免疫, 2023, 29(6): 674-679., articleTitle=null, refAbstract=null), Reference(id=1321169862798459304, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169855848497483, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=23, rfOrder=22, authorNames=null, journalName=null, refType=null, unstructuredReference=于静, 汤奋扬, 汪志国, 等. 2021年江苏省0~6岁儿童出生队列DTaP-IPV/Hib五联疫苗接种率评价[J]. 现代预防医学, 2022, 49(23): 4385-4389., articleTitle=null, refAbstract=null), Reference(id=1321169862873956777, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169855848497483, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=24, rfOrder=23, authorNames=null, journalName=null, refType=null, unstructuredReference=纪文艳, 虞睿, 苗良, 等. 北京市3岁前儿童非免疫规划疫苗接种状况与趋势研究[J]. 首都公共卫生, 2024, 18(2): 65-68., articleTitle=null, refAbstract=null), Reference(id=1321169862953648554, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169855848497483, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=25, rfOrder=24, authorNames=null, journalName=null, refType=null, unstructuredReference=王琴, 陈俊磊, 潘伟毅. 2014—2020年福建省非免疫规划疫苗使用情况监测分析[J]. 中国生物制品学杂志, 2023, 36(7): 815-819., articleTitle=null, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1321169857152926032, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169855848497483, xref=null, ext=[AuthorCompanyExt(id=1321169857165508945, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169855848497483, companyId=1321169857152926032, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Institute of Immunization and Planning, Henan Provincial Center for Disease Control and Prevention, Zhengzhou, Henan 450016, China), AuthorCompanyExt(id=1321169857178091858, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169855848497483, companyId=1321169857152926032, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=河南省疾病预防控制中心免疫预防与规划所，郑州 450016)])], figs=[ArticleFig(id=1321169860512563595, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169855848497483, language=EN, label=Fig.1, caption=Timely vaccination coverage with different doses of pertussis-containing vaccines among children born in Henan province from 2012 to 2021 (%), figureFileSmall=TEIOvoUpLK8PvWhiaohPeQ==, figureFileBig=6hGP3TauKVD4hyk4/pAj3g==, tableContent=null), ArticleFig(id=1321169860592255372, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169855848497483, language=CN, label=图1, caption=2012—2021年河南省出生儿童含百日咳成分疫苗不同剂次及时接种率（%）, figureFileSmall=TEIOvoUpLK8PvWhiaohPeQ==, figureFileBig=6hGP3TauKVD4hyk4/pAj3g==, tableContent=null), ArticleFig(id=1321169860814553485, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169855848497483, language=EN, label=Tab.1, caption=

Pertussis-containing vaccine coverage rates in Henan province from 2012 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
出生年份应种数/人第1剂次第2剂次第3剂次第4剂次平均接种率/%
实种数/人接种率/%实种数/人接种率/%实种数/人接种率/%实种数/人接种率/%
20121 959 2341 869 40395.411 854 22594.641 844 04094.121 792 74891.5093.92
20131 845 0511 728 21193.671 715 11592.961 706 07192.471 655 96989.7592.21
20141 838 0161 762 44695.891 749 73295.201 740 79094.711 693 06992.1194.48
20151 589 0831 536 00096.661 524 99295.971 517 32595.481 482 09093.2795.34
20161 691 6861 674 00598.951 668 41498.621 663 84598.351 638 63596.8698.20
20171 497 8041 486 08499.221 482 77799.001 480 02398.811 462 23597.6398.66
20181 304 7131 293 56199.151 289 89898.861 287 32298.671 275 04697.7398.60
20191 242 2621 230 74499.071 226 77098.751 224 06898.541 214 33497.7598.53
20201 026 1901 018 91299.291 015 92299.001 013 26098.741 000 91797.5498.64
2021896 187891 94899.53889 58399.26887 00698.98873 77797.5098.82
合计14 890 22614 491 31497.3214 417 42896.8214 363 75096.4614 088 82094.6296.31
), ArticleFig(id=1321169860927799694, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169855848497483, language=CN, label=表1, caption=

河南省2012—2021年含百日咳成分疫苗接种率

, figureFileSmall=null, figureFileBig=null, tableContent=
出生年份应种数/人第1剂次第2剂次第3剂次第4剂次平均接种率/%
实种数/人接种率/%实种数/人接种率/%实种数/人接种率/%实种数/人接种率/%
20121 959 2341 869 40395.411 854 22594.641 844 04094.121 792 74891.5093.92
20131 845 0511 728 21193.671 715 11592.961 706 07192.471 655 96989.7592.21
20141 838 0161 762 44695.891 749 73295.201 740 79094.711 693 06992.1194.48
20151 589 0831 536 00096.661 524 99295.971 517 32595.481 482 09093.2795.34
20161 691 6861 674 00598.951 668 41498.621 663 84598.351 638 63596.8698.20
20171 497 8041 486 08499.221 482 77799.001 480 02398.811 462 23597.6398.66
20181 304 7131 293 56199.151 289 89898.861 287 32298.671 275 04697.7398.60
20191 242 2621 230 74499.071 226 77098.751 224 06898.541 214 33497.7598.53
20201 026 1901 018 91299.291 015 92299.001 013 26098.741 000 91797.5498.64
2021896 187891 94899.53889 58399.26887 00698.98873 77797.5098.82
合计14 890 22614 491 31497.3214 417 42896.8214 363 75096.4614 088 82094.6296.31
), ArticleFig(id=1321169861003297167, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169855848497483, language=EN, label=Tab.2, caption=

Replacement of non-national immunization program vaccines containing pertussis components with national immunization program vaccines in children born in Henan province from 2012 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
出生年份含百日咳成分疫苗第1剂次含百日咳成分疫苗第2剂次含百日咳成分疫苗第3剂次含百日咳成分疫苗第4剂次
接种数/
剂次		替代数/
剂次		替代比例/
%		接种数/
剂次		替代数/
剂次		替代比例/
%		接种数/
剂次		替代数/
剂次		替代比例/
%		接种数/
剂次		替代数/
剂次		替代比例/
%
20121 869 40311 3070.601 854 2259 2250.501 844 04010 4770.571 792 7488 3710.47
20131 728 21116 4850.951 715 11515 6380.911 706 07115 8340.931 655 96914 6630.89
20141 762 44635 5572.021 749 73235 0952.011 740 79033 2901.911 693 06932 9671.95
20151 536 00036 6792.391 524 99236 9972.431 517 32534 4342.271 482 09038 6872.61
20161 674 00568 2134.071 668 41469 0664.141 663 84565 2463.921 638 63572 6404.43
20171 486 08469 5444.681 482 77773 5284.961 480 02367 6864.571 462 23592 5506.33
20181 293 561102 9297.961 289 898105 6838.191 287 32298 6357.661 275 046134 35210.54
20191 230 744147 80712.011 226 770149 53612.191 224 068144 11411.771 214 334182 30215.01
20201 018 912181 10417.771 015 922180 81217.801 013 260177 88317.561 000 917180 61918.05
2021891 948195 82321.95889 583193 96721.80887 006190 57321.48873 777181 47220.77
), ArticleFig(id=1321169861078794640, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169855848497483, language=CN, label=表2, caption=

河南省2012—2021年出生儿童接种含百日咳成分疫苗的非免疫规划疫苗替代情况

, figureFileSmall=null, figureFileBig=null, tableContent=
出生年份含百日咳成分疫苗第1剂次含百日咳成分疫苗第2剂次含百日咳成分疫苗第3剂次含百日咳成分疫苗第4剂次
接种数/
剂次		替代数/
剂次		替代比例/
%		接种数/
剂次		替代数/
剂次		替代比例/
%		接种数/
剂次		替代数/
剂次		替代比例/
%		接种数/
剂次		替代数/
剂次		替代比例/
%
20121 869 40311 3070.601 854 2259 2250.501 844 04010 4770.571 792 7488 3710.47
20131 728 21116 4850.951 715 11515 6380.911 706 07115 8340.931 655 96914 6630.89
20141 762 44635 5572.021 749 73235 0952.011 740 79033 2901.911 693 06932 9671.95
20151 536 00036 6792.391 524 99236 9972.431 517 32534 4342.271 482 09038 6872.61
20161 674 00568 2134.071 668 41469 0664.141 663 84565 2463.921 638 63572 6404.43
20171 486 08469 5444.681 482 77773 5284.961 480 02367 6864.571 462 23592 5506.33
20181 293 561102 9297.961 289 898105 6838.191 287 32298 6357.661 275 046134 35210.54
20191 230 744147 80712.011 226 770149 53612.191 224 068144 11411.771 214 334182 30215.01
20201 018 912181 10417.771 015 922180 81217.801 013 260177 88317.561 000 917180 61918.05
2021891 948195 82321.95889 583193 96721.80887 006190 57321.48873 777181 47220.77
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河南省2012—2021年出生儿童含百日咳成分疫苗预防接种及时率分析
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王长双 , 白祎然 , 王燕 , 李军 , 肖占沛 , 马雅婷 , 张明瑜 , 路明霞 , 张延炀 *, *
中国公共卫生 | 专题报道 —— 关注儿童健康成长 2025,41(6): 661-665
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中国公共卫生 |专题报道 —— 关注儿童健康成长 2025 , 41 (6) : 661 -665
河南省2012—2021年出生儿童含百日咳成分疫苗预防接种及时率分析
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王长双, 白祎然, 王燕, 李军, 肖占沛, 马雅婷, 张明瑜, 路明霞, 张延炀*, *
作者信息
  • 河南省疾病预防控制中心免疫预防与规划所，郑州 450016
通讯作者:
张延炀，E-mail：
作者简介:

王长双（1984—），副主任医师，研究方向：疫苗免疫预防与规划

The timely vaccination rate of pertussis-containing vaccines among children born in Henan province from 2012 to 2021: a surveillance data analysis
Changshuang WANG, Yiran BAI, Yan WANG, Jun LI, Zhanpei XIAO, Yating MA, Mingyu ZHANG, Mingxia LU, Yanyang ZHANG
Affiliations
  • Institute of Immunization and Planning, Henan Provincial Center for Disease Control and Prevention, Zhengzhou, Henan 450016, China
    • Corresponding Author:
    ZHANG Yanyang, E-mail:
出版时间: 2025-06-10 doi: 10.11847/zgggws1145734
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摘要
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目的

分析河南省2012—2021年出生儿童含百日咳成分疫苗接种的及时性，为百日咳疫情防控提供依据。

方法

通过河南省免疫规划信息管理系统收集2012—2021年含百日咳成分的疫苗接种信息，描述性分析河南省含百日咳成分疫苗的及时接种率。

结果

2012—2021年河南省共出生14 890 226名儿童，2012—2021年含百日咳成分疫苗平均接种率逐步提高，从2012年的93.92%上升到2021年的98.82%，从2016年开始平均接种率持续维持在98%以上。2012—2021年含百日咳成分疫苗的合计接种率随着接种剂次的增加而下降，第1至第4剂次的接种率分别为97.32%、96.82%、96.46%和94.62%。2012—2021年含百日咳成分疫苗1个月内及时接种率随着接种剂次的增加逐渐下降，第1至第4剂次的1个月内及时接种率分别为81.26%、68.43%、54.83%和42.74%。2012—2021年含百日咳成分疫苗第1剂次非免疫规划疫苗替代率为0.60%～21.95%；第2剂次为0.50%～21.80%；第3剂次为0.57%～21.48%；第4剂次为0.47%～20.77%。

结论

河南省含百日咳成分疫苗接种率长期稳定维持在较高水平，但及时接种率尤其是第3剂次与第4剂次亟待进一步提升；提升含百日咳成分疫苗的及时接种率将是实现百日咳有效控制的重要手段。

百日咳  /  疫苗  /  接种率  /  及时接种率  /  河南省
Objective

To analyze the timeliness of pertussis-containing vaccine (PCV) uptake among children born in Henan province from 2012 to 2021 and to provide a basis for pertussis prevention and control.

Methods

PCV uptake information from 2012 to 2021 was collected through the Henan Provincial Immunization Program Information Management System, and the timely vaccination rate of PCVs in Henan province was descriptively analyzed.

Results

A total of 14 890 226 children were born in Henan province from 2012 to 2021. The average PCV uptake rate gradually increased from 93.92% in 2012 to 98.82% in 2021, and has remained above 98% since 2016. The overall PCV uptake rate from 2012 to 2021 decreased with increasing doses, with rates of 97.32%, 96.82%, 96.46%, and 94.62% for the first to fourth doses, respectively. The timely PCV uptake rate within one month from 2012 to 2021 also gradually decreased with increasing doses, with rates of 81.26%, 68.43%, 54.83%, and 42.74% for the first to fourth doses, respectively. The non-National Immunization Program (NIP) vaccine replacement rate for PCV doses 1 to 4 ranged from 0.60% to 21.95%, 0.50% to 21.80%, 0.57% to 21.48%, and 0.47% to 20.77%, respectively.

Conclusions

The PCV uptake rate in Henan province has remained stable at a high level for a long time, but the timely vaccination rate, especially for the third and fourth doses, needs to be further improved. Increasing the timely PCV uptake rate will be an important measure for effective pertussis control.

pertussis  /  vaccine  /  vaccination coverage  /  timely vaccination coverage  /  Henan province
王长双, 白祎然, 王燕, 李军, 肖占沛, 马雅婷, 张明瑜, 路明霞, 张延炀. 河南省2012—2021年出生儿童含百日咳成分疫苗预防接种及时率分析. 中国公共卫生, 2025 , 41 (6) : 661 -665 . DOI: 10.11847/zgggws1145734
Changshuang WANG, Yiran BAI, Yan WANG, Jun LI, Zhanpei XIAO, Yating MA, Mingyu ZHANG, Mingxia LU, Yanyang ZHANG. The timely vaccination rate of pertussis-containing vaccines among children born in Henan province from 2012 to 2021: a surveillance data analysis[J]. Chinese Journal of Public Health, 2025 , 41 (6) : 661 -665 . DOI: 10.11847/zgggws1145734
正文
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我国2014—2019年百日咳报告发病率逐年上升，2020—2021年报告发病率有所下降，2022年又回升至2.71/10万，达到1989年以来最高水平[1]。有报道称，国外发达国家百日咳再现由来已久，截至目前百日咳再现的问题在这些发达国家仍未得到有效解决[2–3]。与百日咳发病呈现上升趋势不同的是，近年来我国百白破疫苗4剂次报告接种率均持续维持在98%以上的较高水平[4–5]。疫苗作为预防传染病的重要手段之一，麻疹、流行性脑脊髓炎、流行性乙型脑炎和甲型肝炎等疫苗针对传染病发病率均已降至历史最低水平[6]，百日咳作为一种疫苗可预防传染病，中华预防医学会多次组织专家研讨百日咳流行趋势，认为国内存在百日咳大范围流行或集中暴发以及婴幼儿因百日咳致死增多的潜在风险[3]。河南省2017—2021年百日咳病例平均发病率为0.25/10万，2019年达到了0.55/10万[7]。疫苗作为百日咳最有效的特异性防控措施，本文从疫苗及时接种角度分析了河南省2012—2021年含百日咳成分疫苗接种情况，为制定百日咳防控和疫苗免疫策略提供依据。
1　材料与方法
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1.1　数据来源
检索河南省各预防接种门诊采集并实时上传至省免疫规划管理系统的儿童预防接种个案。基于该系统管理的适龄儿童预防接种数据，统计截止时间为2024年6月25日，儿童出生日期范围为2012年1月1日—2021年12月31日。
1.2　含百日咳成分疫苗接种剂次
含百日咳成分疫苗包括吸附无细胞百白破联合疫苗（DTaP）、无细胞百白破b型流感嗜血杆菌联合疫苗（DTaP-Hib）、吸附无细胞百白破灭活脊髓灰质炎和b型流感嗜血杆菌联合疫苗（DTaP-IPV-Hib）。DTaP接种程序为3月龄、4月龄、5月龄各接种1剂次，每剂次间隔28天，18月龄加强1剂次，与上一剂次间隔至少6个月；DTaP-Hib接种程序为3月龄、4月龄、5月龄各接种1剂次，每剂次间隔1个月，18月龄加强1剂次，与上1剂次间隔至少6个月；DTaP-IPV-Hib接种程序为2月龄、3月龄、4月龄各接种1剂次，每剂次间隔1个月，18月龄加强1剂次，与上1剂次间隔至少6个月。将儿童接种的DTaP、DTaP-Hib与DTaP-IPV-Hib按接种时间先后排序，依次作为含百日咳成分疫苗的接种剂次。
1.3　接种率定义及计算
1.3.1　第1剂次与平均接种率
某年度出生儿童含百日咳成分疫苗第1剂次接种率=（该年度出生的儿童中接种含百日咳成分疫苗第1剂次的儿童数/该年度出生儿童数）×100%。某年度出生儿童含百日咳成分疫苗平均接种率=[该年度出生儿童接种的所有剂次含百日咳成分疫苗数/（该年度出生儿童数×4）]×100%。
1.3.2　及时接种率
根据国家免疫规划疫苗儿童免疫程序及说明（2021年版），儿童在3月龄、4月龄、5月龄、18月龄需各接种1剂DTaP。儿童到达相应剂次应种时间后，在1个月内接种称为1个月内及时接种，1个月内及时接种率=（1个月内及时接种儿童数/应种儿童数）×100%；儿童到达相应剂次应种时间后1～2个月内接种称为1～2个月及时接种，1～2个月及时接种率=（1～2个月及时接种儿童数/应种儿童数）×100%；儿童到达相应剂次应种时间后3～4个月内接种称为3～4个月及时接种，3～4个月及时接种率=（3～4个月及时接种儿童数/应种儿童数）×100%；以此类推。
1.4　非免疫规划疫苗替代
DTaP为免疫规划疫苗，替代含百日咳成分疫苗的非免疫规划疫苗为DTaP-Hib和DTap-IPV-Hib。非免疫规划疫苗替代比例=（相应剂次含百日咳成分的非免疫规划疫苗接种数/相应剂次免疫规划疫苗和非免疫规划疫苗接种数之和）×100%。
1.5　统计分析
使用金山WPS办公软件整理和分析数据，描述性分析河南省2012—2021年出生儿童含百日咳成分疫苗接种率变化趋势、1个月内及时接种率、2～3个月及时接种率等，描述性分析非免疫规划疫苗接种替代比例。
2　结　果
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2.1　总体情况（表1）
2012—2021年河南省共出生14 890 226名儿童，2012—2021年含百日咳成分疫苗平均接种率逐步提高，从2012年的93.92%上升到2021年的98.82%，从2016年开始平均接种率持续维持在98%以上。2012—2021年含百日咳成分疫苗的合计接种率随着接种剂次的增加而下降，第1至第4剂次的接种率分别为97.32%、96.82%、96.46%和94.62%。
2.2　含百日咳成分疫苗及时接种情况（图1）
2012—2021年含百日咳成分疫苗1个月内及时接种率随着接种剂次的增加逐渐下降，第1至第4剂次的1个月内及时接种率分别为81.26%、68.43%、54.83%和42.74%；1～2个月及时接种率随着接种剂次的增加而上升，从第1剂次的12.60%上升至第4剂次的32.68%；3～4个月的及时接种率随着接种剂次的增加而上升，从第1剂次的1.59%上升至第4剂次的8.01%。
2.3　含百日咳成分疫苗的非免疫规划疫苗替代情况（表2）
2012—2021年含百日咳成分疫苗第1剂次非免疫规划疫苗替代比例在0.60%～21.95%；第2剂次在0.50%～21.80%；第3剂次在0.57%～21.48%；第4剂次在0.47%～20.77%。
3　讨　论
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近年来欧美等国家均出现百日咳报告发病数持续增加，甚至多个国家报告了大规模的百日咳暴发疫情[8–10]。中国于20世纪60年代开始接种全细胞百日咳疫苗（DTwP），并于1978年将其纳入免疫规划，百日咳发病率大幅下降，年均报告发病率从疫苗前时代的100/10万～200/10万降至2010年的0.13/10万[11–12]。从2007年起逐步使用DTaP替代DTwP，并于2013年完成替代[13]。2011—2017年监测数据显示，百日咳报告发病率从2013年的0.13/10万上升至2017年的0.75/10万，发病呈上升趋势[14]，甚至2022年上升至2.71/10万，达到1989年以来的最高水平[1]。百日咳疫情的上升已使百日咳成为导致儿童发病和死亡的重要疾病之一[15]。与全国百日咳发病趋势相似，河南省百日咳报告发病率从2009年开始呈现波浪式上升趋势，至2019年已达到0.55/10万[7,16]。2018—2021年中国百日咳的监测发现，年龄别报告发病率以0岁组最高，其中<6月龄约占69%。婴儿年龄越小含百日咳成分疫苗接种剂次越少，如不能提高及时接种率，将无法为儿童提供更有效保护，发生百日咳重症的风险越高[17]。在百白破疫苗覆盖率一直保持在较高水平的情况下，百日咳报告发病率保持多年低水平之后却又重新上升，甚至出现暴发疫情[18]，除了医务人员对百日咳的知晓度和关注度的提高、监测敏感度的提升、PCR等实验室检测技术的应用、部分地区疫苗接种率下降、疫苗保护效果不佳、疫苗接种后保护作用持续时间较短等原因以外[19]，含百日咳成分疫苗及时接种率较低也可能是原因之一。
接种含百日咳成分的疫苗作为预防百日咳最有效的特异性措施，而及时接种含百日咳成分疫苗，提高并保持高水平接种率是预防百日咳最基本的免疫策略[3]。河南省2012—2021年出生儿童含百日咳成分疫苗第1～第4剂次1个月内及时接种率分别为81.26%、68.43%、54.83%和42.74%，随着剂次的增加，1个月内及时接种率迅速下降，相较第1剂次，第4剂次的及时接种率降幅达到38.52个百分点。儿童成长到我国规定的起始接种年龄后，第1剂次含百日咳成分疫苗需要1～2个月的时间接种率即可达到90%以上，第2剂次需要3～4个月，第3剂次需要5～6个月，第4剂次需要>9个月的时间。根据WHO推荐的含百日咳成分疫苗基础免疫接种程序，第1剂最早在6周龄且不晚于8周龄时接种，后续剂次则间隔4～8周，且在6月龄前完成3剂基础免疫[19]。我国含百日咳成分疫苗的接种程序为3、4、5和18月龄各接种1剂次DTaP，比WHO推荐的首针起始接种年龄晚了约48天，在规定的起始接种年龄较WHO更晚的情况下，尽可能地及时和全程接种疫苗才能产生有效的免疫保护。接种第1剂DTaP产生的保护效果约为15%～20%，基础免疫3剂后才能产生有效的保护，接种3剂次无细胞百日咳疫苗的保护效果可达到93%[20–21]，及时且全程接种疫苗是预防百日咳的关键。
河南省自2000年开始实施DTaP替换DTwP工作[16]，含百日咳成分疫苗接种率逐步提升，从2012年的93.92%上升至2021年的98.82%，从2016年开始且始终维持在98%以上的较高水平；2021年出生儿童含百日咳成分疫苗第1～第4剂次接种率均超过98%，高于湖南省2020—2022年无细胞百白破的接种率[22]，也高于全国2021年免疫规划疫苗报告接种率[4]。另外，含百日咳成分的非免疫规划疫苗是免疫规划疫苗的重要补充。对于非免疫规划疫苗，接种门诊在充分告知的前提下，采用DTaP-IPV-Hib和DTaP-Hib替代，可减少疫苗接种次数、节省儿童家长时间和精力，从而一定程度上可以提高接种的依从性[23]，提高疫苗及时接种率。根据监测数据显示，随着出生年份的后移，河南省含百日咳成分的非免疫规划疫苗替代率也逐年升高，尤其是2019年以来，替代率较往年大幅升高，2021年甚至超过了20%，与北京市和福建省的分析结果一致[24–25]。
综上所述，河南省含百日咳成分疫苗接种率2012—2021年一直维持在较高水平，但是及时接种率较低，尤其是第3和第4剂次1个月内的及时接种率均不足60%，第3剂次需要5～6个月、第4剂次需要9个月以上的时间接种率才能达到90%以上。在百日咳疫情持续升高的背景下，接种疫苗作为预防百日咳最有效的特异性措施，在提高并保持高水平含百日咳成分疫苗接种率的基础上，进一步提升及时接种率将是控制百日咳疫情的重要手段。

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2025年第41卷第6期
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doi: 10.11847/zgggws1145734
  • 接收时间：2024-08-19
  • 首发时间：2026-10-25
  • 出版时间：2025-06-10
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  • 收稿日期：2024-08-19
  • 修回日期：2024-12-16
  • 录用日期：2025-04-16
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    河南省疾病预防控制中心免疫预防与规划所，郑州 450016

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张延炀，E-mail：
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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