Article(id=1320427682421133909, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320427658937225679, articleNumber=null, orderNo=null, doi=10.11847/zgggws1149243, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1762185600000, receivedDateStr=2025-11-04, revisedDate=1771948800000, revisedDateStr=2026-02-25, acceptedDate=1776268800000, acceptedDateStr=2026-04-16, onlineDate=1792744091848, onlineDateStr=2026-10-23, pubDate=1786291200000, pubDateStr=2026-08-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792744091848, onlineIssueDateStr=2026-10-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792744091848, creator=13701087609, updateTime=1792744091848, updator=13701087609, issue=Issue{id=1320427658937225679, tenantId=1146029695717560320, journalId=1319373219989389464, year='2026', volume='42', issue='8', pageStart='897', pageEnd='1024', issueExtLink='null', onlineDate='null', pubDate='1786291200000', pubDateStr='2026-08-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792744086250, creator='13701087609', updateTime=1792747993375, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1320444046678544663, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320427658937225679, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1320444046678544664, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320427658937225679, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=908, endPage=913, ext={EN=ArticleExt(id=1320427682626654806, articleId=1320427682421133909, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Epidemiological characteristics of mumps breakthrough cases and vaccine effectiveness among children born in Shapingba district, Chongqing (2008–2018): a retrospective cohort study, columnId=1320427660187120197, journalTitle=Chinese Journal of Public Health, columnName=Special Report—Evaluating the Protective Effect of Childhood Vaccination, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the epidemiological characteristics of mumps breakthrough cases and evaluate vaccine effectiveness among children born in Shapingba district, Chongqing from 2008 to 2018, thus providing evidence for optimizing mumps immunization strategies and formulating precise prevention and control measures.

Methods

A retrospective cohort study was conducted among children born between January 1, 2008 and December 31, 2018 and residing in Shapingba district. Basic information and vaccination records for mumps-containing vaccine (MuCV) were obtained from the Chongqing Immunization Planning Information Management System. Mumps incidence data were retrieved from the China Information System for Disease Control and Prevention by matching child′s name, date of birth, gender, and current address. Participants were categorized into 1-dose, 2-dose, and 3-dose groups according to MuCV vaccination doses. Follow-up started from the completion date of each dose and ended at either mumps diagnosis or the study cutoff date (December 31, 2023). Person-years were calculated through the exact calculation method to determine incidence density. Univariate Poisson regression was employed to estimate disease risk across groups, while analyzing demographic characteristics, onset time, and time intervals from MuCV vaccination to mumps onset among breakthrough cases.

Results

The total incidence density of mumps breakthrough cases among children born in Shapingba district, Chongqing from 2008 to 2018 was 21.16 per 10 000 person-years (1 149 cases). The overall incidence of breakthrough cases showed a bimodal distribution pattern, with peaks occurring from April to June and in September. The median intervals from MuCV vaccination to disease onset for breakthrough cases in the 1-dose, 2-dose, and 3-dose groups were 36.50 (24.02, 51.09) months, 59.60 (45.37, 74.00) months, and 80.40 (62.22, 97.49) months, respectively, with differences among the groups (H = 89.63, P < 0.001). The total incidence density of breakthrough cases among children who received 1, 2, and 3 doses of MuCV was 24.82, 16.60, and 10.05 per 10 000 person-years, respectively. Children receiving 2-dose MuCV had a 33% reduced risk of mumps breakthrough infection compared to those receiving 1-dose MuCV (VE = 33%, 95%CI: 24%–41%, P < 0.001).

Conclusions

The total incidence density of mumps breakthrough cases was relatively high among children born in Shapingba district, Chongqing from 2008 to 2018, with peak incidence occurring from April to June and in September. Two-dose MuCV vaccination can extend the duration of immune protection and significantly reduce the risk of breakthrough infection.

, authors=Jianchao SHAO1, Shurong FENG1, Bo YANG1, Shudan LIU2, authorsList=Jianchao SHAO, Shurong FENG, Bo YANG, Shudan LIU, authorCompany=null, correspAuthors=Shudan LIU, authorNote=null, correspAuthorsNote=
LIU Shudan, E-mail:
, copyrightStatement=Copyright © 2026 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=1320427683264189019, articleId=1320427682421133909, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=重庆市沙坪坝区2008—2018年出生儿童流行性腮腺炎突破病例流行病学特征及疫苗保护效果:一项回顾性队列研究, columnId=1320427660346503751, journalTitle=中国公共卫生, columnName=专题报道——儿童疫苗接种保护效果研究, runingTitle=null, highlight=null, articleAbstract=
目的

了解重庆市沙坪坝区2008—2018年出生儿童流行性腮腺炎(简称“流腮”)突破病例流行病学特征及疫苗保护效果,为优化流腮的免疫策略和制定精准防控措施提供参考依据。

方法

采用回顾性队列研究方法,以2008年1月1日—2018年12月31日出生并居住在沙坪坝区的儿童为研究对象,通过重庆市免疫规划信息管理系统获取儿童的基本信息和含腮腺炎成分疫苗(MuCV)接种情况,并基于儿童姓名、出生日期、性别和现住址等信息匹配通过中国疾病预防控制信息系统获取的流腮发病信息,根据MuCV接种剂次将研究对象分为1、2和3剂次组,以完成相应剂次接种的日期为观察起点、流腮发病日期或观察截止日期(2023年12月31日)为观察终点,观察研究对象的流腮发病情况并采用精确计算法计算发病密度;应用单因素Poisson回归模型估计各组研究对象发病风险,同时分析突破病例的人口学特征、发病时间和MuCV接种至发病时间间隔。

结果

重庆市沙坪坝区2008—2018年出生儿童的流腮突破病例总发病密度为21.16/万人年(1 149例),流腮总突破病例在4—6月和9月呈发病双峰;接种1剂次、2剂次和3剂次突破病例MuCV接种至发病时间间隔分别为[36.50(24.02,51.09)]个月、[59.60(45.37,74.00)]个月和[80.40(62.22,97.49)]个月,不同剂次MuCV突破病例接种至发病时间间隔差异有统计学意义(H=89.63,P<0.001);接种1剂次、2剂次和3剂次MuCV儿童流腮突破病例总发病密度分别为24.82/万人年、16.60/万人年和10.05/万人年,接种2剂次MuCV儿童流腮突破感染风险较接种1剂次MuCV儿童降低33%(VE=33%,95%CI=24%~41%,P<0.001)。

结论

重庆市沙坪坝区2008—2018年出生儿童的流腮突破病例总发病密度较高,4—6月和9月为高发月份,接种2剂次MuCV能够延长流腮免疫保护期,显著降低突破感染风险。

, authors=邵建超1, 冯书蓉1, 杨博1, 刘舒丹2, *, *, authorsList=邵建超, 冯书蓉, 杨博, 刘舒丹, authorCompany=null, correspAuthors=刘舒丹, authorNote=

邵建超(1990—),副主任医师,本科,研究方向:免疫规划

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刘舒丹,E-mail:
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Morbidity and Mortality Weekly Report, 2018, 67(1): 33-38., articleTitle=null, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1320427683448738396, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427682421133909, xref=1, ext=[AuthorCompanyExt(id=1320427683457127005, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427682421133909, companyId=1320427683448738396, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Department of Immunization Program Management, Shapingba District Center for Disease Control and Prevention, Chongqing 400000, China), AuthorCompanyExt(id=1320427683465515614, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427682421133909, companyId=1320427683448738396, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1重庆市沙坪坝区疾病预防控制中心免疫规划管理科,重庆 400000)]), AuthorCompany(id=1320427683545207391, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427682421133909, xref=2, ext=[AuthorCompanyExt(id=1320427683549401696, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427682421133909, companyId=1320427683545207391, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2Department of Child, Adolescent Health and Maternal Care, College of Public Health, Chongqing Medical University, Chongqing 400010, China), AuthorCompanyExt(id=1320427683557790305, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427682421133909, companyId=1320427683545207391, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2重庆医科大学公共卫生学院儿少卫生与妇幼保健学教研室,重庆 400010)])], figs=[ArticleFig(id=1320427687487853187, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427682421133909, language=EN, label=Fig.1, caption=Temporal distribution of mumps breakthrough cases among children born in Shapingba district, Chongqing (2008–2018), figureFileSmall=ev3zTdiT+QfmlxQtNoyWJw==, figureFileBig=gKdQmwTC4i9kMEUWBRvyVA==, tableContent=null), ArticleFig(id=1320427687542379140, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427682421133909, language=CN, label=图1, caption=重庆市沙坪坝区2008—2018年出生儿童流腮突破病例发病时间分布, figureFileSmall=ev3zTdiT+QfmlxQtNoyWJw==, figureFileBig=gKdQmwTC4i9kMEUWBRvyVA==, tableContent=null), ArticleFig(id=1320427687722734213, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427682421133909, language=EN, label=Fig.2, caption=Cumulative incidence density of mumps breakthrough cases from MuCV vaccination to onset among children born in Shapingba district, Chongqing (2008–2018), stratified by vaccination doses, figureFileSmall=KT6j3T9L2m/9xnatpCQQ1w==, figureFileBig=KLEQE58F9qj6rzqj4fDVTQ==, tableContent=null), ArticleFig(id=1320427687798231686, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427682421133909, language=CN, label=图2, caption=重庆市沙坪坝区不同接种剂次2008—2018年出生儿童MuCV接种至发病时间间隔的流腮突破病例累计发病密度, figureFileSmall=KT6j3T9L2m/9xnatpCQQ1w==, figureFileBig=KLEQE58F9qj6rzqj4fDVTQ==, tableContent=null), ArticleFig(id=1320427687856951943, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427682421133909, language=EN, label=Tab.1, caption=

Comparison of mumps breakthrough cases among children born in Shapingba district, Chongqing (2008–2018)

, figureFileSmall=null, figureFileBig=null, tableContent=
特征分类调查人数突破病例例数随访人年累计发病密度及95%CI/(1/万人年)χ2值P值
累计发病密度95%CI
出生年份200859598350 665.7816.3812.86~19.90132.48<0.001
2009728210059 356.1816.8513.55~20.15
201079249852 435.6818.6914.99~22.39
2011745014247 571.0829.8524.94~34.76
2012698114847 445.2531.1926.17~36.21
2013643613237 692.2135.0229.05~40.99
201481329840 392.6024.2619.46~29.06
201512 23311648 895.4623.7219.40~28.04
201621 63611365 950.0617.1313.97~20.29
201719 9098047 413.3416.8713.17~20.57
201817 7673945 107.558.655.94~11.37
性别男性62 187664271 630.6324.4422.58~26.3027.78<0.001
女性59 522485271 294.5617.8816.29~19.47
居住地城市107 238997468 612.8621.2819.96~22.600.210.158
乡镇14 47115274 312.3320.4517.20~23.70
户籍类型非本地户籍53 181422238 104.6817.7216.03~19.4124.08<0.001
本地户籍68 528727304 820.5123.8522.12~25.58
MuCV接种剂次1剂次45 555756304 618.2524.8224.81~24.8246.01<0.001
2剂次74 678389234 325.4016.6016.59~16.60
3剂次1 47643 981.5410.059.89~10.20
), ArticleFig(id=1320427687974392456, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320427682421133909, language=CN, label=表1, caption=

重庆市沙坪坝区2008—2018年出生儿童流腮突破病例发生情况比较

, figureFileSmall=null, figureFileBig=null, tableContent=
特征分类调查人数突破病例例数随访人年累计发病密度及95%CI/(1/万人年)χ2值P值
累计发病密度95%CI
出生年份200859598350 665.7816.3812.86~19.90132.48<0.001
2009728210059 356.1816.8513.55~20.15
201079249852 435.6818.6914.99~22.39
2011745014247 571.0829.8524.94~34.76
2012698114847 445.2531.1926.17~36.21
2013643613237 692.2135.0229.05~40.99
201481329840 392.6024.2619.46~29.06
201512 23311648 895.4623.7219.40~28.04
201621 63611365 950.0617.1313.97~20.29
201719 9098047 413.3416.8713.17~20.57
201817 7673945 107.558.655.94~11.37
性别男性62 187664271 630.6324.4422.58~26.3027.78<0.001
女性59 522485271 294.5617.8816.29~19.47
居住地城市107 238997468 612.8621.2819.96~22.600.210.158
乡镇14 47115274 312.3320.4517.20~23.70
户籍类型非本地户籍53 181422238 104.6817.7216.03~19.4124.08<0.001
本地户籍68 528727304 820.5123.8522.12~25.58
MuCV接种剂次1剂次45 555756304 618.2524.8224.81~24.8246.01<0.001
2剂次74 678389234 325.4016.6016.59~16.60
3剂次1 47643 981.5410.059.89~10.20
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重庆市沙坪坝区2008—2018年出生儿童流行性腮腺炎突破病例流行病学特征及疫苗保护效果:一项回顾性队列研究
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邵建超 1 , 冯书蓉 1 , 杨博 1 , 刘舒丹 2, *, *
中国公共卫生 | 专题报道——儿童疫苗接种保护效果研究 2026,42(8): 908-913
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中国公共卫生 |专题报道——儿童疫苗接种保护效果研究 2026 , 42 (8) : 908 -913
重庆市沙坪坝区2008—2018年出生儿童流行性腮腺炎突破病例流行病学特征及疫苗保护效果:一项回顾性队列研究
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邵建超1, 冯书蓉1, 杨博1, 刘舒丹2, *, *
作者信息
  • 1重庆市沙坪坝区疾病预防控制中心免疫规划管理科,重庆 400000
  • 2重庆医科大学公共卫生学院儿少卫生与妇幼保健学教研室,重庆 400010
通讯作者:
刘舒丹,E-mail:
作者简介:

邵建超(1990—),副主任医师,本科,研究方向:免疫规划

Epidemiological characteristics of mumps breakthrough cases and vaccine effectiveness among children born in Shapingba district, Chongqing (2008–2018): a retrospective cohort study
Jianchao SHAO1, Shurong FENG1, Bo YANG1, Shudan LIU2
Affiliations
  • 1Department of Immunization Program Management, Shapingba District Center for Disease Control and Prevention, Chongqing 400000, China
  • 2Department of Child, Adolescent Health and Maternal Care, College of Public Health, Chongqing Medical University, Chongqing 400010, China
  • Corresponding Author:
    LIU Shudan, E-mail:
出版时间: 2026-08-10 doi: 10.11847/zgggws1149243
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目的

了解重庆市沙坪坝区2008—2018年出生儿童流行性腮腺炎(简称“流腮”)突破病例流行病学特征及疫苗保护效果,为优化流腮的免疫策略和制定精准防控措施提供参考依据。

方法

采用回顾性队列研究方法,以2008年1月1日—2018年12月31日出生并居住在沙坪坝区的儿童为研究对象,通过重庆市免疫规划信息管理系统获取儿童的基本信息和含腮腺炎成分疫苗(MuCV)接种情况,并基于儿童姓名、出生日期、性别和现住址等信息匹配通过中国疾病预防控制信息系统获取的流腮发病信息,根据MuCV接种剂次将研究对象分为1、2和3剂次组,以完成相应剂次接种的日期为观察起点、流腮发病日期或观察截止日期(2023年12月31日)为观察终点,观察研究对象的流腮发病情况并采用精确计算法计算发病密度;应用单因素Poisson回归模型估计各组研究对象发病风险,同时分析突破病例的人口学特征、发病时间和MuCV接种至发病时间间隔。

结果

重庆市沙坪坝区2008—2018年出生儿童的流腮突破病例总发病密度为21.16/万人年(1 149例),流腮总突破病例在4—6月和9月呈发病双峰;接种1剂次、2剂次和3剂次突破病例MuCV接种至发病时间间隔分别为[36.50(24.02,51.09)]个月、[59.60(45.37,74.00)]个月和[80.40(62.22,97.49)]个月,不同剂次MuCV突破病例接种至发病时间间隔差异有统计学意义(H=89.63,P<0.001);接种1剂次、2剂次和3剂次MuCV儿童流腮突破病例总发病密度分别为24.82/万人年、16.60/万人年和10.05/万人年,接种2剂次MuCV儿童流腮突破感染风险较接种1剂次MuCV儿童降低33%(VE=33%,95%CI=24%~41%,P<0.001)。

结论

重庆市沙坪坝区2008—2018年出生儿童的流腮突破病例总发病密度较高,4—6月和9月为高发月份,接种2剂次MuCV能够延长流腮免疫保护期,显著降低突破感染风险。

流行性腮腺炎  /  突破病例  /  流行病学特征  /  疫苗保护效果  /  儿童  /  重庆市沙坪坝区
Objective

To investigate the epidemiological characteristics of mumps breakthrough cases and evaluate vaccine effectiveness among children born in Shapingba district, Chongqing from 2008 to 2018, thus providing evidence for optimizing mumps immunization strategies and formulating precise prevention and control measures.

Methods

A retrospective cohort study was conducted among children born between January 1, 2008 and December 31, 2018 and residing in Shapingba district. Basic information and vaccination records for mumps-containing vaccine (MuCV) were obtained from the Chongqing Immunization Planning Information Management System. Mumps incidence data were retrieved from the China Information System for Disease Control and Prevention by matching child′s name, date of birth, gender, and current address. Participants were categorized into 1-dose, 2-dose, and 3-dose groups according to MuCV vaccination doses. Follow-up started from the completion date of each dose and ended at either mumps diagnosis or the study cutoff date (December 31, 2023). Person-years were calculated through the exact calculation method to determine incidence density. Univariate Poisson regression was employed to estimate disease risk across groups, while analyzing demographic characteristics, onset time, and time intervals from MuCV vaccination to mumps onset among breakthrough cases.

Results

The total incidence density of mumps breakthrough cases among children born in Shapingba district, Chongqing from 2008 to 2018 was 21.16 per 10 000 person-years (1 149 cases). The overall incidence of breakthrough cases showed a bimodal distribution pattern, with peaks occurring from April to June and in September. The median intervals from MuCV vaccination to disease onset for breakthrough cases in the 1-dose, 2-dose, and 3-dose groups were 36.50 (24.02, 51.09) months, 59.60 (45.37, 74.00) months, and 80.40 (62.22, 97.49) months, respectively, with differences among the groups (H = 89.63, P < 0.001). The total incidence density of breakthrough cases among children who received 1, 2, and 3 doses of MuCV was 24.82, 16.60, and 10.05 per 10 000 person-years, respectively. Children receiving 2-dose MuCV had a 33% reduced risk of mumps breakthrough infection compared to those receiving 1-dose MuCV (VE = 33%, 95%CI: 24%–41%, P < 0.001).

Conclusions

The total incidence density of mumps breakthrough cases was relatively high among children born in Shapingba district, Chongqing from 2008 to 2018, with peak incidence occurring from April to June and in September. Two-dose MuCV vaccination can extend the duration of immune protection and significantly reduce the risk of breakthrough infection.

mumps  /  breakthrough cases  /  epidemiological characteristics  /  vaccine effectiveness  /  children  /  Shapingba district, Chongqing city
邵建超, 冯书蓉, 杨博, 刘舒丹. 重庆市沙坪坝区2008—2018年出生儿童流行性腮腺炎突破病例流行病学特征及疫苗保护效果:一项回顾性队列研究. 中国公共卫生, 2026 , 42 (8) : 908 -913 . DOI: 10.11847/zgggws1149243
Jianchao SHAO, Shurong FENG, Bo YANG, Shudan LIU. Epidemiological characteristics of mumps breakthrough cases and vaccine effectiveness among children born in Shapingba district, Chongqing (2008–2018): a retrospective cohort study[J]. Chinese Journal of Public Health, 2026 , 42 (8) : 908 -913 . DOI: 10.11847/zgggws1149243
流行性腮腺炎(简称“流腮”)是一种常见的儿童病毒性疾病,典型症状为腮腺肿胀与疼痛,重症可并发脑膜炎、脑炎、卵巢炎或睾丸炎,甚至导致永久性听力损失[1]。中国对流腮的防控主要以疫苗接种为主,该免疫策略已历经2次重要调整[2–3],通过广泛接种,全国流腮发病率出现了明显下降[4]。然而,由于疫苗效力不足和免疫力衰减等原因[5–6],在全国多地的暴发疫情中,41.41%~70.10%的暴发病例为含流腮成分疫苗(mumps containing vaccine, MuCV)免疫后的病例(简称“突破病例”)[7–9],提示突破病例已成为当前流腮防控的突出问题,但目前相关研究较少,其流行病学特征和不同剂次疫苗的保护效果尚未得到充分阐明。重庆市沙坪坝区作为西部中心城区流腮高发地区[10],自2008年起将流腮纳入扩大免疫规划,对18~24月龄儿童常规接种1剂次麻腮风联合减毒活疫苗,并引入腮腺炎减毒活疫苗用于补充免疫或应急接种,这为MuCV免疫策略研究提供了良好的研究场景。为了解重庆市沙坪坝区2008—2018年出生儿童流腮突破病例流行病学特征及疫苗保护效果,为优化流腮的免疫策略和制定精准防控措施提供参考依据,本研究采用回顾性队列研究方法,以2008年1月1日—2018年12月31日出生并居住在沙坪坝区的儿童为研究对象,通过重庆市免疫规划信息管理系统获取儿童的基本信息和MuCV接种情况,并基于儿童姓名、出生日期、性别和现住址等信息匹配通过中国疾病预防控制信息系统获取的流腮发病信息,根据MuCV接种剂次将研究对象分为1、2和3剂次组,以完成相应剂次接种的日期为观察起点、流腮发病日期或观察截止日期(2023年12月31日)为观察终点,观察研究对象的流腮发病情况并计算发病密度,应用单因素Poisson回归模型估计各组研究对象发病风险,同时分析突破病例的人口学特征、发病时间和MuCV接种至发病时间间隔。
通过重庆市免疫规划信息管理系统获取2008年1月1日—2018年12月31日出生并居住于重庆市沙坪坝区儿童的基本信息及MuCV接种记录,并基于儿童姓名、出生日期、性别和现住址等信息匹配通过中国疾病预防控制信息系统获取的流腮发病信息。纳入分析的研究对象均为在重庆市免疫规划信息管理系统中登记在册且有MuCV接种记录、现住址为沙坪坝区的儿童,排除接种第1剂次MuCV前已患流腮和接种第1剂次MuCV后42 d内患流腮者。流腮病例诊断依据2007年中华人民共和国卫生部《流行性腮腺炎诊断标准》[11],流腮突破病例定义为接种MuCV≥42 d发生的流腮病例,按MuCV接种剂次数分为接种1剂次、2剂次和3剂次MuCV突破病例。其中,第2剂次MuCV接种后≥30 d发病者归类为2剂次MuCV突破病例,<30 d发病者归类为1剂次MuCV突破病例;第3剂次MuCV接种后≥30 d发病者归类为3剂次MuCV突破病例,<30 d发病者归类为2剂次MuCV突破病例[12]。本研究经重庆市沙坪坝区疾病预防控制中心医学伦理委员会审查批准(批号:20240904001),并豁免知情同意。
采用回顾性队列研究,根据MuCV接种剂次将研究对象分为1剂次组、2剂次组和3剂次组,观察研究对象的流腮发病情况,观察起点为完成相应剂次接种的日期,观察终点为流腮发病日期或研究截止日期(2023年12月31日)。对于多次流腮突破发病的儿童,观察终点为最后一剂次MuCV接种后的首次发病时间。依据研究对象的观察起始日期与发病日期或研究截止日期间隔计算观察人年数,发病密度计算公式为:发病密度=新发病例总数/观察人年数×10 000[13]。主要指标包括突破发病数、发病密度和MuCV接种至发病时间间隔等。
应用R 4.3.2软件进行数据清理、匹配和统计分析。非正态分布的计量资料以M(Q1,Q3)表示,组间比较采用Kruskal-Wallis检验;计数资料以n和%表示,采用χ2检验进行组间的发病密度比较。应用单因素Poisson回归模型对不同MuCV接种剂次组的总发病密度进行两两比较,对显著性水平进行Bonferroni校正,校正后的α=0.017,计算发病密度比(incidence rate ratio, IRR)及其95%CI,并进一步估算疫苗保护效果(vaccine effectiveness, VE),VE = (1–IRR)×100%[14],其中IRR为接种2、3剂次MuCV组与1剂次MuCV组流腮突破病例的发病密度之比。检验水准为双侧检验α=0.05。
重庆市沙坪坝区最终纳入分析的121 709名2008—2018年出生并接种过MuCV的儿童中,出生年份为2008年5 959人(4.90%),2009年7 282人(5.98%),2010年7 924人(6.51%),2011年7 450人(6.12%),2012年6 981人(5.73%),2013年6 436人(5.29%),2014年8 132人(6.68%),2015年12 233人(10.05%),2016年21 636人(17.78%),2017年19 909人(16.36%),2018年17 767人(14.60%);男性62 187人(51.09%),女性59 522人(48.91%);居住在城市107 238人(88.11%),乡镇14 471人(11.89%);非本地户籍53 181人(43.70%),本地户籍68 528人(56.30%);MuCV接种1剂次45 555人(37.43%),2剂次74 678人(61.36%),3剂次1 476人(1.21%)。
重庆市沙坪坝区最终纳入分析的121 709名2008—2018年出生并接种过MuCV的儿童中,共报告流腮突破病例1 149例,总发病密度为[21.16(95%CI=19.94~22.38)]万人年;重庆市沙坪坝区不同特征儿童比较,不同出生年份、性别、户籍类型和MuCV接种剂次儿童的流腮突破病例发病密度差异均有统计学意义(均P<0.001)。
重庆市沙坪坝区2008—2018年出生儿童流腮总突破病例的月发病数为37~140例,在4—6月和9月呈发病双峰。其中,接种1剂次MuCV突破病例月发病数为20~89例,发病高峰与总体趋势一致;接种2剂次MuCV突破病例月发病数为17~56例,在9月呈发病单峰;接种3剂次MuCV突破病例在7、8、9和12月各发病1例。
重庆市沙坪坝区2008—2018年出生儿童流腮总突破病例MuCV接种至发病的时间间隔为[44.57(28.97,63.03)]个月,其中接种1剂次、2剂次和3剂次突破病例MuCV接种至发病的时间间隔分别为[36.50(24.02,51.09)]个月、[59.60(45.37,74.00)]个月和[80.40(62.22,97.49)]个月,不同剂次MuCV突破病例接种至发病时间间隔差异有统计学意义(H=89.63,P<0.001)。从MuCV接种至发病时间间隔的累计发病密度来看,接种1剂次MuCV突破病例从接种后1个月的0.07/万人年逐渐上升到18个月的3.74/万人年后进入快速上升期,快速上升期持续42个月后,在接种后60个月达到20.91/万人年,并在108个月达到24.56/万人年后趋于平稳;接种2剂次MuCV突破病例从接种后8个月的0.04/万人年缓慢增加至36个月的1.84/万人年后进入快速上升期,快速上升期持续42个月后,在接种后78个月达到13.57/万人年,并在108个月达到16.05/万人年后进入平稳期;而接种3剂次MuCV突破病例接种至发病时间的间隔>51个月。
不同接种MuCV儿童比较,接种2剂次MuCV儿童的流腮突破感染风险较接种1剂次MuCV儿童降低33%(VE=33%,95%CI=24%~41%,P<0.001);接种3剂次MuCV儿童的流腮突破感染风险较接种1剂次MuCV儿童降低60%(VE=60%,95%CI= −8%~85%),较接种2剂次MuCV儿童降低39%(VE=39%,95%CI=−62%~77%),但差异均无统计学意义(均P>0.05)。
目前,中国流腮突破性感染的研究较为缺乏,既往研究通常采用横断面设计描述某段时间各年龄段儿童的流腮发病情况[15–17],难以有效评估疫苗接种与流腮发病之间的因果关系,本研究通过构建回顾性出生队列追踪2008—2018年出生儿童从疫苗接种到流腮发病的全过程,为MuCV接种策略的效果评估提供了更准确和可靠的流行病学证据。本研究结果显示,重庆市沙坪坝区2008—2018年出生儿童的流腮突破病例总发病密度为21.16/万人年,接种2剂次MuCV能够延长流腮免疫保护期,显著降低突破感染风险。
本研究中,2011、2012和2013年出生儿童流腮突破发病密度较高,分别为29.85/万人年、31.19/万人年和35.02/万人年,这可能与流腮流行周期[18]和儿童体内疫苗诱导的免疫保护随时间推移而减弱[19]有关。重庆市既往研究表明,流腮报告病例呈每年4—7月和11月至次年1月2个高峰[10],本研究接种1剂次MuCV的流腮突破病例呈4—6月和9月发病双峰,而接种2剂次MuCV的流腮突破病例仅在9月发病略多,与贵州省2剂次扩大免疫规划时期流腮流行趋势相似[20],这一差异提示2剂次MuCV接种可能在一定程度上改变了流腮的季节性流行模式,这为当前广泛实施2剂次麻腮风减毒活疫苗免费接种政策下的流腮疫情防控提供了更多的策略参考。
浙江省湖州市的研究表明,在流腮突破病例中MuCV接种至发病时间间隔的中位数为4.17年[21],该间隔略长于本研究结果,这可能与两地流腮流行强度和疫苗覆盖率等不同有关。具体来看,本研究中与接种1剂次MuCV后在18个月即进入突破病例快速上升期相比,接种2剂次MuCV后直至36个月才观察到类似的快速上升趋势,延长了18个月的免疫保护起始时间。尽管两者的快速上升期均持续42个月,但在该阶段结束时,接种2剂次MuCV的累计发病密度(13.57/万人年)较接种1剂次MuCV的总发病密度(20.91/万人年)有所降低,提示接种2剂次MuCV不仅能延长流腮的免疫保护期,更能降低免疫衰退高峰期的突破感染风险水平。而在接种后108个月进入发病平稳期时,接种2剂次MuCV的累计发病密度(16.05/万人年)仍持续低于接种1剂次MuCV的累计发病密度(24.56/万人年),进一步凸显了其长期保护优势。这一流行病学上的结论亦得到了血清学监测的印证。湖南省健康人群流腮抗体水平监测结果显示,2剂次MuCV接种后的抗体几何平均浓度明显更高且免疫保护持久性更优[22]。
江军等[23]研究表明,接种不同剂次MuCV儿童均有流腮突破病例发生,但接种2剂次和3剂次的突破病例发病率均低于1剂次,与本研究结果一致。本研究中接种2剂次MuCV儿童的流腮突破感染风险较接种1剂次MuCV儿童降低33%(VE=33%,95%CI=24%~41%,P<0.001),提示增加接种剂次有助于降低流腮发病风险,进一步验证了世界卫生组织推荐的≥2剂次MuCV免疫程序[24]及我国自2020年起实施的2剂次麻腮风联合减毒活疫苗接种策略[3]的有效性。此外,近年来即使在2剂次MuCV高覆盖国家仍出现流腮疫情暴发,如美国[25]和澳大利亚[26],暴发疫情中高危人群第3剂次MuCV接种的必要性受到更多关注[27]。本研究中,接种3剂次MuCV儿童的流腮突破病例累计发病密度均较接种2剂次和1剂次MuCV儿童减少,尽管差异均无统计学意义,但这一初步现象仍为我国在高风险人群或疫情暴发背景下探索3剂次MuCV免疫策略的潜在价值提供了描述性流行病学数据。
综上所述,重庆市沙坪坝区2008—2018年出生儿童的流腮突破病例总发病密度较高,在4—6月和9月呈发病双峰,接种2剂次MuCV能够延长流腮免疫保护期,显著降低突破感染风险。但本研究仍存在一定局限性:首先,该地区从2007年开始逐渐使用预防接种信息系统记录疫苗接种信息,早期适龄儿童建档率水平偏低,可能导致通过匹配识别的流腮突破病例数被低估;其次,流腮属于自限性疾病,部分患者临床症状轻微或不典型,不需要就医治疗即可自愈,可能导致流腮报告病例数低于真实发病数;最后,本研究观察期截至2023年12月31日,部分年龄较小的儿童可能尚未经历流腮发病风险期,导致这批出生儿童的发病数可能被低估。因此,建议通过完善预防接种信息系统和补充早期儿童接种档案来提升接种信息的完整性与准确性,同时强化流腮病例监测以及提升医务人员对不典型病例的识别报告能力以减少漏报,并延长研究观察期、持续追踪低龄儿童发病情况以校正发病评估结果,为流腮防控策略优化提供更可靠依据。

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2026年第42卷第8期
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doi: 10.11847/zgggws1149243
  • 接收时间:2025-11-04
  • 首发时间:2026-10-23
  • 出版时间:2026-08-10
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  • 收稿日期:2025-11-04
  • 修回日期:2026-02-25
  • 录用日期:2026-04-16
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    1重庆市沙坪坝区疾病预防控制中心免疫规划管理科,重庆 400000
    2重庆医科大学公共卫生学院儿少卫生与妇幼保健学教研室,重庆 400010

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2种不同金属材料的力学参数
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species
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Percentage of
total species (%)
属
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species
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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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