PDF(Pubmed)
Abstract：
UNASSIGNED: The largest mumps outbreak in the United States since 2006 occurred in Arkansas during the 2016-17 school year. An additional dose (third dose) of measles-mumps-rubella vaccine (MMR3) was offered to school children. We evaluated the vaccine effectiveness (VE) of MMR3 compared with two doses of MMR for preventing mumps among school-aged children during the outbreak.
UNASSIGNED: A generalized linear mixed effects model was used to estimate the incremental vaccine effectiveness (VE) of a third dose of MMR compared with two doses of MMR for preventing mumps.
UNASSIGNED: We obtained school enrollment, immunization status and mumps case status from school registries, Arkansas\'s immunization registry, and Arkansas\'s mumps surveillance system, respectively. We included students who previously received 2 doses of MMR in schools with ≥1 mumps case after the MMR3 clinic. We used a generalized linear mixed model to estimate VE of MMR3 compared with two doses of MMR.
UNASSIGNED: Sixteen schools with 9272 students were included in the analysis. Incremental VE of MMR3 versus a two-dose MMR regimen was 52.7% (95% confidence interval [CI]: -3.6%‒78.4%) overall and in 8 schools with high mumps transmission it was 64.0% (95% CI: 1.2%‒86.9%). MMR3 VE was higher among middle compared with elementary school students (68.5% [95% CI: -30.2%‒92.4%] vs 37.6% [95% CI: -62.5%‒76.1%]); these differences were not statistically significant.
UNASSIGNED: Our findings suggest MMR3 provided additional protection from mumps compared with two MMR doses in elementary and middle school settings during a mumps outbreak.
UNASSIGNED: A generalized linear mixed effects model was used to estimate the incremental vaccine effectiveness (VE) of a third dose of MMR compared with two doses of MMR for preventing mumps.
UNASSIGNED: We obtained school enrollment, immunization status and mumps case status from school registries, Arkansas\'s immunization registry, and Arkansas\'s mumps surveillance system, respectively. We included students who previously received 2 doses of MMR in schools with ≥1 mumps case after the MMR3 clinic. We used a generalized linear mixed model to estimate VE of MMR3 compared with two doses of MMR.
UNASSIGNED: Sixteen schools with 9272 students were included in the analysis. Incremental VE of MMR3 versus a two-dose MMR regimen was 52.7% (95% confidence interval [CI]: -3.6%‒78.4%) overall and in 8 schools with high mumps transmission it was 64.0% (95% CI: 1.2%‒86.9%). MMR3 VE was higher among middle compared with elementary school students (68.5% [95% CI: -30.2%‒92.4%] vs 37.6% [95% CI: -62.5%‒76.1%]); these differences were not statistically significant.
UNASSIGNED: Our findings suggest MMR3 provided additional protection from mumps compared with two MMR doses in elementary and middle school settings during a mumps outbreak.
摘要：
■自2006年以来，美国最大的腮腺炎疫情发生在2016-17学年的阿肯色州。向学童提供了额外剂量（第三剂）的麻疹-腮腺炎-风疹疫苗（MR3）。我们评估了MMR3的疫苗有效性（VE）与两剂MMR相比，以预防爆发期间学龄儿童的腮腺炎。
■使用广义线性混合效应模型来估算第三剂MMR与两剂MMR预防腮腺炎的增量疫苗有效性（VE）。
■我们获得了入学率，学校登记处的免疫接种状况和腮腺炎病例状况，阿肯色州的免疫登记处,和阿肯色州的腮腺炎监控系统,分别。我们纳入了之前在学校接受2剂MMR的学生，这些学生在MR3诊所后有≥1例腮腺炎病例。与两种剂量的MMR相比，我们使用了广义线性混合模型来估计MR3的VE。
■分析中包括16所学校，9272名学生。MR3与两剂量MMR方案的VE增量总体为52.7％（95％置信区间[CI]：-3.6％-78.4％），在8所腮腺炎高传播学校中，为64.0％（95％CI：1.2％-86.9％）。MMR3VE在中学生中高于小学生（68.5％[95％CI：-30.2％-92.4％]vs37.6％[95％CI：-62.5％-76.1％]）；这些差异没有统计学意义。
■我们的研究结果表明，在腮腺炎爆发期间，与小学和中学的两种MMR剂量相比，MR3提供了对腮腺炎的额外保护。
■使用广义线性混合效应模型来估算第三剂MMR与两剂MMR预防腮腺炎的增量疫苗有效性（VE）。
■我们获得了入学率，学校登记处的免疫接种状况和腮腺炎病例状况，阿肯色州的免疫登记处,和阿肯色州的腮腺炎监控系统,分别。我们纳入了之前在学校接受2剂MMR的学生，这些学生在MR3诊所后有≥1例腮腺炎病例。与两种剂量的MMR相比，我们使用了广义线性混合模型来估计MR3的VE。
■分析中包括16所学校，9272名学生。MR3与两剂量MMR方案的VE增量总体为52.7％（95％置信区间[CI]：-3.6％-78.4％），在8所腮腺炎高传播学校中，为64.0％（95％CI：1.2％-86.9％）。MMR3VE在中学生中高于小学生（68.5％[95％CI：-30.2％-92.4％]vs37.6％[95％CI：-62.5％-76.1％]）；这些差异没有统计学意义。
■我们的研究结果表明，在腮腺炎爆发期间，与小学和中学的两种MMR剂量相比，MR3提供了对腮腺炎的额外保护。
