Vaccination status

疫苗接种状况
  • 文章类型: Journal Article
    背景:卒中后患者的疫苗接种状况,谁是严重急性呼吸系统综合症冠状病毒2(SARS-CoV-2)的严重结局的高风险,是一个重要的问题,但仍不清楚。我们旨在探索疫苗接种状况,与疫苗犹豫相关的因素,以及卒中后患者接种疫苗后的不良反应。
    方法:这项多中心观察性研究纳入了来自六家中国医院的住院卒中后患者(2020年10月1日-2021年3月31日),检查疫苗摄取和自我报告的疫苗犹豫的原因,利用Logistic回归调查疫苗犹豫的危险因素,并记录疫苗接种后的任何不良反应。
    结果:在纳入研究的总共710名中风后患者中,430人(60.6%)完成了推荐的全3剂SARS-CoV-2疫苗接种,176人(24.8%)未接种疫苗。疫苗犹豫的最常见原因是对疫苗副作用(41.5%)和流动性受损(33.9%)的担忧。Logistic回归确定高龄(aOR=1.97,95CI:1.36-2.85,P=0.001),较低的Barthel指数得分(aOR=0.88,95CI:0.82-0.93,P=0.018),改良Rankin量表评分较高(aOR=1.85,95CI:1.32-2.56,P=0.004),和EuroQol5维的常规活动水平较差(aOR=2.82,95CI:1.51-5.28,P=0.001)是疫苗犹豫的独立危险因素。大约14.8%报告了轻微的不良反应,主要是注射部位疼痛。
    结论:我们发现卒中后患者SARS-CoV-2疫苗接种率不足,疫苗犹豫的关键风险因素包括对副作用的担忧,高龄,和功能障碍。在接种疫苗的人群中没有观察到严重的不良反应。
    BACKGROUND: The vaccination status of post-stroke patients, who are at high risk of severe outcomes from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is a significant concern, yet it remains unclear. We aimed to explore the vaccination status, factors associated with vaccine hesitancy, and adverse effects after vaccination among post-stroke patients.
    METHODS: This multi-center observational study enrolled hospitalized post-stroke patients from six Chinese hospitals (Oct 1, 2020 - Mar 31, 2021), examining vaccine uptake and self-reported reasons for vaccine hesitancy, utilizing logistic regression to investigate risk factors for vaccine hesitancy, and recording any adverse reactions post-vaccination.
    RESULTS: Of the total 710 post-stroke patients included in the study, 430 (60.6%) had completed the recommended full-3 dose SARS-CoV-2 vaccination, with 176 (24.8%) remaining unvaccinated. The most common reasons for vaccine hesitancy were concerns about vaccine side effects (41.5%) and impaired mobility (33.9%). Logistic regression identified advanced age (aOR = 1.97, 95%CI: 1.36-2.85, P = 0.001), lower Barthel Index score (aOR = 0.88, 95%CI: 0.82-0.93, P = 0.018), higher Modified Rankin Scale score (aOR = 1.85, 95%CI: 1.32-2.56, P = 0.004), and poorer usual activity level of EuroQol 5-Dimension (aOR = 2.82, 95%CI: 1.51-5.28, P = 0.001) as independent risk factors for vaccine hesitancy. Approximately 14.8% reported minor adverse reactions, mainly pain at the injection site.
    CONCLUSIONS: We found that post-stroke patients have insufficient SARS-CoV-2 vaccination rates, with key risk factors for vaccine hesitancy including concerns about side effects, advanced age, and functional impairments. No severe adverse reactions were observed among the vaccinated population.
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  • 文章类型: Journal Article
    目的:了解维持性血液透析(MHD)患者COVID-19疫苗接种现状及影响因素。
    方法:总共,选择2022年1月至3月在中国四川省进行定期血液透析的585例患者,对其知识进行问卷调查,对COVID-19疫苗接种的态度和做法。采用独立t检验和logistic多因素分析血液透析患者COVID-19疫苗接种的影响因素。
    结果:调查显示,37.44%的MHD患者接种了COVID-19疫苗。MHD患者已婚与COVID-19疫苗接种相关(比值比[OR]=1.96995%CI0.870~4.453)。县域MHD患者COVID-19疫苗接种率较高(OR=0.57295%CI0.301~1.087)。医护人员的家人/亲戚/朋友与MHD患者的COVID-19疫苗接种有关(OR=1.84095%CI1.140~2.970)。5年内其他疫苗接种史是MHD患者COVID-19疫苗接种的一个因素(OR=5.59295%CI2.997~10.434)。态度(OR=0.88595%CI0.808~0.905),COVID-19疫苗接种知识和实践问卷(OR=0.75695%CI0.697~0.819)得分与MHD患者的疫苗接种状况相关。
    结论:MHD患者的COVID-19疫苗接种率较低。婚姻状况,生活环境,家人/亲戚/朋友是否是医务人员,COVID-19疫苗知识和实践问卷的得分是影响其疫苗接种状况的因素。临床应重视MHD患者COVID-19疫苗的不良反应,提高基层医务人员对血液透析的认识,家庭和社会应更加重视MHD患者的COVID-19疫苗接种。
    OBJECTIVE: To investigate the current status of COVID-19 vaccination in maintenance hemodialysis (MHD) patients and its influencing factors.
    METHODS: In total, 585 patients undergoing regular hemodialysis in Sichuan Province of China from January to March 2022 were selected to complete a questionnaire survey on their knowledge, attitudes and practices regarding COVID-19 vaccination. Independent t tests and logistic multivariate analysis were used to analyze the influencing factors of COVID-19 vaccination in hemodialysis patients.
    RESULTS: The survey showed that 37.44% of MHD patients had been vaccinated with the COVID-19 vaccine. Being married was associated with COVID-19 vaccination in patients with MHD (odds ratio [OR] = 1.969 95% CI 0 .870 ~ 4.453). MHD patients living in county areas have higher rates of COVID-19 vaccination (OR = 0.572 95% CI 0.301 ~ 1.087). Family /relatives/friends who are healthcare workers are associated with COVID-19 vaccination for MHD patients (OR = 1.840 95% CI 1.140 ~ 2.970). Other vaccination history within 5 years was a factor in COVID-19 vaccination for MHD patients (OR = 5.592 95% CI 2.997 ~ 10.434). Attitude (OR = 0.885 95% CI 0.808 ~ 0.905), and practice (OR = 0.756 95% CI 0.697 ~ 0.819) scores on the COVID-19 vaccination knowledge and practice questionnaire were related to the vaccination status of MHD patients.
    CONCLUSIONS: MHD patients had lower rates of COVID-19 vaccination. Marital status, living environment, whether family/relatives/friends were medical workers, and the score of the COVID-19 vaccine knowledge and practice questionnaire were the factors influencing their vaccination status. Clinical attention should be given to the adverse reactions of COVID-19 vaccination in MHD patients to improve the awareness of primary medical staff on hemodialysis, and families and society should pay more attention to COVID-19 vaccination in MHD patients.
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  • 文章类型: Journal Article
    根据中国无锡市COVID-19爆发期间的数据,我们探讨了非mRNA疫苗接种后COVID-19住院患者的实验室变量与临床特征之间的关系,并试图确定疫苗接种和COVID-19感染对人类的重大影响。
    进行了一项回顾性观察性队列研究。纳入2022年6月28日至2022年7月24日期间接受非mRNACOVID-19疫苗并因COVID-19住院的患者。不同疫苗状态之间的相关性,PCR检测阴性的时间,和生化参数进行了研究。
    所有患者均患有轻度COVID-19疾病。疫苗剂量对PCR检测阴性的时间没有影响(P=0.559)。在灭活之间没有明显差异,腺病毒载体,和重组亚单位疫苗在PCR检测阴性的时间。刚接受一次剂量的患者血糖水平明显低于接受三次剂量的患者(P=0.024)。而两个剂量对血糖水平没有影响(一个剂量与两剂,P=0.223;两种剂量与三次剂量,P=0.457)。体温(β=0.168,P=0.011)和淋巴细胞百分比(β=-0.219,P=0.001)与COVID-19阴性PCR检测时间相关。长期停留与GOT上升有关,GOT上升在通常范围内(P=0.025)。淋巴细胞百分比(P=0.007)和血清钾(P=0.004)与体温的显着变化一致。
    接种剂量和类型对轻度COVID-19患者进行COVID-19阴性PCR检测的时间没有影响。比较第一次剂量和加强剂量,血糖水平在正常范围内升高。COVID-19核酸转变的时间与体温负相关,淋巴细胞的比例,有,还有血清钾.
    UNASSIGNED: Based on the data during the outbreak of COVID-19 in Wuxi city in China, we explored the relationship between laboratory variables and clinical features in patients hospitalized with COVID-19 after non-mRNA vaccination, and attempted to identify the significant impact of vaccination and COVID-19 infection on humans.
    UNASSIGNED: A retrospective observational cohort study was carried out. Patients who received non-mRNA COVID-19 vaccines and were hospitalized with COVID-19 between June 28, 2022, and July 24, 2022 were included. The correlation between different vaccine statuses, the time to negative PCR test, and biochemical parameters were investigated.
    UNASSIGNED: All patients had a mild COVID-19 disease. The number of vaccine doses exerted no effects on the time to negative PCR test (P = 0.559). No differences were evident among inactivated, adenoviral-vectored, and recombinant subunit vaccines in the time to negative PCR test.Patients who just received one dose had significantly lower blood glucose levels than those who received three doses (P = 0.024), whereas two doses had no effect on blood glucose levels (one dose vs. two doses, P = 0.223; two doses vs. three doses, P = 0.457).Body temperature (β = 0.168, P = 0.011) and the percentage of lymphocytes (β = -0.219, P = 0.001) were substantially correlated with the time to COVID-19 negative PCR test. The prolonged stay was linked to a rise in GOT that fell within the usual range (P = 0.025).The percentage of lymphocytes (P = 0.007) and serum potassium (P = 0.004) were concordant with the marked change in body temperature.
    UNASSIGNED: The dose and type of vaccination had no effect on the time to COVID-19 negative PCR test in patients with mild COVID-19. Comparing the first dose with the booster dose, the blood glucose levels increased within the normal range. The period at which the COVID-19 nucleic acid turned negative correlated with body temperature, the proportion of lymphocytes, GOT, and serum potassium.
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  • 文章类型: Journal Article
    手,手足口病是由肠道病毒感染引起的一种传染病。在这项研究中,我们分析了手足口病的流行病学特征和时间趋势,2011-2021年黄浦区EV71疫苗接种现状及疫苗保护效果评价,上海,中国。从2011年到2021年,手足口病病例呈逐年下降趋势,从2012年的122例报告到2020年的7例,2021年的12例。病因学诊断为CV-A6185例(29.8%),CV-A16在209例(33.7%)中,EV-A71118例(19.0%),其他肠道病毒109例(17.6%)。EV71疫苗上市后,2016年至2021年,共接种了32,221剂EV71疫苗.病例对照结果显示,没有证据支持EV71疫苗的有效性,OR(95%CI)=0.52(0.12~2.3),p=0.37。流行菌株已经改变。未来手足口病的监测和管理仍然非常重要,EV71疫苗被认为纳入国家免疫规划。
    Hand, foot and mouth disease (HFMD) is a kind of infectious disease caused by enterovirus infection. In this study we analysed the epidemiological characteristics and time trends of HFMD, vaccination status and vaccine protection effect assessment of EV71 vaccine from 2011 to 2021 in Huangpu District, Shanghai, China. HFMD cases showed a decreasing trend year by year from 2011 to 2021, from 122 cases reported in 2012 to 7 cases in 2020, and 12 cases in 2021. Etiological diagnosis was CV-A6 in 185 cases (29.8%), CV-A16 in 209 cases (33.7%), EV-A71 in 118 cases (19.0%) and other enteroviruses in 109 cases (17.6%). After the launch of EV71 vaccine, a total of 32,221 doses of EV71 vaccine were administered between 2016 and 2021. The case-control results showed that there was no evidence to support the effectiveness of EV71 vaccine, OR (95% CI) =0.52 (0.12 ~ 2.3), p = 0.37. The epidemic strains have changed. Surveillance and management of HFMD remain very important in the future and EV71 vaccine is considered to be included in National Immunization Program.
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  • 文章类型: Journal Article
    This study aims to explore the relationship between the doses of inactivated COVID-19 vaccines received and SARS-CoV-2 Omicron infection in the real-world setting, so as to preliminarily evaluate the protective effect induced by COVID-19 vaccination. We conducted a test-negative case-control study and recruited the test-positive cases and test-negative controls in the outbreak caused by Omicron BA.2 in April 2022 in Guangzhou, China. All the participants were 3 years and older. The vaccination status between the case group and the control group was compared in the vaccinated and all participants, respectively, to estimate the immune protection of inactivated COVID-19 vaccines. After adjusting for sex and age, compared with a mere single dose, full vaccination of inactivated COVID-19 vaccines (OR = 0.191, 95% CI: 0.050 to 0.727) and booster vaccination (OR = 0.091, 95% CI: 0.011 to 0.727) had a more superior protective effect. Compared with one dose, the second dose was more effective in males (OR = 0.090), as well as two doses (OR = 0.089) and three doses (OR = 0.090) among individuals aged 18-59. Whereas, when compared with the unvaccinated, one dose (OR = 7.715, 95% CI: 1.904 to 31.254) and three doses (OR = 2.055, 95% CI: 1.162 to 3.635) could contribute to the increased risk of Omicron infection after adjusting for sex and age. Meanwhile, by contrast with unvaccinated individuals, the result of increased risk was also manifested in the first dose in males (OR = 12.400) and one dose (OR = 21.500), two doses (OR = 1.890), and a booster dose (OR = 1.945) in people aged 18-59. In conclusion, the protective effect of full and booster vaccination with inactivated COVID-19 vaccines exceeded the incomplete vaccination, of which three doses were more effective. Nevertheless, vaccination may increase the risk of Omicron infection compared with unvaccinated people. This may result from the transmission traits of BA.2, the particularity and stronger protection awareness of the unvaccinated population, as well as the ADE effect induced by the decrease of antibody titers after a long time of vaccination. It is crucial to explore this issue in depth for the formulation of future COVID-19 vaccination strategies.
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  • 文章类型: Journal Article
    随着冠状病毒病(COVID-19)继续在世界各地蔓延,COVID-19疫苗是对抗全球大流行的最有效武器。然而,疫苗犹豫仍然是一个严重的问题,可能对个人的心理健康构成一定的危害,比如焦虑上升。因此,基于自我差异理论,本文旨在通过两项研究探讨COVID-19疫苗犹豫对个体广泛性焦虑障碍的作用及其影响机制。
    一项研究涉及654名中国参与者,他们使用疫苗犹豫问卷和广泛性焦虑症7项(GAD-7)量表。在研究二,疫苗犹豫问卷,GAD-7量表,COVID-19大流行感知风险量表,使用疫苗接种状况问卷,收集了3,282名中国居民的数据。
    疫苗犹豫直接增加广泛性焦虑症;风险感知在疫苗犹豫和广泛性焦虑症之间起部分中介作用;疫苗接种状态缓解疫苗犹豫对风险感知和广泛性焦虑症的影响。
    疫苗犹豫通过风险感知预测广泛性焦虑症,但是风险感知的中介作用是由疫苗接种状态调节的,这意味着对于接种疫苗的群体来说,当他们的疫苗犹豫减少时,这将更容易降低风险感知,从而降低广泛性焦虑症。
    As Coronavirus disease (COVID-19) continues to spread around the world, COVID-19 vaccines are the most effective weapons against the global pandemic. Yet vaccine hesitancy remains a serious problem and can pose certain hazards to individuals\' mental health, such as rising anxiety. Therefore, based on Self-Discrepancy Theory, this paper aims to explore the role of COVID-19 vaccine hesitancy on individual generalized anxiety disorder and its influence mechanisms through two studies.
    Study one involved 654 Chinese participants using the Vaccine Hesitancy Questionnaire and the Generalized Anxiety Disorder 7-item (GAD-7) scale. In Study two, the Vaccine Hesitation Questionnaire, GAD-7 scale, Perceived Risk of COVID-19 pandemic scale, and Vaccination Status Questionnaire were used and data from 3,282 Chinese residents was collected.
    Vaccine hesitancy directly increases generalized anxiety disorder; risk perception plays a partial mediating role between vaccine hesitancy and generalized anxiety disorder; vaccination status moderated vaccine hesitancy\'s effect on risk perception and generalized anxiety disorder.
    Vaccine hesitancy predicts generalized anxiety disorder through risk perception, but the mediating role of risk perception is moderated by vaccination status, which means that for the vaccinated group when their vaccine hesitancy is reduced, it will be easier to reduce the risk perception and thus the generalized anxiety disorder.
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  • 文章类型: Journal Article
    最近,一种COVID-19病毒变种在广州迅速传播,中国,引起公众恐慌。这项研究旨在了解大流行的二次爆发对医学生的心理和睡眠相关后果。在这项基于横断面调查的研究中,参与者于2021年6月8日至22日匿名在线填写结构化问卷。我们收集了参与者的人口统计和一般信息。焦虑,抑郁症,使用Zung焦虑自评量表(SAS)测量睡眠质量,抑郁自评量表(SDS),匹兹堡睡眠质量指数(PSQI)分别。使用应对方式问卷(CSQ)评估保护因素。进行了单因素和多因素逻辑回归分析,以检查与心理健康和睡眠质量问题相关的因素。在广州局部爆发地区的第二波大流行期间,中国,超过三分之一的医学生的心理健康和睡眠质量受到影响。焦虑的患病率,抑郁症,睡眠质量差的占27.54%,27.58%,18.19%,分别。2019届学生,年龄在29岁以上,那些有兄弟姐妹的人,家乡在其他省份的人更容易出现这三种健康问题。与心理健康问题风险增加相关的因素是疫苗接种状态(调整比值比1.603-1.839)和饮食状态(调整比值比1.62-1.929)。积极应对方式为保护因素(p<0.05)。我们发现完成疫苗接种状态,良好的饮食,积极的应对方式与良好的心理健康和睡眠质量有关。
    Recently, a COVID-19 virus variant spread rapidly in Guangzhou, China, causing public panic. This study aimed to understand the psychological and sleep-related consequences of the secondary outbreak of the pandemic on medical students. In this cross-sectional survey-based study, participants anonymously completed structured questionnaires online from June 8-22, 2021. We collected participants\' demographic and general information. Anxiety, depression, and sleep quality were measured using the Zung Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Pittsburgh Sleep Quality Index (PSQI), respectively. Protective factors were assessed using the Coping Style Questionnaire (CSQ). Uni- and multivariate logistic regression analyses were performed examining factors associated with mental health and sleep quality problems. During the second wave of the pandemic in local outbreak areas in Guangzhou, China, more than one-third of medical students\' mental health and sleep quality were affected. The prevalence of anxiety, depression, and poor sleep quality were 27.54%, 27.58%, and 18.19%, respectively. Students belonging to the Class of 2019, aged over 29 years, those with siblings, and those whose hometowns were in other provinces were more prone to the three health problems. Factors associated with an increased risk of mental health problems were vaccination status (adjusted odds ratio 1.603-1.839) and diet status (adjusted odds ratio 1.62-1.929). Positive coping styles served as protective factors (p < 0.05). We discovered that completed vaccination status, good diet, and positive coping styles were related to good mental health and sleep quality.
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  • 文章类型: Journal Article
    Healthcare workers (HCWs) are considered both a high-risk population regarding infections and effective vaccine recommenders whose willingness to be vaccinated is the key to herd immunity. However, the vaccination status, acceptance, and knowledge of the 2019 coronavirus disease (COVID-19) vaccine among HCWs remain unknown. Therefore, we conducted an online survey regarding the above among HCWs in China after the vaccine was made available. Questionnaires returned by 1,779 HCWs were analyzed. Among these participants, 34.9% were vaccinated, 93.9% expressed their willingness to receive the COVID-19 vaccine, and vaccine knowledge level was high (89.2%). A bivariate analysis found that participants with a college degree, low level of knowledge, non-exposure to COVID-19 status, and those who are females or nurses have a lower vaccination rate, while participants who are married, with a monthly income of more than 5,000 yuan, and low knowledge levels are less willing to be vaccinated. A multivariate analysis found that participants with a high (OR = 7.042, 95% CI = 4.0918-12.120) or medium (OR = 3.709, 95% CI = 2.072-6.640) knowledge level about COVID-19 vaccines were more willing to be vaccinated. Participants were less likely to accept a COVID-19 vaccine if they were married (OR = 0.503, 95% CI = 0.310-0.815). In summary, Chinese HCWs have a strong willingness to be vaccinated and a high level of knowledge. Measures, such as targeted education for HCWs with low willingness and low level of knowledge, open vaccine review procedures, increased government trust, reduced vaccine costs, and provide vaccination guarantee policies, may improve the vaccination coverage of the at-risk group.
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  • 文章类型: Journal Article
    为了了解2019/2020年中国卫生保健工作者(HCWs)的流感疫苗接种及其相关性,我们使用自我管理的电子问卷来收集人口统计信息,职业特征,流感疫苗接种状况和“呼吸圈”上的免费疫苗接种,中国呼吸医疗专业媒体平台。在这个季节中,HCW中报告的流感疫苗覆盖率为67%,在工作场所免费接种疫苗的医护人员比没有免费接种疫苗的医护人员多(79%vs.34%,p<.001)。工作场所要求或鼓励接种疫苗的医护人员的流感疫苗覆盖率明显高于没有任何干预措施的医护人员(80%和70%vs.39%,p<.001)。与没有免费接种或任何干预措施的工作场所相比,同时进行免费和必需接种的工作场所的疫苗覆盖率最高(OR=14.86,95%CI:10.93-20.20)。高危部门HCWs的流感疫苗接种覆盖率明显高于其他部门(70%vs.58%,p=.023)。HCW疫苗覆盖率与个人对流感或流感疫苗的意见和态度有关,以及其他限制因素,如流感疫苗的供应,工作场所法规,并获得免费疫苗。
    To understand influenza vaccination and its correlates among health-careworkers (HCWs) during the 2019/2020 season in China, we used a self-administeredelectronic questionnaire to collect information on demographics, occupational characteristics, influenza vaccination status and access to free vaccination on the \"Breath Circles\", a Chinese media platform for respiratory medical professionals. The reported influenza vaccine coverage among HCWs during this season was 67%, with more HCWs in a workplace with free vaccination than those with no free vaccination (79% vs.34%,p < .001). The influenza vaccine coverage among HCWs who were required or encouraged to get vaccinated by the workplace was significantly higher than that without any intervention measures (80% & 70 vs.39%,p < .001). The vaccine coverage in the workplaces with free and required vaccination simultaneously was highest compared to that with neither free vaccination nor any intervention measures (OR = 14.86, 95% CI: 10.93-20.20). The influenza vaccination coverage of HCWs in high-riskdepartments was significantly higher than that of other departments (70% vs.58%,p =.023). HCWs\' vaccine coverage was related to personal opinions and attitudes toward influenza or influenza vaccines, as well as other constraints such as availability of influenza vaccines, workplace regulations, and access to free vaccines.
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  • 文章类型: Journal Article
    Measles incidence has decreased dramatically in China due to the implement of measles-containing vaccine (MCV). However, a measles epidemic caused resurgence recently, even among vaccinated individuals. To evaluate the effectiveness of current immunization programs and discuss initiatives for the next step in measles elimination in mainland China, the characteristics of 121,969 laboratory-confirmed measles cases reported in the measles surveillance system (MSS) during 2014-2018 were analyzed according to the vaccination status of the cases in this study. Children under 2 years of age without MCV vaccination (44,424, 36.42% of all cases) and adults over 20 years of age with an unknown vaccination history (37,564, 30.80% of all cases) accounted for the majority of measles cases from 2014 to 2018. 42,425 (34.78%) of the 77,384 cases with available vaccination information were categorized as programmatically preventable. 38,840 (91.55%) of the 42,425 cases were aged ≥8 months without the MCV vaccination history. 34,959 (28.66%) cases were categorized as programmatically non-preventable, of whom 22,611 (64.68%) were too young to receive their first MCV dose, 6857 (19.61%) received their first dose and were too young to receive their second dose, 5491 (15.71%) received at least two doses of MCV. 15,933 (13.06%) of the 121,969 cases had a history of MCV vaccination. Measles virus infection in cases with an MCV vaccination history mainly occurred within the first month after MCV vaccination, especially in those who received a one-dose measles vaccination. MCV vaccination could reduce the frequencies of clinical symptoms and complications of measles cases. Our study confirmed that the current measles immunization programs used in mainland China is effective in reducing the measles incidence in China. Unvaccinated infants/children aged 8-23 months and high risk susceptible adults over 20 years of age with unknown vaccination histories should be the focus groups of measles immunization activities in China in the future.
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