法国，2018-2024年，尽管疫苗接种覆盖率很高，但幼儿侵袭性乙型流感嗜血杆菌疾病仍在增加

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-07-18 DOI:10.1016/j.vaccine.2025.127499

Anne-Sophie Barret , Céline François , Ala-Eddine Deghmane , Rémi Lefrançois , Lilas Mercuriali , Alexandra Thabuis , Cécile Marie , Elise Carraz-Billat , Laura Zanetti , Isabelle Parent du Châtelet , Muhamed-Kheir Taha

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引用次数: 0

摘要

背景：在法国引入b型流感嗜血杆菌（Hib）结合疫苗导致了二十年来侵袭性Hib疾病的低发病率。2013年，疫苗接种时间表从3+1改为2+1（2、4和11个月）。2018年以后出生的儿童必须接种Hib疫苗。尽管疫苗接种覆盖率超过95%，但侵袭性Hib疾病自2018年以来有所增加。本研究报告了2018年至2024年法国大陆病例的趋势和特征。方法经国家流感嗜血杆菌参考中心培养或PCR证实的5岁以下侵袭性Hib病患儿。疫苗接种状况由生物学家/临床医生或区域调查小组报告。病例按年龄和疫苗接种状况（未接种、部分接种、正确接种）进行描述。疫苗失败被定义为侵袭性Hib疾病，尽管完成了三剂系列。在2-4岁儿童中使用筛查方法估计三剂疫苗的有效性（VE）。结果2018-2024年5岁以下儿童侵袭性Hib病发病率呈上升趋势，在2021年达到高峰，为46例（1.4/10万儿童）。2018 - 2024年，报告侵袭性Hib病181例。在6-11月龄儿童（n=60）中，76.7%正确接种了两剂疫苗。≥12个月的儿童（n=65）中，67.7%正确接种了三剂疫苗，44例疫苗失败。三剂的估计VE为91.2%[95%可信区间：76.3-96.8%]。结论2018-2024年，法国5岁以下儿童侵袭性Hib病发病率上升，大多数病例接种了正确的疫苗。VE估计并不表明免疫力减弱。侵袭性Hib病例增加的原因尚不清楚。我们的结果要求在两次初级剂量后进一步研究VE以及疫苗接种对携带的影响。

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Increase in invasive Haemophilus influenzae type b disease in young children despite high vaccination coverage, France, 2018–2024

Background

The introduction of Haemophilus influenzae type b (Hib) conjugate vaccines in France led to low invasive Hib disease incidence for two decades. In 2013, the vaccination schedule changed from 3+1 to 2+1 ((2, 4, and 11 months). Hib vaccination has been mandatory for children born since 2018. Despite vaccination coverage exceeding 95%, invasive Hib disease has increased since 2018. This study reports trends and characteristics of cases in mainland France from 2018 to 2024.

Methods

Cases were children under five years old with invasive Hib disease confirmed by culture or PCR by the National Reference Center for Haemophilus influenzae. Vaccination status was reported by biologists/clinicians or by regional investigation teams. Cases were described by age and vaccination status (unvaccinated, partially vaccinated, correctly vaccinated). Vaccine failure was defined as invasive Hib disease despite completion of the three-dose series. Vaccine effectiveness (VE) for three doses was estimated using the screening method in children aged 2-4 years.

Results

The incidence of invasive Hib disease among children under 5 years old increased during the 2018-2024 period, peaking in 2021 with 46 cases (1.4/100,000 children). From 2018 to 2024, 181 cases of invasive Hib disease were reported. Among those aged 6-11 months (n=60), 76.7% were correctly vaccinated with two doses. In children ≥12 months (n=65), 67.7% were correctly vaccinated with three doses and there were 44 vaccine failures. The estimated VE for three doses was 91.2% [95% confidence interval: 76.3-96.8%].

Discussion - Conclusion

Invasive Hib disease increased among children under 5 years old in France during 2018-2024, and most cases were correctly vaccinated. VE estimate do not suggest waning immunity. The reasons that may explain the increase in invasive Hib cases remain uncertain. Our results call for further studies on the VE following the two primary doses and the impact of vaccination on carriage.

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

期刊介绍： Vaccine is unique in publishing the highest quality science across all disciplines relevant to the field of vaccinology - all original article submissions across basic and clinical research, vaccine manufacturing, history, public policy, behavioral science and ethics, social sciences, safety, and many other related areas are welcomed. The submission categories as given in the Guide for Authors indicate where we receive the most papers. Papers outside these major areas are also welcome and authors are encouraged to contact us with specific questions.