Incremental Effectiveness of Emergency Vaccination Against a Varicella Outbreak at an Elementary School in Beijing, China, 2019: an Observational Cohort Study

Zhiqiang Cao,Dan Zhao,Rujing Shi, Yanhong Zhao, Xiaojing Wen, Ying Ma,Xiaomei Li,Luodan Suo

VACCINES（2024）

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Abstract

(1) Background: The effect of varicella emergency vaccination (EV) has not been fully evaluated. (2) Methods: This was a cohort study. Participants were categorized into five groups based on their immune status: unvaccinated group, first dose as EV group, one dose no EV group, second dose as EV group, and two doses no EV group. A Cox proportional hazards model was employed to examine the association between the EV measures and the varicella incidence rate in this outbreak. (3) Results: Demographic characteristics, vaccination details, and disease onset information were 100% (918/918) collected. The crude attack rate was 44% (11/25), 8% (3/36), 11% (24/215), 3% (6/176), and 2% (8/466) among the unvaccinated group, first dose as EV group, one dose no EV group, second dose as EV group and two doses no EV group, respectively. Compared to the unvaccinated group and the one dose no EV group, the first dose varicella vaccine as EV and the second dose as EV demonstrated an incremental effectiveness of 90% (95% CI 65–97%) and 79% (95% CI 47–92%), respectively. (4) Conclusions: Both the first dose and the second dose as EV contributed to reducing the incidence rates of varicella and offered incremental vaccine effectiveness in an outbreak setting. Our study underscores the importance and benefits of initiating emergency varicella vaccination early to reduce the disease incidence rate in an elementary school setting where there was no complete coverage of the two doses of varicella vaccine and an outbreak occurred.

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Key words

varicella outbreak,emergency vaccination,post-exposure prophylaxis,vaccine effectiveness

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【要点】：该研究通过观测队列分析，在北京一所小学的爆发案例中评估了水痘紧急疫苗接种的增量效果，结果表明紧急接种一剂和两剂水痘疫苗均能显著提高疫苗的有效性，减少疾病发生率。

【方法】：研究采用Cox比例风险模型，根据免疫状态将参与者分为五组，分析紧急疫苗接种措施与水痘发病率之间的关系。

【实验】：研究收集了918名参与者的 demographic characteristics, vaccination details, and disease onset information，使用的数据集未在文中明确提及。实验结果显示，未接种组的水痘粗发病率为44%，而接种一剂和两剂作为紧急接种的组别，其发病率分别降低了90%和79%。