中国免疫规划工作现状及展望 Current Situation and Prospects of EPI, China 顾清教授 主任医师 Prof. Gu,Qing 天津市疾病预防控制中心主任 Director of Tianjin CDC 2015 年 6 月捷克 June, 2015 Czech
全面实施扩大免疫规划 Carry out Expanded Planning on Immunization(EPI) 1981 年我国正式参加 EPI China participated in EPI in 1981 不断完善接种规划 监督 管理和评估 : 接种质量 效果及不良反应 疾病监测 冷链和疫苗管理 人员培训 提高服务质量 健康教育与宣传 Improve immunization programme constantly Monitor, manage and evaluate: quality, effect and AFEI Diseases surveillance Cold chain and vaccine management Training Improve quality of service Health education and propaganda 2
中国政府给予免疫规划政策支持 Strong Support for EPI from Chinese Goverment 政府承诺 : 每个儿童按时接种是政府责任 1986 年经国务院批准成立全国计划免疫协调领导小组, 确立 4.25 免疫规划宣传日 加大政策投入 2002 年乙肝疫苗纳入 EPI 2007 年扩大至 15 种疫苗预防 16 种传染病 不断提升服务质量 2000 年提出预防接种门诊建设标准 2006 年开展全国信息化建设 To insure every child get vaccine State council approved the establishment of the National immunization coordination leading Group and the Immunization Day on April 25th since 1986. Increaed investment in policy Hepatitis B vaccine into EPI,2002 Increased EPI vaccine into 15 kinds to prevent 16 diseases, 2007 Improved quality of service standard of vaccination clinic issued, 2000 Built EPI information system, 2006 3
疫苗免疫程序 Vaccine HepB BCG Polio DPT DT MR(MV) Age Birth 1 m 2 m 3 m 4 m 5 m 6 m 8 m 18 m 2 y 3 y 4 y 6 y 1 st 1 2 nd Immunization schedule 1 st 2 nd 1 st 3 rd 2 nd 3 rd 3 rd 1 4th 4th 1 MMR (MM, MV) 1 JE-a Men-A 1 st 1st 2nd 2 nd Men A+C 1 st 2 nd HepA-a 1 JE-I HepA-i 1 st, 2 nd 3 rd 1 st 2 nd 4th
取得巨大成就 Great Achievement 疫苗针对传染病发病大幅度下降 5 岁以下儿童乙肝表面抗 原 (HBsAg) 携带率 <1% 继续维持无脊灰状态 麻疹发病大幅度下降 Incidence rate of vaccine preventable diseases dereased sharply HBsAg carrying rate <1% below 5 years old maintaine free-polio status Measles incidence declined 5
疫苗可预防疾病的发病率下降 1000.00 100.00 All vaccine preventable diseases declined Pertussis Hepatitis A 10.00 发病率 (1/10 万 ) 1.00 0.10 0.01 0.00 JE MM Diphtheria 0.00 1977 1980 1983 1986 1989 1992 1995 1998 2001 2004 甲肝百日咳流脑乙脑白喉
向消除麻疹努力 Towards measles elimination Measles incidence dropped dramatically in recent years 2,0.2ml, 8m,7y 2,0.5ml, 8m MR 18m,MMR/M Nation wide SIA 1965: Liquid vaccine 1978: EPI Implemented 1986: Lyophilized Vaccine Source: National Notifiable Disease Reporting System (NNDRS) 1998: Accelerate measles control 2006: Measles Elimination Plan
取得巨大成就 Great Achievement 基层网络覆盖全国各街乡 预防接种门诊建设达到规范 疫苗接种率稳步提高 建立完善的疾病和 AEFI 监测系统 各省建立信息化系统 群众免疫预防意识加强 Vaccine clinics cover all the towns Eastablish standard vaccine clinics Increase the vaccine coverage rate Eastablish and perfect diseases and AEFI surveillance system Eastablish EPI information system Improve the awareness of prevention diseases 8
中国免疫规划工作展望 Outlooks of EPI in China Maintain the monitoring sensitivity 继续保持疾病监测敏感性 巩固无脊灰和控制麻疹成效 继续提升预防接种服务质量 规范化和数字化门诊建设 继续推进网络信息化建设 信息系统全国联网 冷链自动监测系统 地理信息及 APP 终端 继续扩大免疫服务内容 重点人群免疫 : 老年人 学生 医护人员 成年人免疫 Consalidate the results on free-polio status and measles control Keep improving the quality of service eastablish standard and digital vaccination clinics Keep carrying forward the eastaliment of information system National interconnection Cold chain automatic monitoring Application of GPS and APP Keep expanding the immunizaiton item Susceptible population: old people, students, medical staff Adult immunization 9
天津市基本情况 Introuduce of Tianjin, China 天津市地处华北平原东北部 At the east-northen of China 中央政府直辖市 中国北方经济中心 The municipality directly under the central government and economic center of Northen China 面积 :1.2 万平方公里 Area: 12000 sq.km 常住人口 :1400 万, 流动人口 500 万 Residents: 14 milion, Floating Population 5milion 下辖 16 个区 县 16 Districts 10
天津市免疫规划工作成效 Effects on EPI, Tianjin Outstanding of diseases control 疾病防控成绩突出 连续 20 年无本地白喉病例 麻疹等传染病发病下降 95% 以上 率先在全国实施 EPI 全市预防接种门诊 100% 达到规范化建设 信息系统全市联网 : 率先启动接种信息在线查询 开展疫苗物流配送 冷链自动化监测试点 开展国际合作研究 : 与美国密歇根大学进行麻疹防控策略研究 (NIH 项目 ) No local diphtheria case for 20 years Incidence rate of vaccine preventable diseases dreaesed 95%, such as measles Be the first city to conducted EPI All the vaccination clinics achieved the standard requestment Implemented EPI informaiton interconnection Developed the vaccine distribution Practice the pilot work on cold chain automatic monitoring Gained NIH grand on measles control with UM 11
天津免疫规划工作新举措 New Measurs on EPI, Tianjin 成人免疫 家庭免疫计划 (MMR 甲肝疫苗 乙肝疫苗 ) 12-20 岁学生 :MMR 接种 Adult immunization Family immunization planning(mmr, Hepatitis A, Hepatitis B) 12-20 years old: MMR Evaluation for immunization strategy 12
Introduction of New Vaccines 引入新疫苗 使用新疫苗来预防控制疾病 : 脊灰灭活疫苗 B 型流感嗜血杆菌疫苗 肺炎疫苗 轮状病毒疫苗 To use new vaccines in disease control and prevention: IPV, Hib, Pneumonia, Rotavirus vaccines 研发 EV71 疫苗 EV71 vaccine developing, 评价疫苗的有效性和开展流行病学 成本效益分析和收集监测数据 To evaluate the effectiveness of vaccines and to conduct the epidemiological research, cost-effective evaluation, and collect surveillance data
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