Objective : To identify spatio-temporal distribution patterns of mumps in Zhejiang Province from 2008 to 2019, so as to provide insights into precise control of mumps. Methods : The epidemiological data pertaining to mumps in Zhejiang Province from 2008 to 2019 were collected from the China Information System for Disease Control and Prevention. The time- and region-specific incidence of mumps was descriptively analyzed, and the spatio-temporal clustering characteristics of mumps incidence were identified using global and local spatial autocorrelation analyses and spatio-temporal scan analysis. Results : A total of 167 196 cases of mumps were reported in Zhejiang Province from 2008 to 2019, and the incidence of mumps reduced from 56.08/105 in 2008 to 11.35/105 in 2019, with a reduction of 79.76%. There was no remarkable mumps seasonality since 2017; however, spatial autocorrelation was seen in mumps incidence in 2008, 2011 and 2012, respectively ( Moran's I coefficient=0.16, 0.18, 0.16; all P<0.05 ). Spatio-temporal scan analysis identified five spatio-temporal clusters of mumps incidence in 2008, 2011 and 2012, and the most likely spatio-temporal cluster was mainly concentrated in Cangnan County of Wenzhou City, covering 17 counties clustered in the time frame from 15 January 2008 to 28 February 2009, while the other four clusters were concentrated in Pinghu City of Jiaxing City, Kaihua County of Quzhou City, Fuyang District of Hangzhou City and Zhuji City of Shaoxing City, clustered in the time frame from 15 January 2008 to 30 June 2012. Conclusion The incidence of mumps appeared a tendency towards a reduction in Zhejiang Province from 2008 to 2019, and rebounded in some regions. No remarkable mumps seasonality was seen since 2017. The spatio-temporal clusters of mumps incidence were concentrated in Wenzhou and Jiaxing cities of Zhejiang Province in 2008, 2011 and 2012; however, no spatial cluster was identified since 2012.

Objective: To investigate the willingness to receive measles-containing vaccine (MCV) and its influencing factors among healthcare workers in the Yangtze River Delta region, so as to provide the evidence for improving the measles-containing vaccination rate Methods: Healthcare workers were sampled from 19 medical institutions in each of Shanghai Municipality, Jiangsu Province, Zhejiang Province and Anhui Province for questionnaire surveys using a multi-stage stratified convenience sampling methods from July 2020 to March 2021. Participants' gender, age, educational level, professional title, measles-containing vaccination, awareness of MCV and willingness to receive MCV were collected, and the factors affecting the willingness to receive MCV were identified among healthcare workers using a multivariable logistic regression model. Results: Totally 1 403 questionnaires were allocated, and 1 394 valid questionnaires were recovered, with an effective recovery rate of 99.36%. The respondents included 327 men and 1 067 women, with a male to female ratio of 1∶3.26, and 64.35% (897) were at ages of 31 to 50 years. There were 1 005 respondents with a bachelor degree (72.09%), 765 with middle and senior professional titles (54.88%), 676 with a history of measles-containing vaccination (48.49%), 1 176 with willingness to receive MCV (84.36%) and 218 without willingness to receive MCV due to convenience of vaccination (30.73%) and cost (19.27%). Multivariable logistic regression analysis showed that region (Zhejiang, OR=1.613, 95%CI: 1.054-2.470; Anhui, OR=2.058, 95%CI: 1.259-3.363), and no history of measles (OR=2.219, 95%CI: 1.302-3.781) were factors improving the willingness to receive MCV among healthcare workers, and hospital level (secondary, OR=0.483, 95%CI: 0.306-0.763; tertiary, OR=0.251, 95%CI: 0.160-0.394), history of measles-containing vaccination (no, OR=0.262, 95%CI: 0.172-0.399; unknown, OR=0.386, 95%CI: 0.266-0.559), and unawareness of MCV knowledge (OR=0.208, 95%CI: 0.081-0.536) were factors inhibiting the willingness to receive MCV among healthcare workers. Conclusions The willingness to receive MCV correlates with region, history of measles, hospital level, history of measles-containing vaccination and awareness of MCV knowledge among healthcare workers in the Yangtze River Delta region.

Abstract Inoculation of COVID-19 vaccines is an important approach to preventing SARS-CoV-2 infections and reducing the severe disease and mortality of COVID-19. The elderly, children and adolescents, pregnant women, lactating women, patients with chronic diseases and immunocompromised individuals are considered to be susceptible to and at a high risk of COVID-19. Early, safe and effective inoculation of COVID-19 vaccines is critical for the successful building of the population immune barrier against COVID-19. This review, based on data from clinical trials, summarizes the safety and efficacy and safety of COVID-19 vaccines among special populations, so as to provide insights into COVID-19 vaccination among special populations.

Objective : To investigate the awareness of human papillomavirus ( HPV ) vaccine and willingness to vaccinate daughters among parents of primary and middle school students, so as to provide the reference for the promotion of HPV vaccine in primary and middle school girls. Methods : Using multi-stage stratified cluster sampling method, the parents of girls in in Grade Four to Nine from schools in Gongshu District of Hangzhou, Xiuzhou District of Jiaxing and Wuxing District of Huzhou were selected. A questionnaire survey was conducted to collect demographic information, HPV vaccine related knowledge and willingness to vaccinate daughters with HPV vaccines. The multivariate logistic regression model was used to analyze the influencing factors for the willingness to vaccinate daughters with HPV vaccines among parents. Results : Totally 1 500 questionnaires were sent out, and 1 466 were effectively collected, with an effective rate of 97.73%. There were 313 fathers responded, accounting for 21.35%; and 1 153 mothers responded, accounting for 78.65%. The awareness rate of HPV vaccine was 16.81%. The rate of willing to vaccinate daughters with HPV vaccines was 49.86%. The multivariate logistic regression analysis showed that the patients who ever vaccinated daughters with self-paid vaccines ( OR=1.935, 95%CI: 1.473-2.541 ), knew cervical cancer ( OR=1.424, 95%CI: 1.065-1.904 ), knew HPV vaccine dose ( OR=1.672, 95%CI:1.216-2.301 ), knew the best vaccination period ( OR=1.392, 95%CI: 1.032-1.876 ), knew the need of cervical cancer screening even after vaccination ( OR=1.596, 95%CI:1.227-2.075) were more willing to vaccinate daughters with HPV vaccines, while the parents who thought HPV vaccine expensive ( OR=0.154, 95%CI: 0.099-0.240 ) were less willing to vaccinate daughters with HPV vaccines. Conclusions The rates of HPV vaccine awareness and willingness to vaccinate daughters are 16.81% and 49.86% among parents of primary and middle school students. Their knowledge of HPV vaccine and the price of the vaccine may affect their willingness to vaccinate daughters.

Objective: To explore the reliability and validity of the Chinese Pediatric Quality of Life Inventory（PedsQL）in influenza children. Methods: From January 2017 to February 2018,we selected laboratory-diagnosed influenza cases and healthy children according to age and gender ratio by stratified random sampling and systematic sampling method. We employed Chinese version of PedsQL 4.0 to investigate their quality of life,used Cronbach's α to evaluate the reliability,and used Pearson correlation coefficient, t-test,confirmatory factor analysis（CFA）and ROC curve to evaluate the validity. Results: Totally 300 influenza cases and 300 healthy children were surveyed,with 294（98.00%）and 295（98.33%）valid questionnaires recovered. The general Cronbach's α was 0.89,and the Cronbach's α of each dimension ranged from 0.79 to 0.84. The Pearson correlation coefficients between the items and their belonged dimension ranged from 0.537 to 0.755,between the items and other dimension ranged from 0.203 to 0.384. The CFA resulted in RMSEA of 0.06,GFI of 0.88,AGFI of 0.90,CFI of 0.91 and NFI of 0.89. The scores in total and in all the dimensions in influenza cases were significantly different with those in healthy children（P<0.05）. Taking the scores in influenza cases as a golden standard,the area under the ROC curve was 0. 985（P<0.05）,the sensitivity was 0.92,and the specificity was 0.95. When the limit score was 82.18,the Youden index was the largest. Conclusion The Chinese version of PedsQL4.0 has good reliability and validity, which can be applied to quality of life assessment in children.