Lewis L S, Hardy I, Strebel P, Tyshchenko D K, Sevalnyev A, Kozlova I
Adult Vaccine Preventable Diseases Branch, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
J Infect Dis. 2000 Feb;181 Suppl 1:S232-6. doi: 10.1086/315568.
Ukraine has been experiencing epidemic diphtheria since 1991. In efforts to control this epidemic, a mass vaccination campaign was held in April 1995. Persons not vaccinated in the previous 3 years were considered eligible for vaccination with tetanus-diphtheria toxoids (Td). Two cluster sample surveys were conducted to determine vaccination coverage achieved. In the urban and rural survey areas, respectively, 628 and 618 persons 30-49 years of age were interviewed. Fifty-nine percent of urban and 58% of rural participants were eligible for vaccination. During the vaccination campaign, 58% (95% confidence interval [95% CI], 47.1-69.2) of eligible persons received Td in the urban area, compared with 92% (95% CI, 89.2-95.3) in the rural area. Apparent barriers to vaccination included misconceptions about the safety, efficacy, and need for booster doses of Td. Future vaccination campaigns should include targeted information and education messages. Mass vaccination campaigns can be successful in vaccinating large numbers of adults; however, in urban areas, additional efforts may be required to achieve levels of coverage adequate to confer herd immunity and interrupt the diphtheria epidemic.
自1991年以来，乌克兰一直遭受白喉流行疫情。为了控制这一疫情，1995年4月开展了大规模疫苗接种运动。过去3年未接种疫苗的人被视为有资格接种破伤风 - 白喉类毒素（Td）。进行了两次整群抽样调查以确定疫苗接种覆盖率。在城市和农村调查地区，分别对628名和618名30至49岁的人进行了访谈。城市和农村参与者中分别有59%和58%有资格接种疫苗。在疫苗接种运动期间，城市地区58%（95%置信区间[95%CI]，47.1 - 69.2）的符合条件者接种了Td，而农村地区这一比例为92%（95%CI，89.2 - 95.3）。明显的疫苗接种障碍包括对Td的安全性、有效性以及加强剂量必要性的误解。未来的疫苗接种运动应包括有针对性的信息和教育宣传。大规模疫苗接种运动能够成功地为大量成年人接种疫苗；然而，在城市地区，可能需要额外努力以达到足以产生群体免疫并阻断白喉疫情的接种覆盖率水平。
