Kolasa M S, Desai S N, Bisgard K M, Dibling K, Prevots D R
National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Am J Prev Med. 2000 Feb;18(2):140-5. doi: 10.1016/s0749-3797(99)00132-4.
Researchers for this project evaluated compliance with the sequential poliovirus immunization schedule that uses inactivated poliovirus vaccine (IPV) for the first 2 doses of the polio immunization series, and assessed immunization coverage rates before and after implementation of this schedule at 6 public health clinics serving 1 county in Georgia.
Immunization histories for 3 birth cohorts of infants were compared: (1) the baseline cohort, born January 1 through June 30, 1995; (2) the evaluation cohort, born January 1 through June 30, 1997, after implementation of the schedule change; and (3) the dose-3 cohort, born August 1 through November 30, 1996 (i.e., old enough to be eligible for a third dose of poliovirus vaccine following implementation of the sequential schedule).
Following implementation of the new poliovirus immunization recommendations, 94% (534 of 567) of infants who received their first dose of poliovirus vaccine by age 3 months received IPV. Among these infants, 99.6% (532 of 534) were also up to date (UTD) for first doses of diphtheria and tetanus toxoids and acellular pertussis vaccine (DTP1/DTaP1), 99.6% (532 of 534) were UTD for first doses of hemophilus influenza type b (Hib 1), and 98.6% (527 of 534) had received at least one dose of Hepatitis B. Among infants visiting the clinics for their first or second dose of poliovirus vaccine, DTaP/DTP, and/or Hib, 76% received 3 or 4 simultaneous injections. In the dose-3 cohort, 78% (145 of 185) of infants who received a third dose of poliovirus vaccine had received 2 doses of IPV and 1 dose of oral poliovirus vaccine.
Compliance with the recommended use of IPV for the first 2 poliovirus immunization doses as part of the sequential schedule was very high in this low-income and ethnically diverse population. Furthermore, the need for additional injections did not impede the delivery of recommended childhood immunizations.
该项目的研究人员评估了在脊髓灰质炎免疫程序中前两剂使用灭活脊髓灰质炎疫苗（IPV）的序贯脊髓灰质炎免疫程序的依从性，并在佐治亚州一个县的6家公共卫生诊所实施该程序前后评估了免疫覆盖率。
比较了3个婴儿出生队列的免疫史：（1）基线队列，1995年1月1日至6月30日出生；（2）评估队列，在免疫程序变更实施后于1997年1月1日至6月30日出生；（3）第3剂队列，1996年8月1日至11月30日出生（即年龄足够大，在序贯程序实施后有资格接种第三剂脊髓灰质炎疫苗）。
在新的脊髓灰质炎免疫建议实施后，3个月龄前接种第一剂脊髓灰质炎疫苗的婴儿中有94%（567名中的534名）接种了IPV。在这些婴儿中，99.6%（534名中的532名）也按时接种了白喉、破伤风类毒素和无细胞百日咳疫苗（DTP1/DTaP1）的第一剂，99.6%（534名中的532名）按时接种了b型流感嗜血杆菌（Hib 1）的第一剂，98.6%（534名中的527名）至少接种了一剂乙型肝炎疫苗。在到诊所接种第一剂或第二剂脊髓灰质炎疫苗、DTaP/DTP和/或Hib的婴儿中，76%接受了3剂或4剂同时接种。在第3剂队列中，接种第三剂脊髓灰质炎疫苗的婴儿中有78%（185名中的145名）接种了2剂IPV和1剂口服脊髓灰质炎疫苗。
在这个低收入且种族多样的人群中，作为序贯程序一部分，前两剂脊髓灰质炎免疫使用IPV的推荐依从性非常高。此外，额外注射的需求并未妨碍推荐的儿童免疫接种的实施。
