Hennessey K A, Marx A, Hafiz R, Ashgar H, Hadler S C, Jafari H, Sutter R W
Vaccine-Preventable Disease Eradication Division (E-nn05), Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
J Infect Dis. 2000 Jul;182(1):6-11. doi: 10.1086/315675. Epub 2000 Jun 27.
Despite substantial efforts to eradicate poliomyelitis by administering oral poliovirus vaccine through routine immunization and annual national immunization days (NIDs), Pakistan reported 22% (1147) of the worldwide cases in 1997. Reasons for continued high poliomyelitis incidence include failure to vaccinate, vaccine failure, or inadequate immunization strategies. A case-control study was conducted to measure vaccination status and reasons for undervaccination among 66 poliomyelitis cases and 130 age- and neighborhood-matched controls. Cases were undervaccinated through routine immunization (matched odds ratio [MOR], 0.3; 95% confidence interval [CI], 0.1-0.5); however, NID immunization was similar for cases and controls (MOR, 0.6; 95% CI, 0.3-1.2). Reasons for undervaccination included not being informed, considering vaccination unimportant, and long distances to vaccination sites. Failure to vaccinate through routine immunization was a major risk factor for poliomyelitis in Pakistan. Successful NIDs alone will not interrupt poliovirus circulation in Pakistan, and children remain at risk unless routine immunization is strengthened or additional supplementary immunization is provided.
尽管通过常规免疫和年度全国免疫日（NIDs）接种口服脊髓灰质炎疫苗来根除脊髓灰质炎付出了巨大努力，但巴基斯坦在1997年报告的病例数占全球病例数的22%（1147例）。脊髓灰质炎发病率持续居高不下的原因包括未接种疫苗、疫苗失效或免疫策略不足。开展了一项病例对照研究，以衡量66例脊髓灰质炎病例和130例年龄及邻里匹配的对照者的疫苗接种状况及未充分接种疫苗的原因。病例通过常规免疫未充分接种疫苗（匹配比值比[MOR]，0.3；95%置信区间[CI]，0.1 - 0.5）；然而，病例和对照者的全国免疫日免疫情况相似（MOR，0.6；95%CI，0.3 - 1.2）。未充分接种疫苗的原因包括未得到通知、认为接种疫苗不重要以及前往接种地点的距离远。通过常规免疫未接种疫苗是巴基斯坦脊髓灰质炎的主要危险因素。仅靠成功的全国免疫日活动无法在巴基斯坦阻断脊髓灰质炎病毒传播，除非加强常规免疫或提供额外的补充免疫，儿童仍面临风险。
