Pulido M J, Alvarado E A, Berger W, Nelson A, Todoroff C
Immunization Program, Los Angeles County Department of Health Services, 1055 Wilshire Blvd. Suite 1950, Los Angeles, CA 90017, USA.
Asian Am Pac Isl J Health. 2001 Summer-Fall;9(2):211-20.
Hepatitis B virus (HBV) is a known cause of liver cancer, especially among Asian and Pacific Islanders (API). Despite national recommendations and school entry requirements for vaccination, many children are not fully vaccinated with the Hepatitis B vaccine (Hep B) before entering school. The purpose of this study was to measure ethnic group-specific hepatitis B vaccination rates among school-aged API children after implementation of universal recommendations and school laws, and quantify ethnic-specific risk factors associated with late and incomplete vaccinations.
A multilingual questionnaire was distributed to parents of second and fourth graders in nine Los Angeles County (LAC) elementary schools with high proportions of API students. Data on Hepatitis B vaccination dates, source of health care and health information, cultural factors, and general knowledge and attitudes about HBV and vaccination were collected and analyzed.
Overall, 1,696 (77%) of 2,183 questionnaires were returned. Of these, 1,024 were from API children. The API second graders in this survey had a 72% coverage rate, ranging from 46% to 94% among the individual ethnic groups. Fifty-one percent of API fourth graders had three doses of Hep B vaccine, ranging from 38% to 69% among the individual ethnic groups. Factors influencing coverage levels among API fourth graders were speaking limited English at home, living in the United States less than five years, and not having discussed hepatitis B vaccination with a health care provider. Factors influencing low immunization levels differed among the API ethnic groups.
Analysis and intervention on a non-aggregate level are necessary for designing both effective and cultural-specific outreach programs for diverse API communities such as LAC's.
乙肝病毒（HBV）是导致肝癌的已知病因，在亚裔和太平洋岛民（API）中尤为如此。尽管有国家疫苗接种建议和入学要求，但许多儿童在入学前并未完全接种乙肝疫苗（Hep B）。本研究的目的是在实施普遍建议和学校相关法律后，测量学龄期API儿童中按种族划分的乙肝疫苗接种率，并量化与延迟和未完全接种相关的种族特异性风险因素。
向洛杉矶县（LAC）九所API学生比例较高的小学二、四年级学生的家长发放了一份多语言问卷。收集并分析了关于乙肝疫苗接种日期、医疗保健和健康信息来源、文化因素以及对HBV和疫苗接种的一般知识与态度的数据。
总体而言，2183份问卷共回收1696份（77%）。其中，1024份来自API儿童。本次调查中，API二年级学生的疫苗接种覆盖率为72%，各民族群体的覆盖率在46%至94%之间。51%的API四年级学生接种了三剂乙肝疫苗，各民族群体的接种率在38%至69%之间。影响API四年级学生疫苗接种覆盖率的因素包括在家中英语使用受限、在美国居住时间不足五年以及未与医疗保健提供者讨论过乙肝疫苗接种。影响低免疫水平的因素在API各民族群体中有所不同。
对于为像LAC这样多样化的API社区设计有效且具有文化针对性的推广项目而言，在非总体层面进行分析和干预是必要的。
