Vryheid R E
Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University, San Diego, CA, USA.
Asian Am Pac Isl J Health. 2001 Summer-Fall;9(2):221-30.
This report summarizes a vaccination coverage survey of 65 immigrant and refugee families in San Diego County. It included gathering information from 19 community and government organizations on the immunization system, and on families' barriers impeding immunization.
The "rapid appraisal" exploratory method flexibly used several research methods, such as informant interviews and door-to-door surveys, changing methods as new questions were uncovered. The researcher went alone, or with organizations' staffs, to interview families, record their vaccination records, and give them forms telling which vaccine doses they lacked.
The 4:3:1 (4 DTP, 3 polio, 1 MMR) vaccination series completion rate among children while they were aged 19-35 months old ranged from 33% in those born in 1984-1985, to 60% in those born in 1996-1997. The hepatitis B vaccine completion coverage rate among children in the 1984-1993 birth cohorts was 73%. The hepatitis B vaccine completion coverage rate among Hmong, Vietnamese, and Chinese adolescents ranged from 86%-100%, and among the Kurdish was 85%, Somali 73%, Lao 43% and Cambodian adolescents 35%.
The hepatitis B vaccine completion coverage rate was higher among Hmong, Vietnamese, and Chinese adolescents probably because they lived near clinics and schools providing the vaccine to many, and among the Kurdish and Somali because they received many doses in refugee programs. The families experienced immunization barriers involving transportation, languages, little knowledge of immunizations, and missed opportunities. Two populations have cultural barriers: numerous European-Americans believe in anti-vaccine ideas; and many East Africans have little knowledge of the English language and the American system.
Health personnel should continue using current methods to promote immunizations. Community organizations' staffs should consistently check vaccination records, and health officials should do more trainings for those staffs. The National Task Force on Hepatitis B Immunization, Focus on Asians and Pacific Islanders should broaden its work from Asians and Pacific Islanders, to other nationalities with intermediate or high hepatitis B endemicity.
本报告总结了对圣地亚哥县65个移民和难民家庭的疫苗接种覆盖率调查。调查包括从19个社区和政府组织收集有关免疫接种系统以及阻碍家庭接种疫苗的障碍的信息。
“快速评估”探索性方法灵活运用了多种研究方法，如关键 informant 访谈和挨家挨户调查，并根据新发现的问题改变方法。研究人员独自或与各组织的工作人员一起走访家庭，记录他们的疫苗接种记录，并给他们发放表格，告知他们缺少哪些疫苗剂量。
19至35个月大儿童的4:3:1（4剂百白破疫苗、3剂脊髓灰质炎疫苗、1剂麻疹腮腺炎风疹疫苗）疫苗接种系列完成率在1984年至1985年出生的儿童中为33%，在1996年至1997年出生的儿童中为60%。1984年至1993年出生队列中的儿童乙肝疫苗全程接种覆盖率为73%。苗族、越南裔和华裔青少年的乙肝疫苗全程接种覆盖率在86%至100%之间，库尔德青少年为85%，索马里青少年为73%，老挝青少年为43%，柬埔寨青少年为35%。
苗族、越南裔和华裔青少年的乙肝疫苗全程接种覆盖率较高，可能是因为他们居住在向许多人提供疫苗的诊所和学校附近；库尔德和索马里青少年的覆盖率较高，是因为他们在难民项目中接种了许多剂次。这些家庭在免疫接种方面遇到了交通、语言、对免疫接种了解甚少以及错过接种机会等障碍。有两个人口群体存在文化障碍：许多欧裔美国人相信反疫苗观点；许多东非人对英语和美国体系了解甚少。
卫生人员应继续采用当前方法促进免疫接种。社区组织的工作人员应持续检查疫苗接种记录，卫生官员应为这些工作人员开展更多培训。全国乙肝免疫接种特别工作组、关注亚太岛民组织应将其工作从亚太岛民扩大到乙肝流行率中等或较高的其他民族。
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