Luman Elizabeth T, McCauley Mary Mason, Stokley Shannon, Chu Susan Y, Pickering Larry K
National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Pediatrics. 2002 Nov;110(5):935-9. doi: 10.1542/peds.110.5.935.
To examine the timeliness of vaccine administration among infants and young children in the United States.
We analyzed age at receipt of vaccines among 16 211 children aged 24 to 35 months in the 2000 National Immunization Survey and examined receipt at the recommended time of each dose and selected vaccination series, as well as receipt at 4 additional time frames: acceptably early, late, never by 24 months, and too early to be considered valid. We also examined the relationship between timeliness of vaccinations and characteristics of the child, mother, and immunization provider, using multivariate logistic regression.
Only 9% of children received all recommended vaccines at the recommended ages. The rates varied significantly by antigen, ranging from 24% for all Haemophilus influenzae type b doses to 75% for all hepatitis B doses as recommended. Overall, 55% of children did not receive all recommended doses by 24 months of age, and 8% of children received at least 1 vaccination dose too early to be considered valid. Factors associated with not receiving all vaccines as recommended were having more children in the household, mothers younger than 30 years, use of public providers, and multiple vaccination providers.
By 24 months of age, 9 of 10 children received at least 1 vaccine outside the recommended age ranges. High vaccination status of children at 24 months of age does not reflect the reality that many vaccinations are not given at the appropriate ages. Timeliness of vaccination is critical to prevent disease outbreaks, protect children through their first 2 years of life, and minimize the need to repeat doses.
研究美国婴幼儿疫苗接种的及时性。
我们分析了2000年全国免疫调查中16211名24至35个月大儿童的疫苗接种年龄，检查了每剂疫苗和选定疫苗系列在推荐时间的接种情况，以及在另外4个时间框架内的接种情况：可接受的早期、晚期、24个月前从未接种以及过早接种以至于被认为无效。我们还使用多因素逻辑回归分析了疫苗接种及时性与儿童、母亲和免疫接种提供者特征之间的关系。
只有9%的儿童在推荐年龄接种了所有推荐疫苗。不同抗原的接种率差异显著，从所有b型流感嗜血杆菌疫苗剂量的24%到所有推荐的乙肝疫苗剂量的75%不等。总体而言，55%的儿童在24个月龄时未接种所有推荐剂量的疫苗，8%的儿童至少有1剂疫苗接种过早以至于被认为无效。与未按推荐接种所有疫苗相关的因素包括家庭中孩子较多、母亲年龄小于30岁、使用公共接种提供者以及多个接种提供者。
到24个月龄时，十分之九的儿童至少有1剂疫苗是在推荐年龄范围之外接种的。24个月龄儿童的高疫苗接种率并不能反映许多疫苗未在适当年龄接种的现实情况。疫苗接种的及时性对于预防疾病爆发、在儿童生命的前两年保护他们以及尽量减少重复接种的必要性至关重要。
