Zimmerman Richard Kent, Raymund Mahlon, Janosky Janine E, Nowalk Mary Patricia, Fine Michael J
Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, 3518 Fifth Avenue, PA 15261, USA.
Vaccine. 2003 Mar 28;21(13-14):1486-91. doi: 10.1016/s0264-410x(02)00700-4.
National surveys of adult vaccination indicate moderate self-reported immunization rates in the US, with limited validity data. We compared self-report with medical record abstraction for 820 persons aged > or =66 years from inner-city health centers, Veterans Affairs (VA) outpatient clinics, rural and suburban practices. For influenza vaccine, sensitivity was 98% (95% CI: 96-99%); specificity was 38% (95% CI: 33-43%). For pneumococcal polysaccharide vaccine, sensitivity was 85% (95% CI: 82-89%) and specificity was 46% (95% CI: 42-50%). The VA had the highest sensitivity and lowest specificity for both vaccines while the converse was true in inner-city centers. High negative predictive values indicate that clinicians can confidently vaccinate based on negative patient self-report.
全国成年人疫苗接种调查显示，美国自我报告的免疫接种率处于中等水平，有效数据有限。我们对来自市中心医疗中心、退伍军人事务部（VA）门诊诊所、农村和郊区医疗机构的820名年龄≥66岁的人员的自我报告与病历摘要进行了比较。对于流感疫苗，敏感性为98%（95%置信区间：96 - 99%）；特异性为38%（95%置信区间：33 - 43%）。对于肺炎球菌多糖疫苗，敏感性为85%（95%置信区间：82 - 89%），特异性为46%（95%置信区间：42 - 50%）。VA对两种疫苗的敏感性最高，特异性最低，而在市中心医疗中心情况则相反。高阴性预测值表明临床医生可以根据患者的阴性自我报告放心地进行疫苗接种。
