Cortese Margaret M, Diaz Pamela S, Samala Usha, Mennone John Z, Mihalek Edward F, Matuck Michael J, Johnson-Partlow Thomasine, Dicker Richard C, Paul William S
Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Am J Prev Med. 2004 Jan;26(1):29-33. doi: 10.1016/j.amepre.2003.09.021.
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) serves a large proportion of Chicago infants, but some discontinue participation before age 1 year. To determine if children who remained active at WIC immunization-linked sites after their first birthday were more likely to be immunized by ages 19 and 25 months than those who dropped out, a retrospective cohort study was conducted.
Four Chicago WIC sites that used monthly voucher pick-up were chosen. Children born from July 1, 1997 to September 30, 1997 who attended these sites were eligible (N=1142). The cohort was divided into two groups: (1) active group (46%), who had a WIC visit on or after their first birthday; and (2) inactive group (54%), who had their last WIC visit before their first birthday. Children were enrolled through home visits.
The records for 200 children were analyzed. By age 19 months, 65 (84%) of 77 active children had received one dose of measles-mumps-rubella vaccine (MMR), compared to 82 (67%) of 123 inactive children (risk ratio [RR]=1.3; 95% confidence interval [CI], 1.1- 1.5). By age 25 months, 64 (83%) active children had received four doses of diphtheria-tetanus-pertussis vaccine (DTP), one MMR, and three doses of Haemophilus influenzae type b vaccine (Hib), compared with 64 (52%) inactive children (RR=1.6; 95% CI, 1.3-2.0).
In this cohort, children active in WIC after their first birthday were more likely to be immunized by ages 19 and 25 months, compared with those who were no longer active. Chicago children who drop out of WIC may represent those at highest risk for underimmunization and may require special strategies to improve coverage.
妇女、婴儿和儿童特别补充营养计划（WIC）为很大比例的芝加哥婴儿提供服务，但一些婴儿在1岁前就停止参与该计划。为了确定在1岁生日后仍在WIC免疫相关地点保持活跃的儿童，与退出该计划的儿童相比，在19个月和25个月龄时是否更有可能接种疫苗，开展了一项回顾性队列研究。
选择了四个采用每月领取代金券方式的芝加哥WIC地点。1997年7月1日至1997年9月30日在这些地点就诊的儿童符合条件（N = 1142）。该队列分为两组：（1）活跃组（46%），在其1岁生日当天或之后有过一次WIC就诊；（2）非活跃组（54%），在其1岁生日前最后一次就诊。通过家访招募儿童。
分析了200名儿童的记录。到19个月龄时，77名活跃儿童中有65名（84%）接种了一剂麻疹-腮腺炎-风疹疫苗（MMR），相比之下，123名非活跃儿童中有82名（67%）接种了该疫苗（风险比[RR] = 1.3；95%置信区间[CI]，1.1 - 1.5）。到25个月龄时，64名（83%）活跃儿童接种了四剂白喉-破伤风-百日咳疫苗（DTP）、一剂MMR和三剂b型流感嗜血杆菌疫苗（Hib），相比之下，64名（52%）非活跃儿童接种了这些疫苗（RR = 1.6；95% CI，1.3 - 2.0）。
在该队列中，与不再活跃的儿童相比，1岁生日后在WIC保持活跃的儿童在19个月和25个月龄时更有可能接种疫苗。退出WIC的芝加哥儿童可能是免疫接种不足风险最高的人群，可能需要特殊策略来提高疫苗接种覆盖率。
