Lawrence Glenda L, MacIntyre C Raina, Hull Brynley P, McIntyre Peter B
National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, University of Sydney, New South Wales.
Aust N Z J Public Health. 2003;27(4):413-8. doi: 10.1111/j.1467-842x.2003.tb00419.x.
To (i) assess under-reporting of measles-mumps-rubella (MMR) vaccinations to the Australian Childhood Immunisation Register (ACIR); (ii) estimate MMR coverage among five-year-old children and the proportion immune to measles infection; (iii) identify factors related to non-uptake of MMR vaccination.
We analysed ACIR data for a birth cohort of approximately 64,000 children aged five years. The parents of a sample of 506 children with no ACIR record for the second MMR vaccination (MMR2), due at four years of age, were interviewed by telephone to assess under-reporting to the ACIR and reasons for non-uptake of MMR vaccination.
Parents reported that 22% (n = 111) of the surveyed 506 children had received MMR2 before their fifth birthday, and 42% (n = 214) by approximately 5.5 years of age. After correcting for this level of under-reporting to the ACIR, MMR2 coverage for the entire cohort at five years of age was 52.9% (95% CI 52.3-53.4), and increased to 84.1% (95% CI 83.4-84.8) by approximately 5.5 years of age. This was 4.3% and 8.2%, respectively, higher than ACIR coverage estimates at the two ages. Based on the corrected MMR coverage estimates, 93% of the cohort was immune to measles due to vaccination. The most common parent-reported reason for incomplete vaccination was lack of knowledge about the MMR vaccination schedule.
Measles elimination in Australia will require continued effort in vaccination coverage and timeliness among pre-school children. School-entry requirements are important for MMR2 uptake. Strategies are needed to improve reporting to the ACIR for more accurate measurement of coverage.
(i)评估向澳大利亚儿童免疫登记册（ACIR）报告的麻疹-腮腺炎-风疹（MMR）疫苗接种漏报情况；(ii)估计五岁儿童的MMR疫苗接种覆盖率以及对麻疹感染具有免疫力的比例；(iii)确定与未接种MMR疫苗相关的因素。
我们分析了约64,000名五岁出生队列儿童的ACIR数据。通过电话采访了506名四岁应接种第二剂MMR疫苗（MMR2）但在ACIR中无记录儿童的家长，以评估向ACIR的漏报情况以及未接种MMR疫苗的原因。
家长报告称，在接受调查的506名儿童中，22%（n = 111）在五岁生日前接种了MMR2疫苗，到约5.5岁时，这一比例为42%（n = 214）。在纠正向ACIR的这种漏报水平后，整个队列五岁时的MMR2疫苗接种覆盖率为52.9%（95%置信区间52.3 - 53.4），到约5.5岁时升至84.1%（95%置信区间83.4 - 84.8）。这分别比这两个年龄的ACIR覆盖率估计值高4.3%和8.2%。根据校正后的MMR疫苗接种覆盖率估计，该队列中93%的儿童因接种疫苗而对麻疹具有免疫力。家长报告的疫苗接种不完整的最常见原因是对MMR疫苗接种时间表缺乏了解。
澳大利亚要消除麻疹，需要继续努力提高学龄前儿童的疫苗接种覆盖率和及时性。入学要求对MMR2疫苗接种很重要。需要采取策略来改善向ACIR的报告，以便更准确地衡量覆盖率。
