Skowronski Danuta M, Pielak Karen, Remple Valencia P, Halperin Beth A, Patrick David M, Naus Monika, McIntyre Cheryl
University of British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, Canada V5Z 4R4.
Vaccine. 2004 Dec 2;23(3):353-61. doi: 10.1016/j.vaccine.2004.05.033.
Lifetime protection against pertussis has been adopted as a goal of immunization programs in Canada. To anticipate adult coverage with a combined product containing tetanus (T) and diphtheria (d) toxoids and acellular pertussis (aP) vaccine as a booster dose, we conducted a survey of households in British Columbia, Canada.
In a random telephone survey involving 800 adults, 25 years of age and older, we assessed current behaviors related to adult Td immunization and beliefs regarding pertussis vaccine under various scenarios relevant to adult decision-making.
Forty-five percent of participants reported having received tetanus vaccine within the previous 10 years; this rate was lowest amongst elderly persons 65 years of age or more (28%). On multi-variate analysis, being up-to-date with tetanus immunization was independently associated with belief that an adult should be immunized against tetanus and perception that tetanus is life-threatening and inversely associated with being elderly. At baseline, 59% of respondents indicated willingness to receive pertussis immunization if provided free; this increased to 76% following sequential information about communicability and severity of pertussis illness and safety, efficacy and convenience of vaccine and up to 87% if accompanied by physician or nurse recommendation. Sixty-three percent of adults indicated they would receive the vaccine if required to pay $40.00 (Cdn) for it.
Personal risk perception, public funding and physician recommendation are important to adults when considering tetanus and pertussis immunization. These factors may be relevant as immunization programs are expanded to include more adults generally.
终身预防百日咳已被确立为加拿大免疫规划的目标。为预测含有破伤风（T）和白喉（d）类毒素及无细胞百日咳（aP）疫苗的联合产品作为加强剂量在成人中的覆盖率，我们在加拿大不列颠哥伦比亚省开展了一项家庭调查。
在一项涉及800名25岁及以上成年人的随机电话调查中，我们评估了与成人破伤风免疫相关的当前行为，以及在与成人决策相关的各种情况下对百日咳疫苗的看法。
45%的参与者报告在过去10年内接种过破伤风疫苗；这一比例在65岁及以上的老年人中最低（28%）。多变量分析显示，及时接种破伤风疫苗与认为成年人应接种破伤风疫苗、认为破伤风危及生命的信念独立相关，与年龄较大呈负相关。基线时，59%的受访者表示如果免费提供愿意接种百日咳疫苗；在依次了解百日咳疾病的传染性和严重性、疫苗的安全性、有效性和便利性后，这一比例增至76%，如果有医生或护士推荐，这一比例高达87%。63%的成年人表示，如果需要支付40加元，他们会接种该疫苗。
在考虑破伤风和百日咳免疫时，个人风险认知、公共资金和医生建议对成年人很重要。随着免疫规划扩大到包括更多成年人，这些因素可能具有相关性。
