Meyerhoff A S, Jacobs R J
Capitol Outcomes Research, Inc., 6188 Old Franconia Road, Alexandria, VA 22310, USA.
Prev Med. 2005 Aug;41(2):540-4. doi: 10.1016/j.ypmed.2004.12.001.
Missed childhood vaccination opportunities have been generally described, yet not since the immunization schedule's recent rapid expansion. Little is known about the relationship between the number of vaccine doses due and whether all scheduled doses are administered, and the effect of dose deferral on immunization coverage.
32 private pediatrics centers reviewed medical records covering the first 2 years of life for 858 patients. For each visit during ages 2-8 months, we determined the numbers of vaccine doses due versus administered. Logistic regression was used to assess the effect of dose deferral on immunization coverage at ages 1 and 2 years.
Of 2224 visits during ages 2-8 months at which > or =1 dose was administered, > or =1 due dose was deferred at 26%, 34%, and 48% of the visits at which < or =3, 4, and 5 doses were due, respectively. Absence of a deferred dose visit predicted increased coverage at age 1 (adjusted odds ratio: 2.4, 95% confidence interval: 1.8-3.2) and 2 years (2.1, 1.4-3.0).
Administering some but not all vaccine doses at visits during ages 2-8 months impairs immunization coverage through age 2 years.
儿童疫苗接种机会缺失的情况已被普遍描述，但自免疫规划近期快速扩展以来尚未见相关报道。对于应接种疫苗剂量数量与是否接种所有计划剂量之间的关系，以及剂量延迟对接种覆盖率的影响，人们知之甚少。
32家私立儿科中心回顾了858例患者出生后头两年的病历。对于2至8月龄期间的每次就诊，我们确定了应接种疫苗剂量与实际接种剂量的数量。采用逻辑回归分析评估剂量延迟对1岁和2岁时接种覆盖率的影响。
在2至8月龄期间进行的2224次至少接种1剂疫苗的就诊中，当应接种剂量分别≤3剂、4剂和5剂时，≥1剂应接种剂量被延迟的就诊比例分别为26%、34%和48%。未出现延迟剂量就诊预测1岁时接种覆盖率增加（调整优势比：2.4，95%置信区间：1.8 - 3.2），2岁时为2.1（1.4 - 3.0）。
在2至8月龄期间就诊时接种部分而非全部疫苗剂量会损害2岁前的接种覆盖率。
