Kalies Helen, Grote Veit, Verstraeten Thomas, Hessel Luc, Schmitt Heinz-Josef, von Kries Rüdiger
Department of Pediatric Epidemiology, Institute for Social Pediatrics and Adolescent Medicine of Ludwig-Maximilians-University, Munich, Germany.
Pediatr Infect Dis J. 2006 Jun;25(6):507-12. doi: 10.1097/01.inf.0000222413.47344.23.
In Germany, Haemophilus influenzae type b (Hib), polio and hepatitis B (HBV) vaccines have been combined with diphtheria, tetanus and acellular pertussis vaccines. We examined whether the use of combination vaccines has improved the timing of these vaccinations.
Vaccination information was obtained from representative nationwide telephone interviews about 2701 children born from 1996 through 2003 in Germany. We assessed up-to-date vaccination as the percentage of children vaccinated by 3, 5 and 15 months for the first dose, full primary series and full immunization, respectively. We compared results over periods when different combination vaccines were used. We also compared median age at first dose, full priming and full immunization for children receiving different types of combination vaccines.
During the study period, monovalent vaccines were replaced by higher-valent combination vaccines. With the change from mono- to 4-, 5- and 6-valent vaccines, up-to-date vaccination increased for Hib, polio and HBV. Median age at immunization improved by 0.5 month for Hib, 0.4 month for polio and 0.9 month for HBV at the first dose and 2.2 months for Hib, 3.2 months for polio and 1.4 months for HBV at full immunization when comparing hexavalent with monovalent vaccines. Median age for 4-5-valent vaccines was intermediate. The difference between monovalent and 6-valent vaccines remained significant after stratifying/adjusting for the effect of birth cohorts.
Combination vaccines are usually advocated for reducing the number of injections. In Germany, however, the use of combination vaccines has also significantly improved timeliness of immunizations.
在德国，b型流感嗜血杆菌（Hib）、脊髓灰质炎和乙型肝炎（HBV）疫苗已与白喉、破伤风和无细胞百日咳疫苗联合使用。我们研究了联合疫苗的使用是否改善了这些疫苗接种的及时性。
通过对德国1996年至2003年出生的2701名儿童进行具有全国代表性的电话访谈获取疫苗接种信息。我们分别将3个月、5个月和15个月时接种首剂疫苗、完成基础免疫全程和完成全程免疫的儿童百分比评估为及时接种情况。我们比较了使用不同联合疫苗期间的结果。我们还比较了接种不同类型联合疫苗儿童的首剂疫苗接种、基础免疫全程接种和全程免疫接种的中位年龄。
在研究期间，单价疫苗被更高价的联合疫苗所取代。随着从单价疫苗向4价、5价和6价疫苗的转变，Hib、脊髓灰质炎和HBV疫苗的及时接种率有所提高。与单价疫苗相比，接种六价疫苗时，Hib首剂疫苗接种的中位年龄提前了0.5个月，脊髓灰质炎提前了0.4个月，HBV提前了0.9个月；全程免疫时，Hib提前了2.2个月，脊髓灰质炎提前了3.2个月，HBV提前了1.4个月。4 - 5价疫苗的中位年龄处于中间水平。在对出生队列的影响进行分层/调整后，单价疫苗和6价疫苗之间的差异仍然显著。
联合疫苗通常被提倡用于减少注射次数。然而，在德国，联合疫苗的使用也显著提高了免疫接种的及时性。
