Elliott C, Farmer K
Herbertpur Christian Hospital, P.O. Herbertpur, District Dehradun, Uttaranchal, PIN 248142, India.
Child Care Health Dev. 2006 Jul;32(4):415-21. doi: 10.1111/j.1365-2214.2006.00623.x.
Immunization has played a major part in reducing childhood morbidity and mortality worldwide. Knowledge of vaccine coverage and reasons for poor uptake are essential for the achievement of herd immunity.
An observational study was carried out in September 2003, in 10 villages in the Vikas Nagar area around Herbertpur Christian Hospital in Uttaranchal, North India. We aimed to assess vaccination rates and potential socio-cultural, economic and religious influences on vaccine uptake. A total of 470 families were visited and details of immunization status of the oldest child under 7 years in each household were taken. Age range of children included was 9 months to 6 years.
The overall primary immunization rate was 77.2%, children receiving the first booster was 73.1% and children receiving the second booster was 58.4%. The most common vaccinations to be missed were the diphtheria, pertussis, tetanus at 18 months and diphtheria, tetanus at 5 years. Measles was the most frequently omitted vaccination in the primary course (19.4%). Poor education was the most frequent reason given by parents for failure to vaccinate. Immunization rates did not differ according to gender of the child. A lower immunization rate was found in Muslim families (65.4% primary) compared with Hindu (85.2%). Parental literacy had a beneficial effect such that up to 20% more children were immunized.
These results highlight the potential importance of literacy, and religious or cultural influences on the success of the Expanded Programme of Immunization, and will have important implications for areas with similar cultural demographics.
免疫接种在全球范围内降低儿童发病率和死亡率方面发挥了重要作用。了解疫苗接种覆盖率及接种率低的原因对于实现群体免疫至关重要。
2003年9月，在印度北部北阿坎德邦赫伯特布尔基督教医院周边维卡斯纳加尔地区的10个村庄开展了一项观察性研究。我们旨在评估疫苗接种率以及社会文化、经济和宗教因素对疫苗接种的潜在影响。共走访了470个家庭，并记录了每户中7岁以下最大孩子的免疫接种状况详情。纳入研究的儿童年龄范围为9个月至6岁。
总体基础免疫接种率为77.2%，接受首次加强免疫的儿童比例为73.1%，接受第二次加强免疫的儿童比例为58.4%。最常漏种的疫苗是18个月龄时的白喉、百日咳、破伤风疫苗以及5岁时的白喉、破伤风疫苗。麻疹是基础免疫过程中最常漏种的疫苗（19.4%）。家长给出的未接种疫苗的最常见原因是教育程度低。免疫接种率在儿童性别方面没有差异。与印度教家庭（基础免疫接种率85.2%）相比，穆斯林家庭的免疫接种率较低（基础免疫接种率65.4%）。父母的识字能力有积极影响，识字家庭的儿童免疫接种率高出多达20%。
这些结果凸显了识字能力以及宗教或文化因素对扩大免疫规划成功实施的潜在重要性，对于具有相似文化人口特征的地区具有重要意义。
