Verani Jennifer R, Irigoyen Matilde, Chen Shaofu, Chimkin Frank
Department of Pediatrics, Columbia University, 622 W 168th St, New York, NY 10032, USA.
Pediatrics. 2007 Mar;119(3):e580-6. doi: 10.1542/peds.2006-1580.
In 2002, the Advisory Committee on Immunization Practices recommended universal influenza vaccination of 6- to 23-month-olds. Little is known about coverage and missed opportunities for influenza vaccination at inner-city practices. The objective of this study was to assess the 2000-2001 to 2004-2005 coverage and the prevalence of missed opportunities for influenza vaccination among inner-city children.
We conducted a retrospective review for the 2000-2001 to 2004-2005 influenza seasons at a practice network in New York City. The study population included 5 annual cohorts of 6- to 29-month olds as of March 31 of each year with > or = 1 visit to the network in the previous 12 months (n = 7063). Immunization data were obtained from the network registry and the New York Citywide Immunization Registry. Coverage levels were estimated for 1 dose (partial) and 2 doses (full). Missed opportunities were assessed for visits within each influenza season.
Coverage rose steadily throughout the 5 years (full: 1.6% to 23.7%; partial: 1.5% to 18.1%). The relationship between year and coverage was linear. Missed opportunities occurred in 82% of visits and were more common for first (89%) than for repeat doses (38%). Missed opportunities per child per season decreased from 2.9 to 2.0 during the study period.
Influenza vaccine coverage among 6- to 23-month-olds at inner-city practices increased steadily from 2000-2001 through 2004-2005, and the prevalence of missed opportunities per child decreased. However, coverage remained suboptimal, with most of children not vaccinated or undervaccinated. Missed opportunities were major contributors to low coverage.
2002年，免疫实践咨询委员会建议对6至23个月大的儿童普遍接种流感疫苗。对于市中心区医疗机构的流感疫苗接种覆盖率及错过接种机会的情况，人们了解甚少。本研究的目的是评估2000 - 2001年至2004 - 2005年市中心区儿童流感疫苗的接种覆盖率及错过接种机会的情况。
我们对纽约市一个医疗机构网络在2000 - 2001年至2004 - 2005年流感季节进行了回顾性研究。研究人群包括每年3月31日时年龄在6至29个月、过去12个月内到该网络就诊≥1次的5个年度队列（n = 7063）。免疫数据来自该网络登记处及纽约市全市免疫登记处。估计了1剂（部分接种）和2剂（全程接种）的覆盖率。对每个流感季节内的就诊情况评估错过接种机会的情况。
在这5年中覆盖率稳步上升（全程接种：从1.6%升至23.7%；部分接种：从1.5%升至18.1%）。年份与覆盖率之间呈线性关系。82%的就诊存在错过接种机会的情况，首剂（89%）比重复接种剂次（38%）更常见。在研究期间，每个儿童每个季节错过接种机会的次数从2.9次降至2.0次。
2000 - 2001年至2004 - 2005年，市中心区医疗机构中6至23个月大儿童的流感疫苗接种覆盖率稳步上升，每个儿童错过接种机会的情况减少。然而，覆盖率仍未达到最佳水平，大多数儿童未接种或接种不足。错过接种机会是覆盖率低的主要原因。
