Skull Susan A, Andrews Ross M, Byrnes Graham B, Kelly Heath A, Nolan Terence M, Brown Graham V, Campbell Donald A
Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia.
Vaccine. 2007 Jun 15;25(25):4775-83. doi: 10.1016/j.vaccine.2007.04.015. Epub 2007 Apr 26.
Use of self-reported vaccination status is commonplace in assessing vaccination coverage for public health programs and individuals, yet limited validity data exist. We compared self-report with provider records for pneumococcal (23vPPV) and influenza vaccine for 4887 subjects aged>or=65 years from two Australian hospitals. Self-reported influenza vaccination status had high sensitivity (98%), positive predictive value (PPV) (88%) and negative predictive value (NPV) (91%), but low specificity (56%). Self-reported 23vPPV (previous 5 years) had a sensitivity of 84%, specificity 77%, PPV 85% and NPV 76%. Clinicians can be reasonably confident of self-reported influenza vaccine status, and for positive self-report for 23vPPV in this setting. For program evaluation, self-reported influenza vaccination coverage among inpatients overestimates true coverage by about 10% versus 1% for 23vPPV. Self-report remains imperfect and whole-of-life immunisation registers a preferable goal.
在评估公共卫生项目和个人的疫苗接种覆盖率时，使用自我报告的疫苗接种状况很常见，但有效的数据有限。我们比较了来自两家澳大利亚医院的4887名年龄≥65岁受试者的肺炎球菌（23价肺炎多糖疫苗）和流感疫苗自我报告情况与医疗机构记录。自我报告的流感疫苗接种状况具有较高的敏感性（98%）、阳性预测值（PPV）（88%）和阴性预测值（NPV）（91%），但特异性较低（56%）。自我报告的23价肺炎多糖疫苗（过去5年）敏感性为84%，特异性为77%，PPV为85%，NPV为76%。临床医生可以对自我报告的流感疫苗接种状况有合理的信心，在这种情况下对于23价肺炎多糖疫苗的自我报告阳性也是如此。对于项目评估，住院患者中自我报告的流感疫苗接种覆盖率高估了实际覆盖率约10%，而23价肺炎多糖疫苗高估了1%。自我报告仍然存在缺陷，终身免疫登记是一个更理想的目标。
