Pearce A, Elliman D, Law C, Bedford H
Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK.
Arch Dis Child. 2009 Jan;94(1):49-51. doi: 10.1136/adc.2007.132647. Epub 2008 May 7.
To investigate the relationship between primary immunisation status and MMR uptake.
Nationally representative Millennium Cohort Study.
Children born in the UK, 2000-2002.
14,578 children with immunisation data.
MMR status at 3 years, defined as immunised with MMR, immunised with at least one single antigen vaccine or unimmunised.
88.6% of children had been immunised with MMR, 5.2% had received at least one of the single antigen vaccines and 6.1% were unimmunised against measles, mumps and rubella at age 3 years. Children who were unimmunised with the primary vaccines at ages 9 months (1.2%, n = 168) and 3 years (0.4%, n = 67) were 13 (95% CI 10.8 to 14.7) and 17 (95% CI 14.6 to 19.7) times more likely to be unimmunised against measles, mumps and rubella compared with children who were fully immunised. They were also more likely to be immunised with at least one of the single antigen vaccines with risk ratios of 2.8 (95% 1.2 to 6.1) and 4.3 (95% CI 1.8 to 10.1). Similar but smaller associations were observed if children were partially immunised with the primary vaccines at 9 months (3.4%, n = 502) and 3 years (3.6%, n = 522) with risk ratios of 4.0 (95% 3.2 to 4.9) and 5.2 (95% 4.2 to 6.1) for no MMR immunisation, and 2.0 (95% C 1.1 to 3.6) and 1.6 (95% CI 1.1 to 2.5) for single antigen vaccine use.
Children who remain unimmunised with primary vaccines are also more likely not to receive MMR. More work is needed to determine how best to target this group.
研究初次免疫状态与麻疹、腮腺炎和风疹联合疫苗(MMR)接种率之间的关系。
具有全国代表性的千禧队列研究。
2000 - 2002年在英国出生的儿童。
14578名有免疫数据的儿童。
3岁时的MMR疫苗接种状态,定义为接种了MMR疫苗、接种了至少一种单价抗原疫苗或未接种。
88.6%的儿童接种了MMR疫苗,5.2%的儿童接种了至少一种单价抗原疫苗,6.1%的儿童在3岁时未接种麻疹、腮腺炎和风疹疫苗。9个月时(1.2%,n = 168)和3岁时(0.4%,n = 67)未接种基础疫苗的儿童,与完全接种疫苗的儿童相比,未接种麻疹、腮腺炎和风疹疫苗的可能性分别高13倍(95%可信区间10.8至14.7)和17倍(95%可信区间14.6至19.7)。他们接种至少一种单价抗原疫苗的可能性也更高,风险比分别为2.8(95% 1.2至6.1)和4.3(95%可信区间1.8至10.1)。如果儿童在9个月时(3.4%,n = 502)和3岁时(3.6%,n = 522)部分接种了基础疫苗,也观察到了类似但较小的关联,未接种MMR疫苗的风险比分别为4.0(95% 3.2至4.9)和5.2(95% 4.2至6.1),接种单价抗原疫苗的风险比分别为2.0(95% C 1.1至3.6)和1.6(95%可信区间1.1至2.5)。
未接种基础疫苗的儿童也更有可能不接种MMR疫苗。需要开展更多工作来确定针对这一群体的最佳方法。