Stinchfield Patricia K
Infectious Disease, Immunology, Rheumatology and Infection Control, Children's Hospitals and Clinics of Minnesota, St. Paul, Minnesota 55102, USA.
Am J Med. 2008 Jul;121(7 Suppl 2):S11-21. doi: 10.1016/j.amjmed.2008.05.003.
The Centers for Disease Control and Prevention (CDC) recommends that most (73%) persons residing in the United States be vaccinated against influenza each year. The actual rate of influenza vaccination is substantially below target levels: about 60% of persons >or=65 years (target is 90%) and only 10% to 40% of other groups (target is 60% for younger persons who have risk factors and 60% for healthcare personnel). Vaccinating patients throughout the influenza vaccination season (from October into January and beyond)--providing access beyond the traditional "fall immunization season"--is an important step toward meeting the substantial need for influenza vaccination. Vaccination rates may also be increased by interventions that increase patient demand and access to vaccine and overcome practice-related barriers. Such interventions include vaccination-only clinics, standing orders, strong recommendations from healthcare providers, as well as reminder and recall efforts. For maximum impact on immunization rates, interventions should be combined into a multifaceted immunization program rather than used alone. Interventions that address site-specific needs, taking resources into account, should be implemented on a practice-by-practice basis. With supply of influenza vaccine now plentiful, efforts need to be focused on reducing missed vaccination opportunities and promoting vaccination beyond the traditional fall time frame to protect as many Americans as possible from serious and potentially deadly influenza infection.
美国疾病控制与预防中心(CDC)建议,美国大多数(73%)居民每年接种流感疫苗。流感疫苗的实际接种率远低于目标水平:65岁及以上人群的接种率约为60%(目标是90%),其他群体的接种率仅为10%至40%(有风险因素的较年轻人群的目标是60%,医护人员的目标是60%)。在整个流感疫苗接种季节(从10月至1月及以后)为患者接种疫苗——提供传统“秋季免疫季节”之外的接种机会——是满足流感疫苗大量需求的重要一步。通过增加患者需求、提供疫苗接种机会以及克服与医疗机构相关的障碍等干预措施,也可以提高接种率。此类干预措施包括仅提供疫苗接种的诊所、长期医嘱、医护人员的强烈建议以及提醒和召回措施。为了对免疫接种率产生最大影响,应将这些干预措施整合到一个多方面的免疫接种计划中,而不是单独使用。应根据各个医疗机构的具体情况,考虑资源因素,实施针对特定场所需求的干预措施。鉴于目前流感疫苗供应充足,工作重点应放在减少错过的接种机会,并在传统秋季时间框架之外推广接种,以保护尽可能多的美国人免受严重且可能致命的流感感染。