Mhatre Sharmila L, Schryer-Roy Anne-Marie
International Development Research Centre, 150 Kent Street, Ottawa, Canada.
BMC Int Health Hum Rights. 2009 Oct 14;9 Suppl 1(Suppl 1):S1. doi: 10.1186/1472-698X-9-S1-S1.
Immunization can and does save lives. However, the presence of vaccines does not easily translate into every child being vaccinated, and this is what the studies in this journal supplement reveal. From South Asia to West Africa,the evidence presented here reveals what we are calling the fallacy of coverage, going beyond uncovering the real vaccination rates to providing evidence on the reasons for the lack of effective coverage.The evidence for the fallacy of coverage is part of an operational research program entitled the Canadian International Immunization Initiative Phase 2 (CIII2). Through a competitive peer review process, six research grants were awarded to increase access to and enhance immunization services. This journal supplement provides a forum for the presentation of the results of five of the six studies.The story of the fallacy of coverage is made up of five theme areas of evidence - timeliness of immunization, social and gender inequities, vaccine efficacy, understanding demand side issues to tailor interventions, and national data sets masking actual district level coverage rates - that reveal the discrepancies in immunization coverage rates and the reasons behind these discrepancies. As part of the story, and to turn around the fallacy of coverage, the studies also provide proof of effective and locally relevant solutions.Policies and funding, while keeping an eye on future diseases, clearly need to maintain and increase support to address existing vaccine-preventable diseases to increase coverage such that by 2015 we can achieve 90% national vaccination coverage and reach the MDG of reducing mortality rates among children under five by two-thirds.The results from the operational research grants of the CIII2 offer some answers on how to reach this goal by demonstrating how locally generated evidence can inform immunization strategies to ensure that children who need to get vaccinated will get vaccinated, and vaccinated on time.
免疫接种能够而且确实拯救生命。然而，有疫苗并不意味着每个儿童都能接种疫苗，而本期刊增刊中的研究揭示了这一点。从南亚到西非，这里呈现的证据揭示了我们所说的覆盖率误区，不仅揭示了实际的疫苗接种率，还提供了有效覆盖率不足的原因的证据。覆盖率误区的证据是名为加拿大国际免疫倡议第二阶段（CIII2）的一项行动研究计划的一部分。通过竞争性同行评审过程，六项研究资助得以获批，以增加免疫接种服务的可及性并加强免疫接种服务。本期刊增刊为展示六项研究中的五项研究结果提供了一个平台。覆盖率误区的情况由五个证据主题领域构成——免疫接种的及时性、社会和性别不平等、疫苗效力、理解需求方问题以调整干预措施，以及掩盖实际地区层面覆盖率的国家数据集——这些揭示了免疫接种覆盖率的差异以及这些差异背后的原因。作为情况的一部分，并且为了扭转覆盖率误区，这些研究还提供了有效且与当地相关的解决方案的证据。政策和资金在关注未来疾病的同时，显然需要维持并增加支持，以应对现有的疫苗可预防疾病，从而提高覆盖率，以便到2015年我们能够实现全国90%的疫苗接种覆盖率，并实现将五岁以下儿童死亡率降低三分之二的千年发展目标。CIII2行动研究资助的结果就如何实现这一目标提供了一些答案，展示了本地产生的数据如何为免疫接种策略提供信息，以确保需要接种疫苗的儿童能够接种疫苗并按时接种。
