肺炎球菌结合疫苗接种率：测量方法学问题及公共资助计划的影响。
Uptake of pneumococcal conjugate vaccine: methodological issues in measurement and impact of publicly funded programs.
机构信息
Department of Social and Preventive Medicine, Laval University, Quebec City, QC.
出版信息
Can J Public Health. 2009 Nov-Dec;100(6):413-6. doi: 10.1007/BF03404335.
BACKGROUND
In Quebec, the pneumococcal conjugate vaccine was available on the private market as early as 2001 and has been included in the publicly funded immunization program since December 2004.
OBJECTIVES
To compare the advantages and limitations of two different sources for assessing vaccination coverage in the target population of children and to evaluate the impact of the public health program on uptake rates.
METHODS
Data from a province-wide survey of a random sample of parents and from the Quebec City Immunization Registry were used to compute vaccination rates over time in different population groups.
RESULTS
Data from the immunization survey and the regional registry were congruent regarding trends. Immunization rates were overestimated, more in the registry than in the survey. During the 2001-2004 period, uptake rates were low, and many children received fewer than the recommended number of doses. As soon as free vaccination was granted, uptake increased markedly and close to 90% of children received the recommended three doses, the level required for inducing herd effects. Delay in the administration of the third booster dose was observed.
CONCLUSIONS
Free vaccination is a major determinant of vaccine uptake and should remain a fundamental principle of the Canadian health system.
背景
早在 2001 年，肺炎球菌结合疫苗就在魁北克的私人市场上供应，并自 2004 年 12 月起纳入公共资助免疫计划。
目的
比较评估目标人群儿童疫苗接种覆盖率的两种不同来源的优缺点，并评估公共卫生计划对接种率的影响。
方法
利用全省范围内随机抽取的父母调查数据和魁北克市免疫登记处的数据，计算不同人群组随时间推移的疫苗接种率。
结果
免疫调查和区域登记处的数据在趋势上是一致的。免疫率被高估了，登记处比调查中更严重。在 2001-2004 年期间，接种率较低，许多儿童接种的剂量少于推荐的数量。一旦免费接种获得批准，接种率就会显著增加，接近 90%的儿童接种了推荐的三剂疫苗，这是诱导群体效应所需的水平。观察到第三剂加强针的接种时间延迟。
结论
免费接种是疫苗接种率的主要决定因素，应继续成为加拿大卫生系统的基本原则。
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