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疫苗短缺期间对临时建议和 Hib 疫苗使用的了解。

Knowledge of interim recommendations and use of Hib vaccine during vaccine shortages.

机构信息

University of Colorado, Department of Pediatrics, Aurora, CO 80045-0508, USA.

出版信息

Pediatrics. 2010 May;125(5):914-20. doi: 10.1542/peds.2009-1710. Epub 2010 Apr 19.

Abstract

OBJECTIVES

The goals were to determine among pediatricians and family physicians (1) knowledge of interim recommendations regarding Haemophilus influenzae type b (Hib) vaccine administration, (2) current practices, and (3) factors associated with nonadherence.

METHODS

An Internet-based survey was conducted in April 2008 among national samples.

RESULTS

Response rates were 68% (220 of 325 physicians) among pediatricians and 51% (153 of 302 physicians) among family physicians. Seventy-three percent of pediatricians and 45% of family medicine physicians reported insufficient Hib vaccine supplies, and 22% to 24% reported having to defer doses for infants 2 to 6 months of age > or =10% of the time. Ninety-eight percent of pediatricians and 81% of family physicians were aware of the interim recommendations (P < or = .0001), and virtually all knew that the booster dose should be deferred; however, 22% of pediatricians and 33% of family medicine physicians reported not deferring this dose. Physicians in both specialties were less likely to adhere to recommendations to defer in this age group if they thought that their practice had sufficient vaccine supplies (pediatricians, odds ratio: 0.01 [95% confidence interval: 0.003-0.03]; family medicine physicians, odds ratio: 0.10 [95% confidence interval: 0.03-0.33]). Family medicine physicians were less likely to adhere to recommendations if they had not heard about the interim recommendations (odds ratio: 0.04 [95% confidence interval: 0.01-0.21]).

CONCLUSIONS

Most primary care physicians experienced Hib vaccine shortages, and many have had to defer doses for 2- to 6-month-old children. Most are knowledgeable regarding interim recommendations, but one-fifth to one-third reported nonadherence.

摘要

目的

本研究旨在确定儿科医生和家庭医生(1)对 Hib 疫苗接种的临时建议的了解程度、(2)当前的实践情况,以及(3)不遵守建议的相关因素。

方法

2008 年 4 月,采用基于互联网的方法对全国样本进行了调查。

结果

儿科医生的回应率为 68%(220/325 名医生),家庭医生的回应率为 51%(153/302 名医生)。73%的儿科医生和 45%的家庭医学医生报告称 Hib 疫苗供应不足,22%至 24%的医生报告称,他们不得不经常推迟 2 至 6 个月大的婴儿的剂量,这种情况占比超过 10%。98%的儿科医生和 81%的家庭医生了解临时建议(P < or =.0001),几乎所有人都知道加强剂量应推迟;然而,22%的儿科医生和 33%的家庭医学医生报告说没有推迟该剂量。如果医生认为自己的做法有足够的疫苗供应,那么他们就不太可能遵守在这个年龄段推迟的建议(儿科医生,优势比:0.01 [95%置信区间:0.003-0.03];家庭医学医生,优势比:0.10 [95%置信区间:0.03-0.33])。如果家庭医生没有听说过临时建议,他们就不太可能遵守建议(优势比:0.04 [95%置信区间:0.01-0.21])。

结论

大多数初级保健医生都面临 Hib 疫苗短缺的问题,许多人不得不推迟 2 至 6 个月大婴儿的剂量。大多数医生都了解临时建议,但有 1/5 至 1/3 的人报告说不遵守。

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