Stein-Zamir Chen, Zentner Gary, Tallen-Gozani Esther, Grotto Itamar
Jerusalem District Health Office, Ministry of Health, Israel.
Isr Med Assoc J. 2010 May;12(5):296-300.
Immunization coverage is a major health indicator. In Israel, routine childhood immunizations are provided at community public well-baby clinics. Immunization monitoring is an important cornerstone of a national health policy; however data obtained through sampling carries the risk of under-representation of certain population strata, particularly high risk groups. Despite high national average immunization coverage, specific subpopulations are under-immunized, as highlighted by outbreaks of vaccine-preventable diseases. The mean national immunization coverage at age 2 years (2006 data) was: DTaP-IPV-Hib4 (all 93%), HBV3 (96%), MMR1 (94%), HAV1 (90%). These reports are based on a 17% population-based sampIe in some districts and on cumulative reports in others. A national immunization registry requires data completeness, protection of confidentiality, compulsory reporting by providers, and links to other computerized health records. It should provide individual immunization data from infancy to adulthood and be accessible to both providers and consumers. In 2008 the Israel Ministry of Health launched a national immunization registry based on immunization reporting from well-baby clinics using a web-based computerized system. As of January 2010,120 well-baby clinics are connected to the nascent registry, which includes the records of some 50,000 children. The implementation of a comprehensive national immunization registry augurs well for the prospect of evidence-based assessment of the health status of children in Israel.
免疫接种覆盖率是一项主要的健康指标。在以色列,常规儿童免疫接种在社区公共母婴保健诊所进行。免疫接种监测是国家卫生政策的重要基石;然而,通过抽样获得的数据存在某些人群阶层代表性不足的风险,尤其是高危人群。尽管全国平均免疫接种覆盖率较高,但仍有特定亚人群免疫接种不足,这在疫苗可预防疾病的暴发中得到了凸显。2岁时的全国平均免疫接种覆盖率(2006年数据)为:白百破-灭活脊髓灰质炎疫苗-乙型流感嗜血杆菌结合疫苗4(均为93%)、乙肝疫苗3(96%)、麻疹-腮腺炎-风疹疫苗1(94%)、甲肝疫苗1(90%)。这些报告在一些地区基于17%的人群样本,在其他地区基于累计报告。全国免疫接种登记系统要求数据完整、保护隐私、提供者强制报告以及与其他计算机化健康记录建立链接。它应提供从婴儿期到成年期的个人免疫接种数据,并且提供者和消费者都可以访问。2008年,以色列卫生部基于母婴保健诊所的免疫接种报告,使用基于网络的计算机化系统启动了全国免疫接种登记系统。截至2010年1月,120家母婴保健诊所与新生的登记系统相连,该系统包含约50000名儿童的记录。全面的全国免疫接种登记系统的实施为对以色列儿童健康状况进行循证评估的前景带来了良好预兆。