Department of Surgery and Cancer, Imperial College, London, United Kingdom.
PLoS One. 2011;6(5):e19381. doi: 10.1371/journal.pone.0019381. Epub 2011 May 13.
Continued suboptimal measles-mumps-rubella (MMR) vaccine uptake has re-established measles epidemic risk, prompting a UK catch-up campaign in 2008-09 for children who missed MMR doses at scheduled age. Predictors of vaccine uptake during catch-ups are poorly understood, however evidence from routine schedule uptake suggests demographics and attitudes may be central. This work explored this hypothesis using a robust evidence-based measure.
Cross-sectional self-administered questionnaire with objective behavioural outcome.
365 UK parents, whose children were aged 5-18 years and had received <2 MMR doses before the 2008-09 UK catch-up started.
Parents' attitudes and demographics, parent-reported receipt of invitation to receive catch-up MMR dose(s), and catch-up MMR uptake according to child's medical record (receipt of MMR doses during year 1 of the catch-up).
Perceived social desirability/benefit of MMR uptake (OR = 1.76, 95% CI = 1.09-2.87) and younger child age (OR = 0.78, 95% CI = 0.68-0.89) were the only independent predictors of catch-up MMR uptake in the sample overall. Uptake predictors differed by whether the child had received 0 MMR doses or 1 MMR dose before the catch-up. Receipt of catch-up invitation predicted uptake only in the 0 dose group (OR = 3.45, 95% CI = 1.18-10.05), whilst perceived social desirability/benefit of MMR uptake predicted uptake only in the 1 dose group (OR = 9.61, 95% CI = 2.57-35.97). Attitudes and demographics explained only 28% of MMR uptake in the 0 dose group compared with 61% in the 1 dose group.
Catch-up MMR invitations may effectively move children from 0 to 1 MMR doses (unimmunised to partially immunised), whilst attitudinal interventions highlighting social benefits of MMR may effectively move children from 1 to 2 MMR doses (partially to fully immunised). Older children may be best targeted through school-based programmes. A formal evaluation element should be incorporated into future catch-up campaigns to inform their continuing improvement.
麻疹-腮腺炎-风疹（MMR）疫苗持续接种率不理想，重新引发了麻疹流行风险，因此 2008-09 年在英国开展了针对错过常规年龄接种的儿童的补种活动。然而，目前对补种期间疫苗接种率的预测因素知之甚少，但是常规免疫接种率的证据表明，人口统计学和态度可能是关键因素。本研究使用可靠的循证措施来验证这一假设。
横断面自我管理问卷调查和客观的行为结果。
365 名英国家长，他们的孩子年龄在 5-18 岁之间，在 2008-09 年英国开展补种活动之前，已经接受了<2 剂 MMR 疫苗。
家长的态度和人口统计学特征、家长报告收到接种补种 MMR 剂量的邀请情况，以及根据儿童病历记录的补种 MMR 接种率（在补种活动的第一年接种 MMR 疫苗）。
在整个样本中，感知 MMR 接种的社会期望/获益（比值比 = 1.76，95%置信区间 = 1.09-2.87）和儿童年龄较小（比值比 = 0.78，95%置信区间 = 0.68-0.89）是唯一能够独立预测样本中补种 MMR 接种率的因素。补种 MMR 接种率的预测因素因儿童在补种前是否接受 0 剂或 1 剂 MMR 疫苗而有所不同。补种邀请仅在接受 0 剂疫苗的儿童中预测了接种率（比值比 = 3.45，95%置信区间 = 1.18-10.05），而感知 MMR 接种的社会期望/获益仅在接受 1 剂疫苗的儿童中预测了接种率（比值比 = 9.61，95%置信区间 = 2.57-35.97）。态度和人口统计学特征仅解释了 0 剂量组 MMR 接种率的 28%，而在 1 剂量组中解释了 61%。
补种 MMR 疫苗的邀请可能会有效地将儿童从 0 剂疫苗接种率（未免疫到部分免疫）转变为 1 剂疫苗接种率（部分免疫到完全免疫），而强调 MMR 社会获益的态度干预措施可能会有效地将儿童从 1 剂疫苗接种率（部分免疫）转变为 2 剂疫苗接种率（完全免疫）。年龄较大的儿童可能通过学校计划进行最佳靶向。未来的补种活动应纳入正式的评估内容，以便为其持续改进提供信息。
