Global Immunization Division, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
Vaccine. 2012 Feb 21;30(9):1746-51. doi: 10.1016/j.vaccine.2011.12.015. Epub 2012 Jan 3.
Since 1977, vaccinations to protect against tuberculosis, diphtheria, tetanus, pertussis, polio, and measles (and rubella since 2009) have been offered to children in Haiti through the routine immunization program. From April to July 2009, a national vaccination coverage survey was conducted to assess the success of the routine immunization program at reaching children in Haiti.
A multi-stage cluster survey was conducted using a modified WHO method for household sampling. A standardized questionnaire was administered to collect vaccination histories, demographic information, and reasons for under-vaccination of children aged 12-23 months. A child who received the eight recommended routine vaccinations was considered fully vaccinated. The routine vaccination schedule was used to define valid doses and estimate the percentage of children vaccinated on time.
Among 1345 children surveyed, 40.4% (95% CI: 36.6-44.2) of the 840 children with vaccination cards had received all eight recommended vaccinations. Coverage was highest for the Bacille Calmette-Guérin vaccine (87.3%), the first doses of the diphtheria-tetanus-pertussis vaccine (92.0%), and oral poliovirus vaccine (93.4%) and lowest for measles vaccine (46.9%). Timely vaccination rates were lower. Assuming similar coverage for the 505 children without cards, coverage with the complete vaccination series among all surveyed children 31.9%. Reasons for under-vaccination included not having enough time to reach the vaccination location (24.8%), having a child who was ill (13.8%), and not knowing when, or forgetting, to go for vaccination (12.8%).
Coverage for early-infant vaccines was high; however, most children did not complete the full vaccination series, and many children received vaccinations later than recommended. Efforts to improve the immunization program should include increasing the frequency of outreach services, training for vaccination staff to minimize missed opportunities, and better communicating the timing of vaccinations to encourage caregivers to bring their children for vaccinations at the recommended age. Efforts to promote the benefits of vaccination and card retention are also needed.
自 1977 年以来，通过常规免疫计划向海地儿童提供了预防结核病、白喉、破伤风、百日咳、脊髓灰质炎和麻疹（2009 年起包括风疹）的疫苗。2009 年 4 月至 7 月，开展了全国疫苗接种覆盖率调查，以评估海地常规免疫计划为儿童接种疫苗的效果。
采用世界卫生组织（WHO）改良的家庭抽样方法进行多阶段聚类调查。使用标准化问卷收集儿童 12-23 月龄的疫苗接种史、人口统计学信息和未及时接种疫苗的原因。如果儿童接受了推荐的 8 种常规疫苗接种，则视为完全接种。使用常规疫苗接种时间表来确定有效剂量并估计按时接种疫苗的儿童比例。
在调查的 1345 名儿童中，有 840 名有疫苗接种卡的儿童中，40.4%（95%置信区间：36.6-44.2）的儿童接受了所有推荐的 8 种疫苗接种。卡介苗（87.3%）、白喉-破伤风-百日咳疫苗（92.0%）和口服脊髓灰质炎疫苗（93.4%）的接种率最高，麻疹疫苗（46.9%）的接种率最低。及时接种率较低。假设 505 名无卡儿童的接种率相似，那么所有接受调查的儿童中，完成完整疫苗接种系列的比例为 31.9%。未及时接种疫苗的原因包括没有足够的时间到达疫苗接种地点（24.8%）、儿童患病（13.8%）以及不知道何时或忘记去接种疫苗（12.8%）。
早期婴儿疫苗的接种率很高；然而，大多数儿童未完成完整的疫苗接种系列，许多儿童的接种时间晚于推荐时间。改善免疫计划的努力应包括增加外展服务的频率、培训疫苗接种工作人员以尽量减少错失机会，以及更好地向照顾者传达接种疫苗的时间，以鼓励他们在推荐年龄带孩子接种疫苗。还需要努力宣传疫苗接种的好处和保留疫苗接种卡。
