Division of Infectious Diseases and Hospital Epidemiology, University Children’s Hospital, Zurich, Switzerland.
Pediatrics. 2012 Sep;130(3):e600-6. doi: 10.1542/peds.2012-0132. Epub 2012 Aug 20.
To describe measles vaccination patterns in a cohort of Swiss children aged up to 3 years insured with a single health insurer.
A dynamic cohort study evaluating measles immunizations patterns in children born between 2006 and 2008 was conducted. Time-to-event analysis was used to describe timing of measles immunization. Effective vaccine coverage was calculated by using an area under the curve approach.
In the study cohort, 62.6% of 13-month-old children were up-to-date for the first measles immunization (recommended at 12 months of age). Approximately 59% of 25-month-old children were up-to-date for the second measles immunization (recommended at 15-24 months of age). Most doses were delivered during months in a child's life when well-child visits are recommended (eg, 12 months of age). For second measles vaccine dose, accelerations in vaccine delivery occurred at time points for well-child visits during the months 19 and 25 of age but with lower final uptake than for the first measles vaccine dose. Until their second birthday, children in our cohort spent on average 177 days and 89 days susceptible to measles due to policy recommendations and additional delays, respectively. In a group of children aged 6 months to 2 years reflecting the age distribution in our cohort, effective vaccine coverage was only 48.6%.
Timing and timeliness of measles immunizations influence effective population vaccine coverage and should be routinely reported in addition to coverage whenever possible. Proposed timing and relation of recommended vaccinations to well-child visits could be relevant aspects in optimizing measles vaccine coverage to reach measles elimination.
描述在瑞士一家单一健康保险公司投保的儿童中麻疹疫苗接种模式。
开展了一项动态队列研究，评估 2006 年至 2008 年期间出生的儿童的麻疹免疫接种模式。采用时间事件分析描述麻疹免疫接种的时间。利用曲线下面积法计算有效疫苗覆盖率。
在研究队列中，13 月龄儿童中有 62.6%的人及时接种了第一剂麻疹疫苗（推荐在 12 月龄时接种）。大约 59%的 25 月龄儿童及时接种了第二剂麻疹疫苗（推荐在 15-24 月龄时接种）。大多数疫苗接种都是在儿童生命中建议进行常规健康检查的月份进行的（例如，12 月龄）。对于第二剂麻疹疫苗，在 19 月龄和 25 月龄的常规健康检查时间点，疫苗接种加速，但最终接种率低于第一剂麻疹疫苗。在他们满 2 岁之前，由于政策建议和额外的延迟，我们队列中的儿童平均有 177 天和 89 天容易感染麻疹，分别为。在一个反映我们队列中年龄分布的 6 个月至 2 岁儿童组中，有效疫苗覆盖率仅为 48.6%。
麻疹免疫接种的时间和及时性会影响人群疫苗接种的有效性，因此应在可能的情况下，除了覆盖率之外，还应定期报告。建议的接种时间和与常规健康检查的关系可能是优化麻疹疫苗覆盖率以实现麻疹消除的重要方面。
