Pilger Daniel, Nguipdop-Djomo Patrick, Abubakar Ibrahim, Elliman David, Rodrigues Laura C, Watson John M, Eastman Vera, Mangtani Punam
Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
BMJ Open. 2012 Sep 10;2(5). doi: 10.1136/bmjopen-2012-001303. Print 2012.
Assess the current BCG vaccination policies and delivery pathways for immunisation in Primary Care Trusts (PCTs) in England since the 2005 change in recommendations.
A survey of key informants across PCTs using a standardised, structured questionnaire.
152 PCTs in England.
Complete questionnaires were returned from 127 (84%) PCTs. Sixteen (27%) PCTs reported universal infant vaccination and 111 (73%) had selective infant vaccination. Selective vaccination outside infancy was also reported from 94 (74%) PCTs. PCTs with selective infant policy most frequently vaccinated on postnatal wards (51/102, 50%), whereas PCTs with universal infant vaccination most frequently vaccinated in community clinics (9/13, 69%; p=0.011). To identify and flag up eligible infants in PCTs with targeted infant immunisation, those who mostly vaccinate on postnatal wards depend on midwives and maternity records, whereas those who vaccinate primarily in the community rely more often on various healthcare professionals.
Targeted infant vaccination has been implemented in most PCTs across the UK. PCTs with selective infant vaccination provide BCG vaccine via a greater variety of healthcare professionals than those with universal infant vaccination policies. Data on vaccine coverage would help evaluate the effectiveness of delivery. Interruptions of delivery noted here emphasise the importance of not just an agreed, standardised, local pathway, but also a named person in charge.
评估自2005年建议变更以来，英格兰初级保健信托基金（PCTs）的当前卡介苗接种政策及免疫接种实施途径。
使用标准化结构化问卷对各PCTs的关键信息提供者进行调查。
英格兰的152个PCTs。
127个（84%）PCTs返回了完整问卷。16个（27%）PCTs报告采用普遍婴儿接种，111个（73%）采用选择性婴儿接种。94个（74%）PCTs还报告了婴儿期外的选择性接种。实行选择性婴儿接种政策的PCTs最常在产后病房接种（51/102，50%），而实行普遍婴儿接种的PCTs最常在社区诊所接种（9/13，69%；p=0.011）。对于实行针对性婴儿免疫接种的PCTs，为识别并标记符合条件的婴儿，那些主要在产后病房接种的依赖助产士和产妇记录，而那些主要在社区接种的则更多依赖各类医疗保健专业人员。
英国多数PCTs已实施针对性婴儿接种。与实行普遍婴儿接种政策的PCTs相比，实行选择性婴儿接种的PCTs通过更多种类的医疗保健专业人员提供卡介苗。疫苗覆盖率数据将有助于评估接种实施的有效性。此处指出的接种实施中断情况强调了不仅要有商定的、标准化的本地途径，还要有指定负责人的重要性。
