Office of Public Health (Drs Bednarczyk and Birkhead), Bureau of Immunization (Mr Flynn, Mss DuVall, Meldrum, and Santilli and Drs Easton, Sharma, and Blog), Division of Epidemiology (Dr Blog), and Emerging Infections Program (Dr Zansky), New York State Department of Health, Albany, New York; and Department of Epidemiology and Biostatistics (Drs McNutt and Birkhead), School of Public Health, University at Albany, Rensselaer, New York.
J Public Health Manag Pract. 2013 Nov-Dec;19(6):589-97. doi: 10.1097/PHH.0b013e31828002af.
To examine differences in H1N1 influenza vaccine distribution strategies that may impact the ability to rapidly administer vaccine during a pandemic or public health emergency.
Retrospective evaluation of immunization data in the New York State Immunization Information System (NYSIIS).
Analysis of existing NYSIIS data.
Children and adolescents younger than 19 years for whom information on at least 1 H1N1 influenza vaccine was present in NYSIIS.
MAIN OUTCOME MEASURE(S): Median time to administer vaccines to children and adolescents younger than 19 years by December 31, 2009, by county; venue of H1N1 vaccine administration (local health department [LHD] or private medical provider); comparison of immunization-seeking behavior for routine childhood vaccinations and H1N1 vaccine.
A total of 459 189 first or only doses of H1N1 influenza vaccine were recorded in NYSIIS as being administered to New York State, outside of New York City, children aged less than 19 years, between October 2, 2009, and December 31, 2009. Overall, LHD administered 31% of H1N1 vaccine doses; in counties having population less than 100,000, LHD administered 63% of H1N1 doses compared with 23% in counties having population more than 100,000. Time to median administration was faster for LHD in smaller counties and similar for LHD and private medical providers in larger counties. Children who always received routine childhood immunizations either within or outside of their county of residence often had the same practice for H1N1 vaccine, with 85% of children following these patterns. Children who did not follow these patterns were more likely to receive H1N1 influenza vaccine through LHD.
Local health departments were able to rapidly administer large quantities of H1N1 influenza vaccine, and patterns of health care seeking relying on increased use of LHD needs to be further studied for future public health emergency planning.
研究可能影响大流行或公共卫生紧急情况下快速接种疫苗能力的 H1N1 流感疫苗分配策略的差异。
在纽约州免疫信息系统（NYSIIS）中对免疫数据进行回顾性评估。
对现有的 NYSIIS 数据进行分析。
年龄在 19 岁以下且 NYSIIS 中至少有 1 剂 H1N1 流感疫苗信息的儿童和青少年。
截至 2009 年 12 月 31 日，各县儿童和青少年接种疫苗的中位数时间；H1N1 疫苗接种地点（地方卫生部门[LHD]或私人医疗提供者）；常规儿童疫苗接种和 H1N1 疫苗接种的免疫寻求行为比较。
2009 年 10 月 2 日至 2009 年 12 月 31 日，NYSIIS 记录了在纽约州（纽约市以外）年龄小于 19 岁的儿童中，共接种了 459189 剂 H1N1 流感疫苗。总体而言，LHD 接种了 31%的 H1N1 疫苗剂量；在人口少于 10 万的县，LHD 接种了 63%的 H1N1 剂量，而人口超过 10 万的县接种了 23%。在较小的县，LHD 的中位数接种时间更快，而在较大的县，LHD 和私人医疗提供者的中位数接种时间相似。无论是否在居住地县内，始终接受常规儿童免疫接种的儿童通常也会接种 H1N1 疫苗，其中 85%的儿童遵循这些模式。不遵循这些模式的儿童更有可能通过 LHD 接种 H1N1 流感疫苗。
地方卫生部门能够迅速大量接种 H1N1 流感疫苗，需要进一步研究依赖增加使用 LHD 的医疗保健寻求模式，以为未来的公共卫生应急规划做准备。
