Johns Tracy L, Roetzheim Richard, Chen Ren
University of South Florida Family Medicine Residency and Dr Joseph A. Eaddy Family Medicine Research Center, Clearwater, FL 33755, USA.
J Prim Care Community Health. 2013 Apr 1;4(2):95-100. doi: 10.1177/2150131912455428. Epub 2012 Aug 1.
BACKGROUND . The incidence of pertussis in the United States has been increasing. Adult vaccination is important to reduce disease burden and prevent transmission to infants at high risk of complications. The tetanus-diphtheria-acellular pertussis (Tdap) vaccine has been available in the United States since 2005 and is indicated as a one-time replacement for the routine tetanus-diphtheria (Td) booster. However, among adults receiving tetanus vaccination, only about half receive Tdap. PURPOSE . To identify predictors of adult Tdap vaccination among individuals who receive tetanus vaccine. METHODS . National Health Interview Survey data from 2008 were analyzed in 2011. Respondents were 18 to 64 years old, received tetanus vaccination during 2005-2008, and were aware if it contained pertussis. Predictors of Tdap vaccination were identified with multivariate logistic regression using procedures for complex survey methods. RESULTS . Overall, 51.1% of respondents received Tdap. Vaccination was less likely for those 50 to 64 years old compared with those 18 to 24 years old (odds ratio [OR] = 0.61, 95% confidence interval [CI] = 0.38-0.96). Some college education was associated with higher odds of vaccination compared with lower education levels (OR = 1.55, 95% CI = 1.16-2.07). Having 2 to 3 office visits (OR = 2.01, 95% CI = 1.32-3.06) or 4 to 9 office visits (OR = 1.60, 95% CI = 1.06-2.42) in the previous year increased the odds of vaccination compared with no visits. Individuals with functional limitation due to illness had lower odds compared with no limitation (OR = 0.70, 95% CI = 0.54-0.91). CONCLUSIONS . In 2008, 51.1% of adult Td vaccinations included pertussis, suggesting continued efforts to remove barriers are needed. Interventions should target older, functionally impaired, and educationally disadvantaged populations.
背景。美国百日咳的发病率一直在上升。成人接种疫苗对于减轻疾病负担以及防止疾病传播给有并发症高风险的婴儿非常重要。破伤风-白喉-无细胞百日咳（Tdap）疫苗自2005年起在美国可用，被指定作为常规破伤风-白喉（Td）加强针的一次性替代疫苗。然而，在接受破伤风疫苗接种的成年人中，只有约一半接种了Tdap。目的。确定接受破伤风疫苗接种的个体中成人接种Tdap疫苗的预测因素。方法。2011年对2008年的国家健康访谈调查数据进行了分析。受访者年龄在18至64岁之间，在2005 - 2008年期间接受过破伤风疫苗接种，并且知道疫苗中是否含有百日咳成分。使用复杂调查方法的程序通过多变量逻辑回归确定Tdap疫苗接种的预测因素。结果。总体而言，51.1%的受访者接种了Tdap。与18至24岁的人群相比，50至64岁的人群接种疫苗的可能性较小（优势比[OR] = 0.61，95%置信区间[CI] = 0.38 - 0.96）。与较低教育水平相比，接受过一些大学教育的人群接种疫苗的优势较高（OR = 1.55，95% CI = 1.16 - 2.07）。与没有就诊相比，前一年有2至3次门诊就诊（OR = 2.01，95% CI = 1.32 - 3.06）或4至9次门诊就诊（OR = 1.60，95% CI = 1.06 - 2.42）会增加接种疫苗的几率。因疾病导致功能受限的个体与没有功能受限的个体相比，接种疫苗的几率较低（OR = 0.70，95% CI = 0.54 - 0.91）。结论。2008年，51.1%的成人破伤风疫苗接种包含百日咳成分，这表明需要继续努力消除障碍。干预措施应针对年龄较大、功能受损以及教育程度较低的人群。
