Pavlopoulou Ioanna D, Michail Koralia A, Samoli Evangelia, Tsiftis George, Tsoumakas Konstantinos
Pediatric Clinic, "P & A Kyriakou" Children's Hospital, National and Kapodistrian University of Athens, Faculty of Nursing, Athens, Greece.
BMC Public Health. 2013 Oct 2;13:908. doi: 10.1186/1471-2458-13-908.
In Greece, several new childhood vaccines were introduced recently but were reimbursed gradually and at different time points. The aim of this study was to assess immunization coverage and identify factors influencing complete and age-appropriate vaccination among children attending public nurseries in the municipal district of Athens.
A cross-sectional study, using stratified sampling was performed. Immunization history was obtained from vaccination booklets. Demographic and socioeconomic data were obtained from school registries and telephone interviews. Vaccination rates were estimated by sample weighted proportions while associations between complete and age-appropriate immunization and potential determinants by logistic regression analysis.
A total of 731 children (mean age: 46, median: 48, range: 10-65 months) were included. Overall immunization coverage with traditional vaccines (DTP, polio, Hib, HBV, 1st dose MMR) was satisfactory, exceeding 90%, but the administration of booster doses was delayed (range: 33.7- 97.4%, at 60 months of age). Complete vaccination rates were lower for new vaccines (Men C, PCV7, varicella, hepatitis A), ranging between 61-92%. In addition, a significant delay in timely administration of Men C, PCV7, as well as HBV was noted (22.9%, 16.0% and 27.7% at 12 months of age, respectively). Child's age was strongly associated with incomplete vaccination with all vaccines (p< 0.001), while as immigrant status was a predictor of incomplete (p=0.034) and delayed vaccination (p<0.001) with traditional vaccines. Increasing household size and higher maternal education were negatively associated with the receipt of all and newly licensed vaccines, respectively (p=0.035).
Our findings highlight the need to monitor uptake of new vaccines and improve age- appropriate administration of booster doses as well as early vaccination against hepatitis B. Immigrant status, increased household size and high maternal education may warrant targeted intervention.
在希腊，近期引入了几种新的儿童疫苗，但这些疫苗是在不同时间点逐步获得报销的。本研究的目的是评估雅典市辖区公立托儿所儿童的免疫接种覆盖率，并确定影响其完成全程和适龄疫苗接种的因素。
采用分层抽样进行横断面研究。从疫苗接种手册中获取免疫接种史。人口统计学和社会经济数据通过学校登记册和电话访谈获得。通过样本加权比例估计疫苗接种率，同时通过逻辑回归分析确定全程和适龄免疫接种与潜在决定因素之间的关联。
共纳入731名儿童（平均年龄：46个月，中位数：48个月，范围：10 - 65个月）。传统疫苗（百白破、脊髓灰质炎、b型流感嗜血杆菌、乙肝、第一剂麻疹 - 腮腺炎 - 风疹联合疫苗）的总体免疫接种覆盖率令人满意，超过90%，但加强剂的接种有所延迟（60月龄时范围为33.7% - 97.4%）。新疫苗（C群脑膜炎球菌结合疫苗、7价肺炎球菌结合疫苗、水痘疫苗、甲型肝炎疫苗）的全程接种率较低，在61% - 92%之间。此外，还注意到C群脑膜炎球菌结合疫苗、7价肺炎球菌结合疫苗以及乙肝疫苗的及时接种存在显著延迟（12月龄时分别为22.9%、16.0%和27.7%）。儿童年龄与所有疫苗的未全程接种密切相关（p < 0.001），而移民身份是传统疫苗未全程接种（p = 0.034）和延迟接种（p < 0.001）的一个预测因素。家庭规模增加和母亲受教育程度较高分别与所有疫苗和新获许可疫苗的接种呈负相关（p = 0.035）。
我们的研究结果凸显了监测新疫苗接种情况以及改善加强剂适龄接种和乙肝早期接种的必要性。移民身份、家庭规模增加和母亲受教育程度较高可能需要有针对性的干预。
