MMWR Surveill Summ. 2013 Oct 25;62(4):1-28.
PROBLEM/CONDITION: Substantial improvement in annual influenza vaccination of recommended groups is needed to reduce the health effects of influenza and reach Healthy People 2020 targets. No single data source provides season-specific estimates of influenza vaccination coverage and related information on place of influenza vaccination and concerns related to influenza and influenza vaccination.
2007-08 through 2011-12 influenza seasons.
CDC uses multiple data sources to obtain estimates of vaccination coverage and related data that can guide program and policy decisions to improve coverage. These data sources include the National Health Interview Survey (NHIS), the Behavioral Risk Factor Surveillance System (BRFSS), the National Flu Survey (NFS), the National Immunization Survey (NIS), the Immunization Information Systems (IIS) eight sentinel sites, Internet panel surveys of health-care personnel and pregnant women, and the Pregnancy Risk Assessment and Monitoring System (PRAMS).
National influenza vaccination coverage among children aged 6 months-17 years increased from 31.1% during 2007-08 to 56.7% during the 2011-12 influenza season as measured by NHIS. Vaccination coverage among children aged 6 months-17 years varied by state as measured by NIS. Changes from season to season differed as measured by NIS and NHIS. According to IIS sentinel site data, full vaccination (having either one or two seasonal influenza vaccinations, as recommended by the Advisory Committee on Immunization Practices for each influenza season, based on the child's influenza vaccination history) with up to two recommended doses for the 2011-12 season was 27.1% among children aged 6 months-8 years and was 44.3% for the youngest children (aged 6-23 months). Influenza vaccination coverage among adults aged ≥18 years increased from 33.0% during 2007-08 to 38.3% during the 2011-12 influenza season as measured by NHIS. Vaccination coverage by age group for the 2011-12 season as measured by BRFSS was <5 percentage points different from NHIS estimates, whereas NFS estimates were 6-8 percentage points higher than BRFSS estimates. Vaccination coverage among persons aged ≥18 years varied by state as measured by BRFSS. For adults aged ≥18 years, a doctor's office was the most common place for receipt of influenza vaccination (38.4%, BRFSS; 32.5%, NFS) followed by a pharmacy (20.1%, BRFSS; 19.7%, NFS). Overall, 66.9% of health-care personnel (HCP) reported having been vaccinated during the 2011-12 season, as measured by an Internet panel survey of HCP, compared with 62.4%, as estimated through NHIS. Vaccination coverage among pregnant women was 47.0%, as measured by an Internet panel survey of women pregnant during the influenza season, and 43.0%, as measured by BRFSS during the 2011-12 influenza season. Overall, as measured by NFS, 86.8% of adults aged ≥18 years rated the influenza vaccine as very or somewhat effective, and 46.5% of adults aged ≥18 years believed their risk for getting sick with influenza if unvaccinated was high or somewhat high.
During the 2011-12 season, influenza vaccination coverage varied by state, age group, and selected populations (e.g., HCP and pregnant women), with coverage estimates well below the Healthy People 2020 goal of 70% for children aged 6 months-17 years, 70% for adults aged ≥18 years, and 90% for HCP.
Continued efforts are needed to encourage health-care providers to offer influenza vaccination and to promote public health education efforts among various populations to improve vaccination coverage. Ongoing surveillance to obtain coverage estimates and information regarding other issues related to influenza vaccination (e.g., knowledge, attitudes, and beliefs) is needed to guide program and policy improvements to reduce morbidity and mortality associated with influenza by increasing vaccination rates. Ongoing comparisons of telephone and Internet panel surveys with in-person surveys such as NHIS are needed for appropriate interpretation of data and resulting public health actions. Examination of results from all data sources is necessary to fully assess the various components of influenza vaccination coverage among different populations in the United States.
问题/状况：需要大幅提高推荐人群的年度流感疫苗接种率，以减轻流感的健康影响，实现“健康人民 2020 年”目标。没有单一的数据来源可以提供季节性流感疫苗接种率的具体估计，以及与流感和流感疫苗接种相关的信息。
2007-08 至 2011-12 流感季节。
疾病预防控制中心使用多种数据源来获取疫苗接种率和相关数据的估计值，以指导计划和政策决策，提高接种率。这些数据源包括国家健康访谈调查（NHIS）、行为风险因素监测系统（BRFSS）、国家流感调查（NFS）、国家免疫接种调查（NIS）、免疫接种信息系统（IIS）八个监测点、医护人员和孕妇互联网小组调查、以及妊娠风险评估和监测系统（PRAMS）。
根据 NHIS 的调查，儿童（6 个月至 17 岁）的流感疫苗接种率从 2007-08 年度的 31.1%增加到 2011-12 年度的 56.7%。根据 NIS 的调查，儿童（6 个月至 17 岁）的疫苗接种率因州而异。根据 NIS 和 NHIS 的调查，各季节的变化情况不同。根据 IIS 监测点的数据，在 2011-12 年度，根据每个流感季节的免疫接种实践咨询委员会的建议，对于每个流感季节，6 个月至 8 岁的儿童最多接种两剂推荐剂量，完全接种（根据儿童的流感疫苗接种史，接种一剂或两剂季节性流感疫苗）率为 27.1%，而最小的儿童（6-23 个月）为 44.3%。根据 NHIS 的调查，18 岁及以上成年人的流感疫苗接种率从 2007-08 年度的 33.0%增加到 2011-12 年度的 38.3%。根据 BRFSS 的调查，2011-12 年度各年龄组的疫苗接种率比 NHIS 的估计值低 5 个百分点左右，而 NFS 的估计值比 BRFSS 的估计值高 6-8 个百分点。18 岁及以上成年人的疫苗接种率因州而异。根据 BRFSS 的调查，医生办公室是接受流感疫苗接种的最常见场所（38.4%，BRFSS；32.5%，NFS），其次是药店（20.1%，BRFSS；19.7%，NFS）。总体而言，在 2011-12 年度，66.9%的医护人员（HCP）接受了流感疫苗接种，这是通过对 HCP 的互联网小组调查得出的，而根据 NHIS 的调查，这一比例为 62.4%。在流感季节怀孕的妇女中，疫苗接种率为 47.0%，这是通过对怀孕妇女的互联网小组调查得出的，而根据 BRFSS 的调查，这一比例为 2011-12 年度的 43.0%。总体而言，根据 NFS 的调查，86.8%的 18 岁及以上成年人认为流感疫苗非常有效或相当有效，46.5%的 18 岁及以上成年人认为，如果不接种疫苗，他们患流感的风险很高或相当高。
在 2011-12 年度，流感疫苗接种率因州、年龄组和特定人群（如医护人员和孕妇）而异，接种率估计值远低于“健康人民 2020 年”目标，即儿童（6 个月至 17 岁）为 70%，成年人（18 岁及以上）为 70%，医护人员为 90%。
需要继续努力鼓励医护人员提供流感疫苗接种，并在各人群中开展公共卫生教育工作，以提高疫苗接种率。需要持续进行监测，以获取疫苗接种率和与流感疫苗接种相关的其他问题（如知识、态度和信念）的信息，以指导计划和政策的改进，通过提高疫苗接种率来降低与流感相关的发病率和死亡率。需要对电话和互联网小组调查与 NHIS 等面对面调查进行持续比较，以便对数据进行适当解释并采取相应的公共卫生行动。需要检查所有数据源的结果，以充分评估美国不同人群中流感疫苗接种率的各个组成部分。
