荷兰早产儿和低出生体重儿白喉、破伤风、无细胞百日咳和灭活脊髓灰质炎疫苗接种的延迟启动。

Delayed start of diphtheria, tetanus, acellular pertussis and inactivated polio vaccination in preterm and low birth weight infants in the Netherlands.

机构信息

From the *Department of Epidemiology and Surveillance; †Preparedness and Response Unit; and ‡Regional Coordination of Programmes/Purchase, Storage and Distribution, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.

出版信息

Pediatr Infect Dis J. 2014 Feb;33(2):190-8. doi: 10.1097/INF.0000000000000106.

DOI:10.1097/INF.0000000000000106

PMID:24168985

Abstract

BACKGROUND

It is recommended that preterm (PT) and low birth weight infants be vaccinated according to standard guidelines. We studied the timeliness of the first diphtheria, tetanus, acellular pertussis and inactivated polio vaccination in the Netherlands, by gestational age (GA) and birth weight (BW).

METHODS

We included all vaccinated children born during 2006-2010. Data from the national immunization register were used to determine the vaccination age and the proportion of timely vaccinated infants (<70 days). Results were compared between groups based on GA (extreme PT: <32, PT: 32-36, full term (FT): ≥37 weeks) and BW. Characteristics associated with the timeliness of vaccination were studied by Cox regression analyses.

RESULTS

The median vaccination age was lower with a higher GA/BW. The proportion of timely vaccinated infants was 66% for extreme PT, 76% for PT and 82% for FT infants. Similar results were seen by BW. Overall, the proportion of timely vaccinated infants increased from 2006 (77%) until 2010 (85%) and there were regional differences and differences by ethnicity. In extreme PT and PT infants, living in a very highly urbanized municipality and being light for GA were associated with less timely vaccination. Being vaccinated in a hospital was associated with a timelier vaccination in extreme PT infants. However, the reverse was seen for PT infants.

CONCLUSIONS

In the Netherlands, PT and low birth weight infants were less often timely vaccinated than FT infants and were, therefore, at increased risk of vaccine-preventable infections. In FT infants, the timeliness of vaccination is better but could also be optimized.

摘要

背景

建议早产儿（PT）和低出生体重儿按照标准指南进行疫苗接种。我们根据胎龄（GA）和出生体重（BW）研究了荷兰首次接种白喉、破伤风、无细胞百日咳和灭活脊髓灰质炎疫苗的及时性。

方法

我们纳入了所有在 2006 年至 2010 年期间出生的接种疫苗的儿童。利用国家免疫登记处的数据，确定了疫苗接种年龄和及时接种婴儿的比例（<70 天）。根据 GA（极早产：<32，早产：32-36，足月（FT）：≥37 周）和 BW，比较了各组的结果。通过 Cox 回归分析研究了与疫苗接种及时性相关的特征。

结果

随着 GA/BW 的增加，中位接种年龄降低。及时接种疫苗的婴儿比例，极早产婴儿为 66%，早产婴儿为 76%，FT 婴儿为 82%。按 BW 观察到相似的结果。总体而言，及时接种疫苗的婴儿比例从 2006 年（77%）增加到 2010 年（85%），并且存在地区差异和种族差异。在极早产和早产婴儿中，居住在高度城市化的直辖市和 GA 较轻与接种时间较晚相关。在医院接种疫苗与极早产婴儿及时接种相关，而在早产婴儿中则相反。