Public Health Unit, North Lisbon Health Care Center, Largo Professor Arnaldo Sampaio, Lisbon, Portugal.
BMC Public Health. 2013 Dec 5;13:1130. doi: 10.1186/1471-2458-13-1130.
Vaccination is the key measure available for prevention of the public health burden of annual influenza epidemics. This article describes national trends in seasonal influenza vaccine (IV) coverage in Portugal from 1998/99 to 2010/11, analyzes progress towards meeting WHO 2010 coverage goals, and addresses the effect of major public health threats of the last 12 years (SARS in 2003/04, influenza A (H5N1) in 2005/06, and the influenza A (H1N1)2009 pandemic) on vaccination trends.
The National Institute of Health surveyed (12 times) a random sample of Portuguese families. IV coverage was estimated and was adjusted for age distribution and country region. Independence of age and sex coverage distribution was tested using a modified F-statistic with a 5% significance level. The effect of SARS, A (H5N1), and the A (H1N1)2009 pandemic was tested using a meta-regression model. The model was adjusted for IV coverage in the general population and in the age groups.
Between 1998/99 and 2010/11 IV, coverage in the general population varied between 14.2% (CI(95%): 11.6%-16.8%) and 17.5% (CI(95%): 17.6%-21.6%). There was no trend in coverage (p = 0.097). In the younger age group (<15 years) a declining trend was identified until 2008/09 (p = 0.005). This trend reversed in 2009/10. There was also a gradual and significant increase in seasonal IV coverage in the elderly (p for trend < 0.001). After 2006/07, IV coverage remained near 50%. Adjusting for baseline trends, there was significantly higher coverage in the general population in 2003/04 (p = 0.032) and 2005/06 (p = 0.018). The high coverage observed in the <15-year age group in season 2009/10 was also significant (p = 0.015).
IV coverage in the elderly population displayed an increasing trend, but the 75% WHO 2010 target was not met. This result indicates that influenza vaccination strategy should be improved to meet the ambitious WHO coverage goals. The major pandemic threats of the past decade had a modest but significant effect on seasonal influenza vaccination. There was an increase in vaccine uptake proportion in the general population in 2003/04 and in 2005/06, and in individuals <15 years old in 2009/10.
接种疫苗是预防年度流感流行对公共卫生造成负担的关键措施。本文描述了 1998/99 至 2010/11 年期间葡萄牙季节性流感疫苗（IV）接种率的国家趋势，分析了实现世卫组织 2010 年接种目标的进展情况，并探讨了过去 12 年（2003/04 年的 SARS、2005/06 年的 H5N1 流感和 2009 年的 H1N1 流感大流行）重大公共卫生威胁对疫苗接种趋势的影响。
国家卫生研究所（National Institute of Health）对（12 次）葡萄牙家庭进行了随机抽样调查。估计了 IV 接种率，并根据年龄分布和国家区域进行了调整。使用具有 5%显著性水平的修正 F 统计量检验了年龄和性别分布的独立性。使用荟萃回归模型测试了 SARS、H5N1 和 H1N1 2009 大流行的影响。该模型针对一般人群和年龄组中的 IV 接种率进行了调整。
1998/99 至 2010/11 年期间，一般人群的 IV 接种率在 14.2%（95%CI：11.6%-16.8%）和 17.5%（95%CI：17.6%-21.6%）之间波动。接种率没有趋势（p = 0.097）。在年轻年龄组（<15 岁）中，直到 2008/09 年才出现下降趋势（p = 0.005）。这种趋势在 2009/10 年发生了逆转。老年人中季节性 IV 接种率也逐渐显著增加（p 趋势 <0.001）。2006/07 年后，IV 接种率接近 50%。在调整了基线趋势后，2003/04 年（p = 0.032）和 2005/06 年（p = 0.018）的一般人群接种率明显更高。2009/10 年 15 岁以下年龄组的高接种率也具有显著意义（p = 0.015）。
老年人的 IV 接种率呈上升趋势，但未达到世卫组织 2010 年 75%的目标。这一结果表明，应改进流感疫苗接种策略，以实现雄心勃勃的世卫组织接种目标。过去十年的重大大流行威胁对季节性流感疫苗接种产生了适度但显著的影响。2003/04 年和 2005/06 年一般人群的疫苗接种比例增加，2009/10 年 15 岁以下人群的疫苗接种比例也增加。
