Robison Steve G
Immunization Program, State of Oregon, Oregon Health Authority, 800 NE Oregon Street, Suite 370, Portland, OR 97232, USA.
ISRN Prev Med. 2012 Aug 14;2013:351540. doi: 10.5402/2013/351540. eCollection 2013.
The successful completion of early childhood immunizations is a proxy for overall quality of early care. Immunization statuses are usually assessed by up-to-date (UTD) rates covering combined series of different immunizations. However, series UTD rates often only bear on which single immunization is missing, rather than the success of all immunizations. In the US, most series UTD rates are limited by missing fourth DTaP-containing immunizations (diphtheria/tetanus/pertussis) due at 15 to 18 months of age. Missing 4th DTaP immunizations are associated either with a lack of visits at 15 to 18 months of age, or to visits without immunizations. Typical immunization data however cannot distinguish between these two reasons. This study compared immunization records from the Oregon ALERT IIS with medical encounter records for two-year olds in the Oregon Health Plan. Among those with 3 valid DTaPs by 9 months of age, 31.6% failed to receive a timely 4th DTaP; of those without a 4th DTaP, 42.1% did not have any provider visits from 15 through 18 months of age, while 57.9% had at least one provider visit. Those with a 4th DTaP averaged 2.45 encounters, while those with encounters but without 4th DTaPs averaged 2.23 encounters.
幼儿免疫接种的成功完成是早期护理整体质量的一个指标。免疫接种状况通常通过涵盖不同免疫接种联合系列的最新（UTD）率来评估。然而，系列UTD率往往只涉及缺少哪种单一免疫接种，而不是所有免疫接种的成功情况。在美国，大多数系列UTD率受到15至18个月龄应接种的含第四剂白喉破伤风百日咳疫苗（DTaP）缺失的限制。第四剂DTaP疫苗缺失与15至18个月龄时未就诊或就诊但未接种疫苗有关。然而，典型的免疫接种数据无法区分这两个原因。本研究将俄勒冈州警报免疫信息系统（ALERT IIS）的免疫接种记录与俄勒冈健康计划中两岁儿童的医疗就诊记录进行了比较。在9个月龄时已接种3剂有效DTaP疫苗的儿童中，31.6%未能及时接种第四剂DTaP；在未接种第四剂DTaP的儿童中，42.1%在15至18个月龄时未进行任何医疗就诊，而57.9%至少进行了一次医疗就诊。接种了第四剂DTaP的儿童平均就诊2.45次，而有就诊但未接种第四剂DTaP的儿童平均就诊2.23次。
