Suryadevara Manika, Bonville Cynthia A, Cibula Donald A, Valente Matthew, Handel Andrew, Domachowse James R, Domachowske Joseph B
Department of Pediatrics, State University of New York Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, United States.
Department of Pediatrics, State University of New York Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, United States.
Vaccine. 2014 Dec 5;32(51):7000-7004. doi: 10.1016/j.vaccine.2014.10.018. Epub 2014 Oct 25.
Pertussis is a highly contagious vaccine preventable disease resulting in significant infant morbidity and mortality. Despite the recommendations for pertussis vaccine (Tdap) in adults, coverage rates in this age group remain suboptimal. We sought to determine factors associated with Tdap receipt among adults with children in the household who live in central New York.
The study team surveyed Tdap immunization status of adults who accessed medical services for their children provided by Golisano Children's Hospital, Syracuse, New York. Adults who did not know their Tdap vaccine status were excluded. Each participant was asked a standard set of questions to determine factors associated with Tdap receipt. Logistic regression was used to calculate simple and adjusted odds ratios for Tdap receipt in relation to adults' demographic characteristics, knowledge of Tdap and physician recommendations.
Eight hundred twenty four participants were included in this study; 34% had received Tdap in the past 5 years; 58% reported that their provider or child's pediatrician recommended adult Tdap vaccination. Tdap receipt was associated with knowing the symptoms of pertussis infection, female gender, younger age, and provider recommendation (p<0.05). Participants whose provider recommended Tdap vaccine were 24.6 times more likely to receive vaccine when compared to those whose providers did not recommend vaccine (95% CI: 16.3, 37.2, p<0.05).
Tdap coverage rates are low among this study population, with provider recommendation most strongly associated with Tdap receipt. Future steps to improve vaccine coverage should include both increasing community awareness and determining barriers to provider recommendation.
百日咳是一种具有高度传染性、可通过疫苗预防的疾病，会导致婴儿出现严重发病和死亡情况。尽管有针对成人接种百日咳疫苗（破伤风类毒素、白喉、无细胞百日咳疫苗，Tdap）的建议，但该年龄组的接种率仍不理想。我们试图确定纽约中部有孩子的成年人家中与接种Tdap相关的因素。
研究团队调查了在纽约州锡拉丘兹市戈利萨诺儿童医院为其子女接受医疗服务的成年人的Tdap免疫状况。不知道自己Tdap疫苗接种状况的成年人被排除在外。向每位参与者询问一组标准问题，以确定与接种Tdap相关的因素。采用逻辑回归分析来计算与成年人的人口统计学特征、对Tdap的了解程度以及医生建议相关的接种Tdap的简单和调整后的优势比。
本研究纳入了824名参与者；34%的人在过去5年中接种了Tdap；58%的人报告称其医疗服务提供者或孩子的儿科医生建议进行成人Tdap疫苗接种。接种Tdap与了解百日咳感染症状、女性性别、较年轻年龄以及医疗服务提供者的建议相关（p<0.05）。与医疗服务提供者未建议接种疫苗的参与者相比，其医疗服务提供者建议接种Tdap疫苗的参与者接种疫苗的可能性高24.6倍（95%置信区间：16.3，37.2，p<0.05）。
该研究人群中Tdap接种率较低，医疗服务提供者的建议与接种Tdap的关联性最强。未来提高疫苗接种率的措施应包括提高社区意识以及确定医疗服务提供者建议方面的障碍。
