Schweitzer A, Krause G, Pessler F, Akmatov M K
Helmholtz Centre for Infection Research, Braunschweig, Germany.
Hannover Medical School, Hannover, Germany.
BMC Public Health. 2015 Aug 19;15:798. doi: 10.1186/s12889-015-2091-9.
Timing of childhood vaccinations has received close attention in many countries. Little is known about the trends in correctly timed vaccination in former Soviet countries. We examined trends in vaccination coverage and correct timing of vaccination in two post-Soviet countries, Armenia and Kyrgyzstan, and analyzed factors associated with delayed vaccinations.
We used data from the Demographic and Health Surveys; the surveys were conducted in 2000 (n = 1726), 2005 (n = 1430) and 2010 (n = 1473) in Armenia and in 1997 (n = 1127) and 2012 (n = 4363) in Kyrgyzstan. We applied the Kaplan-Meier method to estimate age-specific vaccination coverage with diphtheria, tetanus and pertussis (DTP) vaccine and a measles-containing vaccine (MCV). A Cox proportional hazard regression with shared frailty was used to examine factors associated with delayed vaccinations.
Vaccination coverage for all three doses of the DTP vaccine increased in Armenia from 92 % in 2000 to 96 % in 2010. In Kyrgyzstan, DTP coverage was 96 % and 97 % in 1997 and 2012, respectively. Vaccination coverage for MCV increased from 89 % (Armenia, 2000) and 93 % (Kyrgyzstan, 1997) to 97 % (Armenia, 2010) and 98 % (Kyrgyzstan, 2012). The proportion of children with correctly timed vaccinations increased over time for all examined vaccinations in both countries. For example, the proportion of children in Armenia with correctly timed first DTP dose (DTP1) increased from 46 % (2000) to 66 % (2010). In Kyrgyzstan, the proportion of correctly timed DTP1 increased from 75 % (1997) to 87 % (2012). In Armenia, delays in the third DTP dose (DTP3) and MCV vaccinations were less likely to occur in the capital, whereas in Kyrgyzstan DTP3 and MCV start was delayed in the capital compared to other regions of the country. Also, in Armenia living in urban areas was associated with delayed vaccinations.
Vaccination coverage and timing of vaccination improved over the last years in both countries. Further efforts are needed to reduce regional differences in timely vaccinations.
儿童疫苗接种时间在许多国家都受到密切关注。在前苏联国家，关于按时接种疫苗的趋势知之甚少。我们研究了两个后苏联国家亚美尼亚和吉尔吉斯斯坦的疫苗接种覆盖率及正确接种时间的趋势，并分析了与延迟接种相关的因素。
我们使用了人口与健康调查的数据；这些调查分别于2000年（n = 1726）、2005年（n = 1430）和2010年（n = 1473）在亚美尼亚进行，以及于1997年（n = 1127）和2012年（n = 4363）在吉尔吉斯斯坦进行。我们应用Kaplan-Meier方法来估计白喉、破伤风和百日咳（DTP）疫苗及含麻疹疫苗（MCV）的特定年龄接种覆盖率。使用带有共享脆弱性的Cox比例风险回归来研究与延迟接种相关的因素。
亚美尼亚三剂DTP疫苗的接种覆盖率从2000年的92%增至2010年的96%。在吉尔吉斯斯坦，1997年和2012年的DTP覆盖率分别为96%和97%。MCV的接种覆盖率从（亚美尼亚，2000年的）89%和（吉尔吉斯斯坦，1997年的）93%增至（亚美尼亚，2010年的）97%和（吉尔吉斯斯坦，2012年的）98%。两国所有所研究疫苗按时接种的儿童比例均随时间增加。例如，亚美尼亚按时接种第一剂DTP（DTP1）的儿童比例从2000年的46%增至2010年的66%。在吉尔吉斯斯坦，按时接种DTP1的比例从1997年的75%增至2012年的87%。在亚美尼亚，首都地区第三剂DTP（DTP3）和MCV疫苗接种延迟的可能性较小，而在吉尔吉斯斯坦，与该国其他地区相比，首都地区DTP3和MCV的接种起始时间延迟。此外，在亚美尼亚，居住在城市地区与延迟接种有关。
过去几年两国的疫苗接种覆盖率和接种时间均有所改善。需要进一步努力以减少及时接种疫苗方面的地区差异。
