Weinmann Sheila, Mullooly John P, Drew Lois, Chun Colleen S
Investigator at the Center for Health Research in Portland, OR.
Emeritus Senior Investigator for the Center for Health Research in Portland, OR.
Perm J. 2016 Spring;20(2):54-8. doi: 10.7812/TPP/15-160. Epub 2016 Apr 15.
The introduction of the varicella vaccine as a routine pediatric immunization in the US, in 1995, provided an opportunity to assess factors associated with uptake of new vaccines in the member population of the Kaiser Permanente Northwest (KPNW) Health Plan.
Identify factors associated with varicella vaccination in the KPNW population in the first five years after varicella vaccine was introduced.
A retrospective cohort of children under age 13 years between June 1995 and December 1999, without a history of varicella disease was identified using KPNW automated data. Membership records were linked to vaccine databases. Cox regression was used to estimate likelihood of varicella vaccination during the study period in relation to age, sex, primary clinician's specialty, and Medicaid eligibility. For a subset whose parents answered a behavioral health survey, additional demographic and behavioral characteristics were evaluated.
Varicella vaccination.
We identified 88,646 children under age 13 years without a history of varicella; 22% were vaccinated during the study period. Varicella vaccination was more likely among children who were born after 1995, were not Medicaid recipients, or had pediatricians as primary clinicians. In the survey-linked cohort, positively associated family characteristics included smaller family size; higher socioeconomic status; and parents who were older, were college graduates, reported excellent health, and received influenza vaccination.
Understanding predictors of early varicella vaccine-era vaccine acceptance may help in planning for introduction of new vaccines to routine schedules.
1995年水痘疫苗在美国作为常规儿童免疫接种引入,这为评估凯撒永久医疗集团西北分部(KPNW)健康计划成员群体中与新疫苗接种相关的因素提供了契机。
确定在引入水痘疫苗后的头五年里,KPNW人群中与水痘疫苗接种相关的因素。
利用KPNW自动化数据,确定了1995年6月至1999年12月期间13岁以下无水痘病史的儿童回顾性队列。会员记录与疫苗数据库相链接。采用Cox回归分析来估计研究期间水痘疫苗接种的可能性与年龄、性别、初级临床医生专业以及医疗补助资格之间的关系。对于其父母回答了行为健康调查的一个子集,评估了额外的人口统计学和行为特征。
水痘疫苗接种情况。
我们确定了88,646名13岁以下无水痘病史的儿童;在研究期间,22%的儿童接种了疫苗。1995年以后出生、非医疗补助受助者或初级临床医生为儿科医生的儿童更有可能接种水痘疫苗。在与调查相关的队列中,与接种呈正相关的家庭特征包括家庭规模较小、社会经济地位较高,以及父母年龄较大、是大学毕业生、报告健康状况良好且接种了流感疫苗。
了解水痘疫苗早期时代疫苗接受情况的预测因素可能有助于规划将新疫苗纳入常规接种计划。