Rebmann T, Baskin C R, Loux T M, Wakefield M
Institute for Biosecurity, Saint Louis University, College for Public Health & Social Justice, St Louis, MO, USA.
Institute for Biosecurity, Saint Louis University, College for Public Health & Social Justice, St Louis, MO, USA.
Public Health. 2017 Jan;142:152-158. doi: 10.1016/j.puhe.2016.07.012. Epub 2016 Sep 5.
Study objectives were to assess parents' and childcare agency staff's uptake of and attitudes/beliefs related to hepatitis A vaccine.
Cross-sectional survey.
Questionnaires were administered to parents and staff in 23 St. Louis childcare agencies between September and December 2014. Categorical data were compared using Chi-squared test. Multivariate logistic regression, stratified by staff vs parents, was used to find predictors of hepatitis A vaccine uptake.
In total, 351 staff and parents participated (response rate = 32%). More staff than parents had been offered or recommended to receive hepatitis A vaccine by a healthcare provider (55.4% vs 36.6% and 53.3% vs 28.7%, respectively; P = .001 for both). More staff than parents received hepatitis A vaccine (85.3% vs 67.5%, Chi-squared test = 11.0, P < .001). Predictors of staff vaccine uptake included being aware of CDC vaccination recommendations (OR = 11.2, CI = [1.4-91], P < .05), employer recommendation to get vaccinated (OR = 8.1, CI = [1.8-36.8], P < .01), and having a mandatory staff vaccination policy (OR = 4.8, CI = [1.2-19.7], P < .05). Predictors of parent vaccine uptake included being offered the vaccine by a healthcare provider (OR = 4.3, CI = [1.3-4.9], P < .001), being aware of the CDC vaccination recommendations (OR = 4.0, CI = [2.0-8.0], P < .001), and having received influenza vaccine previously (OR = 2.5, CI = [1.3-4.9], P < .01).
In this study population, many childcare agency staff and parents have received hepatitis A vaccine, though staff immunization rates are at the minimum needed to reach herd immunity levels. Having employers encourage vaccination, offer free vaccine, or make vaccine available onsite could increase staff vaccination rates. Public health should partner with childcare agencies to increase staff vaccine uptake, which could result in community herd immunity.
研究目的是评估家长和儿童保育机构工作人员对甲型肝炎疫苗的接种情况以及与之相关的态度/信念。
横断面调查。
2014年9月至12月期间,对圣路易斯23家儿童保育机构的家长和工作人员进行问卷调查。分类数据采用卡方检验进行比较。采用多因素逻辑回归分析,按工作人员和家长分层,以找出甲型肝炎疫苗接种的预测因素。
共有351名工作人员和家长参与(回复率 = 32%)。医疗保健提供者向工作人员提供或建议接种甲型肝炎疫苗的比例高于家长(分别为55.4%对36.6%以及53.3%对28.7%;两者P均 = 0.001)。接种甲型肝炎疫苗的工作人员比例高于家长(85.3%对67.5%,卡方检验 = 11.0,P < 0.001)。工作人员接种疫苗的预测因素包括了解美国疾病控制与预防中心(CDC)的疫苗接种建议(比值比[OR] = 11.2,置信区间[CI] = [1.4 - 91],P < 0.05)、雇主建议接种疫苗(OR = 8.1,CI = [1.8 - 36.8],P < 0.01)以及有强制性的工作人员疫苗接种政策(OR = 4.8,CI = [1.2 - 19.7],P < 0.05)。家长接种疫苗的预测因素包括医疗保健提供者提供疫苗(OR = 4.3,CI = [1.3 - 4.9],P < 0.001)、了解CDC的疫苗接种建议(OR = 4.0,CI = [2.0 - 8.0],P < 0.001)以及之前接种过流感疫苗(OR = 2.5,CI = [1.3 - 4.9],P < 0.01)。
在本研究人群中,许多儿童保育机构工作人员和家长已接种甲型肝炎疫苗,尽管工作人员的免疫率处于达到群体免疫水平所需的最低值。让雇主鼓励接种疫苗、提供免费疫苗或在现场提供疫苗可提高工作人员的接种率。公共卫生部门应与儿童保育机构合作,提高工作人员的疫苗接种率,这可能会带来社区群体免疫。