Liu Shijun, Wang Jun, Liu Yan, Xu Yuyang, Che Xinren, Gu Wenwen, Du Jian, Zhang Xiaoping, Xu Erping
a Hangzhou Center for Disease Control and Prevention , Hangzhou , China.
Hum Vaccin Immunother. 2017 Jul 3;13(7):1539-1543. doi: 10.1080/21645515.2017.1304868. Epub 2017 Apr 13.
Objective To describe the epidemiological characteristics of contraindications in children routine vaccination, to evaluate vaccination doctors' ability to determine contraindications. Method Using cross-section study, 34 urban and 15 suburb units were selected from 206 Community Health Center (CHC) in Hangzhou, China. Subjects were all children coming to CHCs for routine vaccination. All situations considered to be unsuitable for vaccination were recorded as contraindications. 3 experts were used to classify these abnormal records as true or false contraindications. Then, the multi-analysis was used to find factors related with the rate of false contraindications. Results There were 2801 children with 2969 contraindications in the present study. The prevalence of contraindications was 3.03‰ by dose of vaccines. Cough (24.78%), fever (21.86%) and medication (19.54%) were the most common contraindications in children routine vaccination. Measles-rubella vaccine (MR) (6.78‰), measles-mumps-rubella vaccine (MMR) (5.87‰) and hepatitis B vaccine (Hep B) (5.25‰) had higher prevalence of contraindications than other vaccines. According to the evaluation of 3 experts, about 13.53% of contraindications were misdiagnosed by vaccination doctor. The rate of misdiagnosed contraindications was correlated with the sex, age and educational background of vaccination doctor, total dose of vaccination of CHC. Conclusion A portion of children might miss the routine vaccination because of misdiagnosed contraindications. More investigations are needed to report the epidemiological distribution of contraindication in routine vaccination of children.
目的 描述儿童常规疫苗接种中禁忌证的流行病学特征，评估疫苗接种医生判断禁忌证的能力。方法 采用横断面研究，从中国杭州206家社区卫生服务中心中选取34家城区和15家郊区单位。研究对象为所有到社区卫生服务中心进行常规疫苗接种的儿童。所有被认为不适合接种的情况均记录为禁忌证。由3名专家将这些异常记录分类为真禁忌证或假禁忌证。然后，采用多因素分析找出与假禁忌证发生率相关的因素。结果 本研究中有2801名儿童存在2969条禁忌证。按疫苗剂次计算，禁忌证患病率为3.03‰。咳嗽（24.78%）、发热（21.86%）和正在用药（19.54%）是儿童常规疫苗接种中最常见的禁忌证。麻疹风疹疫苗（MR）（6.78‰）、麻疹腮腺炎风疹疫苗（MMR）（5.87‰）和乙型肝炎疫苗（Hep B）（5.25‰）的禁忌证患病率高于其他疫苗。根据3名专家的评估，约13.53%的禁忌证被疫苗接种医生误诊。误诊禁忌证的发生率与疫苗接种医生的性别、年龄、学历、社区卫生服务中心疫苗接种总量有关。结论 部分儿童可能因禁忌证误诊而错过常规疫苗接种。需要进一步调查以报告儿童常规疫苗接种中禁忌证的流行病学分布情况。
