Scheepers Elsemieke D, van Lier Alies, Drijfhout Ingrid H, Berbers Guy, van der Maas Nicoline A T, de Melker Hester E, Knol Mirjam J
Centre for Infectious Disease Control, Department of Epidemiology and Surveillance, National Institute for Public Health and the Environment (RIVM), Postbox 1 (internal postbox 75), 3720 BA, Bilthoven, The Netherlands.
Eur J Pediatr. 2017 Jun;176(6):769-778. doi: 10.1007/s00431-017-2904-1. Epub 2017 Apr 20.
In the Netherlands, the recommended priming immunization schedule for diphtheria, tetanus, pertussis and polio (DTaP-IPV) is at 2, 3 and 4 months of age. We evaluated the compliance with the recommended schedule, as well as its characteristics. We included all infants born between 2007 and 2012 who received minimally one DTaP-IPV vaccination (n = 1,061,578). Infants complied with the schedule if they received the first vaccination between 6 and 9 weeks of age, and the second and third vaccination 2-6 weeks after the first and second vaccination. We examined associations between compliance and several characteristics using log-binomial regression. Compliance for the first, second and third vaccination was 81.6, 88.3 and 84.2%, respectively. Compliance with the total recommended schedule was 64.5%, and increased from 60.1% for 2007 to 68.5% for 2012. Compliance was higher for full-term infants (65.9%), infants with normal birth weight (66.0%) and when both parents were born in the Netherlands (66.8%).
Delayed vaccination during the primary vaccination schedule occurs in one sixth of the Dutch children. Efforts to improve compliance should be focused in particular on preterm infants, infants with low birth weight and infants whose parents are not born in the Netherlands. What is Known: • A delayed start of vaccination leads to a longer period at risk for infectious diseases, e.g. pertussis • Delayed vaccination is associated with several factors including prematurity, low birth weight, family size, birth order, low socioeconomic status and health status of the child What is New: • Compliance with the recommended priming immunization schedule for diphtheria, tetanus, pertussis and polio was 64.5%, and increased from 60.1% for 2007 to 68.5% for 2012 • If the first vaccination was delayed, there was a higher chance that the following vaccinations were administered 'out-of-schedule' as well, resulting in even a higher age at second and third vaccination.
在荷兰，白喉、破伤风、百日咳和脊髓灰质炎（DTaP-IPV）的推荐初始免疫接种程序是在2、3和4月龄时进行。我们评估了对推荐程序的依从性及其特征。我们纳入了2007年至2012年期间出生且至少接种过一剂DTaP-IPV疫苗的所有婴儿（n = 1,061,578）。如果婴儿在6至9周龄之间接种第一剂疫苗，且在第一剂和第二剂疫苗接种后2至6周接种第二剂和第三剂疫苗，则认为其符合接种程序。我们使用对数二项回归分析了依从性与多个特征之间的关联。第一剂、第二剂和第三剂疫苗的接种依从率分别为81.6%、88.3%和84.2%。对整个推荐接种程序的依从率为64.5%，并从2007年的60.1%增至2012年的68.5%。足月婴儿（65.9%）、出生体重正常的婴儿（66.0%）以及父母双方均在荷兰出生的婴儿（66.8%）的依从率更高。
荷兰六分之一的儿童在初次接种程序期间出现疫苗接种延迟。提高依从性的努力应特别关注早产儿、低出生体重婴儿以及父母不是在荷兰出生的婴儿。已知信息：• 疫苗接种开始延迟会导致感染疾病（如百日咳）的风险期延长 • 疫苗接种延迟与多种因素相关，包括早产、低出生体重、家庭规模、出生顺序、社会经济地位低以及儿童健康状况 新发现：• 白喉、破伤风、百日咳和脊髓灰质炎推荐初始免疫接种程序的依从率为64.5%，并从2007年的60.1%增至2012年的68.5% • 如果第一剂疫苗接种延迟，后续疫苗接种“超期”的可能性也更高，导致第二剂和第三剂疫苗接种时年龄更大。
