英国一年级本科生中新的脑膜炎疫苗接种计划的接受情况：一项横断面研究。
Uptake of a new meningitis vaccination programme amongst first-year undergraduate students in the United Kingdom: A cross-sectional study.
作者信息
Blagden Sarah, Seddon Daniel, Hungerford Daniel, Stanistreet Debbi
机构信息
Department of Public Health and Policy, Institute of Psychology Health and Society, University of Liverpool, Liverpool, United Kingdom.
NHS England, Regatta Place, Brunswick Business Park, Liverpool, United Kingdom.
出版信息
PLoS One. 2017 Aug 2;12(8):e0181817. doi: 10.1371/journal.pone.0181817. eCollection 2017.
BACKGROUND
In 2015 meningococcal group W was declared endemic in the UK, with the meningococcal ACWY vaccination (MenACWY) subsequently introduced amongst adolescents and first-year university students. This study aimed to determine MenACWY uptake amongst students and to evaluate how this was influenced by demographics and via the Health Belief Model (HBM).
METHODS
This was a cross-sectional study conducted at a British university amongst first-year undergraduate students aged 18-25 years. Data collection was via an electronic questionnaire encompassing demographics, the HBM and vaccination status. Univariable analysis of the associations between demographics, health beliefs and vaccination was performed, followed by multiple logistic regression.
RESULTS
401 participants were included in analysis. Vaccine uptake was 68.1%. Variables independently associated with vaccination upon multiple regression were age, gap-year, perceived effectiveness of the vaccine and knowledge about risk of meningitis. Compared to 18 year-olds, the odds of vaccination were reduced for 19 year-olds (aOR = 0.087, 95% CI = 0.010-0.729), 20 year-olds (aOR = 0.019, 95% CI = 0.002-0.161) and 21-25 year-olds (aOR = 0.003, 95% CI = <0.001-0.027). In contrast, taking a gap year (aOR = 2.939, 95% CI = 1.329-6.501), higher perceived vaccine effectiveness (aOR = 3.555, 95% CI = 1.787-7.073) and knowledge about meningitis risk (aOR = 2.481, 95% CI = 1.165-5.287) were independently associated with increased uptake.
CONCLUSIONS
MenACWY uptake amongst students in this study and in other sources is above the national coverage for all adolescents (35.3%), indicating that this vaccination programme may be increasing health inequalities. Older students are less likely to become vaccinated due to differing vaccination policy in this age-group. In future, strategies that focus on specific student cohorts and that highlight vaccine effectiveness and the risk of meningitis should be considered. National evaluation of this vaccination programme is recommended to clarify its impact on health inequalities.
背景
2015年，W群脑膜炎球菌在英国被宣布为地方病，随后在青少年和大学一年级学生中引入了ACWY群脑膜炎球菌疫苗（MenACWY）。本研究旨在确定学生中MenACWY疫苗的接种率，并评估人口统计学因素以及健康信念模式（HBM）对其的影响。
方法
这是一项在英国一所大学针对18至25岁本科一年级学生开展的横断面研究。通过电子问卷收集数据，内容涵盖人口统计学信息、健康信念模式和疫苗接种状况。对人口统计学因素、健康信念与疫苗接种之间的关联进行单变量分析，随后进行多因素逻辑回归分析。
结果
401名参与者纳入分析。疫苗接种率为68.1%。多因素回归分析中与疫苗接种独立相关的变量包括年龄、间隔年、对疫苗有效性的认知以及对脑膜炎风险的了解。与18岁学生相比，19岁学生接种疫苗的几率降低（调整后比值比[aOR]=0.087，95%置信区间[CI]=0.010 - 0.729），20岁学生（aOR = 0.019，95% CI = 0.002 - 0.161）以及21 - 25岁学生（aOR = 0.003，95% CI = <0.001 - 0.027）。相反，间隔年（aOR = 2.939，95% CI = 1.329 - 6.501）、更高的疫苗有效性认知（aOR = 3.555，95% CI = 1.787 - 7.073）以及对脑膜炎风险的了解（aOR = 2.481，95% CI = 1.165 - 5.287）与接种率增加独立相关。
结论
本研究及其他研究中该大学学生的MenACWY疫苗接种率高于所有青少年的全国覆盖率（35.3%），这表明该疫苗接种计划可能在加剧健康不平等。由于该年龄组不同的疫苗接种政策，年龄较大的学生接种疫苗的可能性较小。未来，应考虑针对特定学生群体并突出疫苗有效性和脑膜炎风险的策略。建议对该疫苗接种计划进行全国评估，以阐明其对健康不平等的影响。
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