Hu Yu, Li Qian, Chen Yaping
Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou 310000, China.
Int J Environ Res Public Health. 2017 Sep 20;14(9):1086. doi: 10.3390/ijerph14091086.
this study aimed to assess both immunization coverage and timeliness, as well as reasons for non-vaccination, and identity the risk factors of delayed immunization, for the vaccines scheduled during the first year of life, in Zhejiang province, east China. A cluster survey among children aged 24-35 months was conducted. Demographic information and socio-economic characteristics of the selected child, the mother, and the household were collected. Immunization data were transcribed from immunization cards. Timeliness was assessed with Kaplan-Meier analysis for each vaccine given before 12 months of age, based on the time frame stipulated by the expanded program on immunization of China. Cox proportional hazard regression was applied to identify risk factors of delayed immunization. A total of 2772 eligible children were surveyed. The age-appropriate coverage ranged from 25.4% (95% CI: 23.7-27.0%) for Bacillus Calmette-Guerin (BCG) to 91.3% (95% CI: 90.2-92.3%) for the first dose of oral poliomyelitis vaccine (OPV1). The most frequent reason for non-vaccination was parent's fear of adverse events of immunization. Delayed immunizations were associated with mother having a lower education level, mother having a job, delivery at home, increasing number of children per household, and having a lower household income. Although the timeliness of immunization has improved since 2011, necessary steps are still needed to achieve further improvement. Timeliness of immunization should be considered as another important indicator of expanded program on immunization (EPI) performance. Future interventions on vaccination coverage should take into consideration demographic and socio-economic risk factors identified in this study. The importance of adhering to the recommended schedule should be explained to parents.
本研究旨在评估中国东部浙江省一岁以内计划免疫疫苗的接种率、及时性、未接种原因以及确定延迟接种的风险因素。对24 - 35月龄儿童进行整群抽样调查,收集了入选儿童、其母亲及家庭的人口学信息和社会经济特征,从预防接种证转录免疫接种数据。根据中国扩大免疫规划规定的时间框架,采用Kaplan-Meier分析评估12月龄前接种的每种疫苗的及时性。应用Cox比例风险回归确定延迟接种的风险因素。共调查了2772名符合条件的儿童。适龄接种率从卡介苗(BCG)的25.4%(95%CI:23.7 - 27.0%)到口服脊髓灰质炎疫苗第一剂(OPV1)的91.3%(95%CI:90.2 - 92.3%)不等。未接种的最常见原因是家长担心免疫接种的不良事件。延迟接种与母亲教育程度较低、母亲有工作、在家分娩、家庭子女数量增加以及家庭收入较低有关。尽管自2011年以来免疫接种及时性有所提高,但仍需采取必要措施以进一步改善。免疫接种及时性应被视为扩大免疫规划(EPI)绩效的另一重要指标。未来提高疫苗接种率的干预措施应考虑本研究中确定的人口学和社会经济风险因素。应向家长解释遵守推荐免疫程序的重要性。