Immunisation, Hepatitis and Blood Safety Department,National Infections Service, Public Health England,London,UK.
Epidemiol Infect. 2018 Jan;146(2):197-206. doi: 10.1017/S0950268817002497. Epub 2017 Dec 14.
This study assessed variation in coverage of maternal pertussis vaccination, introduced in England in October 2012 in response to a national outbreak, and a new infant rotavirus vaccination programme, implemented in July 2013. Vaccine eligible patients were included from national vaccine coverage datasets and covered April 2014 to March 2015 for pertussis and January 2014 to June 2016 for rotavirus. Vaccine coverage (%) was calculated overall and by NHS England Local Team (LT), ethnicity and Index of Multiple Deprivation (IMD) quintile, and compared using binomial regression. Compared with white-British infants, the largest differences in rotavirus coverage were in 'other', white-Irish and black-Caribbean infants (-13·9%, -12·1% and -10·7%, respectively), after adjusting for IMD and LT. The largest differences in maternal pertussis coverage were in black-other and black-Caribbean women (-16·3% and -15·4%, respectively). Coverage was lowest in London LT for both programmes. Coverage decreased with increasing deprivation and was 14·0% lower in the most deprived quintile compared with the least deprived for the pertussis programme and 4·4% lower for rotavirus. Patients' ethnicity and deprivation were therefore predictors of coverage which contributed to, but did not wholly account for, geographical variation in coverage in England.
本研究评估了 2012 年 10 月在英格兰推出的针对全国性爆发的百日咳母亲疫苗接种覆盖率的变化,以及 2013 年 7 月推出的新婴儿轮状病毒疫苗接种计划。从全国疫苗覆盖数据集纳入符合疫苗接种条件的患者,涵盖 2014 年 4 月至 2015 年 3 月的百日咳和 2014 年 1 月至 2016 年 6 月的轮状病毒。疫苗覆盖率(%)总体计算,并按英格兰国民保健署(NHS)地方团队(LT)、种族和多重剥夺指数(IMD)五分位数计算,并使用二项式回归进行比较。与白种-英国婴儿相比,轮状病毒接种覆盖率最大的差异存在于“其他”、白种-爱尔兰和黑种-加勒比婴儿中(分别为-13.9%、-12.1%和-10.7%),在调整 IMD 和 LT 后。百白破疫苗接种覆盖率最大的差异存在于黑种-其他和黑种-加勒比妇女中(分别为-16.3%和-15.4%)。两个项目在伦敦 LT 的覆盖率最低。随着贫困程度的增加,覆盖率降低,在最贫困的五分位数中,与最不贫困的五分位数相比,百白破疫苗接种覆盖率低 14.0%,轮状病毒疫苗接种覆盖率低 4.4%。因此,患者的种族和贫困程度是覆盖率的预测因素,这些因素促成了英格兰覆盖率的地理差异,但并未完全解释。