Lancashire County Council, County Hall, Fishergate, Preston, UK.
Health Education North West, Regatta Place, Brunswick Business Park, Summers Road, Liverpool, UK.
J Public Health (Oxf). 2019 Mar 1;41(1):149-157. doi: 10.1093/pubmed/fdy010.
In 2015 the meningococcal ACWY (MenACWY) vaccination was introduced amongst adolescents in England following increased incidence and mortality associated with meningococcal group W.
MenACWY vaccination uptake data for 17-18 years old and students delivered in primary care were obtained for 20 National Health Service clinical commissioning groups (CCGs) via the ImmForm vaccination system. Data on general practice characteristics, encompassing demographics and patient satisfaction variables, were extracted from the National General Practice Profiles resource. Univariable analysis of the associations between practice characteristics and vaccination was performed, followed by multivariable negative binomial regression.
Data were utilized from 587 general practices, accounting for ~8% of all general practices in England. MenACWY vaccination uptake varied from 20.8% to 46.8% across the CCGs evaluated. Upon multivariable regression, vaccination uptake increased with increasing percentage of patients from ethnic minorities, increasing percentage of patients aged 15-24 years, increasing percentage of patients that would recommend their practice and total Quality and Outcomes Framework achievement for the practice. Conversely, vaccination uptake decreased with increasing deprivation.
This study has identified several factors independently associated with MenACWY vaccination in primary care. These findings will enable a targeted approach to improve general practice-level vaccination uptake.
2015 年,在与脑膜炎奈瑟菌 W 群相关的发病率和死亡率增加后,英国开始在青少年中接种脑膜炎球菌 ACWY(MenACWY)疫苗。
通过 ImmForm 疫苗接种系统,从 20 个国家卫生服务临床委托组(CCG)获得了针对 17-18 岁青少年和在初级保健中接种的 MenACWY 疫苗接种数据。从国家全科医生概况资源中提取了有关一般实践特征(包括人口统计学和患者满意度变量)的数据。对实践特征与疫苗接种之间的关联进行了单变量分析,然后进行了多变量负二项回归分析。
利用了来自 587 个普通实践的数据,占英格兰所有普通实践的约 8%。评估的 CCG 中 MenACWY 疫苗接种率从 20.8%到 46.8%不等。经过多变量回归,疫苗接种率随着少数民族患者比例、15-24 岁患者比例、愿意推荐自己诊所的患者比例和诊所整体质量和结果框架(Quality and Outcomes Framework,QOF)达成率的增加而增加。相反,疫苗接种率随着贫困程度的增加而降低。
本研究确定了与初级保健中 MenACWY 疫苗接种独立相关的几个因素。这些发现将能够针对特定实践来提高一般实践水平的疫苗接种率。