喷射免疫接种器在口服脊髓灰质炎疫苗入户接种活动中的可行性。
Feasibility of jet injector use during inactivated poliovirus vaccine house-to-house vaccination campaigns.
机构信息
Polio Eradication Branch, Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Connecting Research to Development, Beirut, Lebanon.
出版信息
Vaccine. 2018 Aug 6;36(32 Pt B):4935-4938. doi: 10.1016/j.vaccine.2018.06.011. Epub 2018 Jul 3.
BACKGROUND
To attain high coverage during polio vaccination campaigns, an outreach house-to-house strategy is used to administer oral poliovirus vaccine. Administering an injectable vaccine house-to-house requires a skilled work force and increases risks of needle stick injuries. Needle-free injection devices provide a safer alternative to needles and syringes for administering injectable vaccines. We evaluated the feasibility and acceptability of a needle-free injection device to administer injectable poliovirus vaccine during a house-to-house vaccination outreach activity.
METHODS
Vaccination teams administered injectable poliovirus vaccine using the Pharmajet® needle-free intramuscular jet injector to children ages 6-59 months in 766 homes. Data on the feasibility of using the jet injector in an outreach campaign setting and the acceptability of the jet injector by caregivers and vaccinators were collected.
RESULTS
A total of 993 injections were administered. Vaccinators faced challenges during device preparation in 16% (n = 158) of injections; challenges were related to problems loading the injector and not having a flat surface to use for setup of the injector. Among 32 vaccinators interviewed after the vaccination campaign, the main reported advantage of the device was absence of sharps disposal (91%) while the main reported disadvantage was unacceptability by parents (90%) which was related to the vaccine, not the device.
CONCLUSIONS
The needle-free jet injector was feasible for use in house-to-house campaigns. Acceptability by vaccinators was low as 81% stated that the jet injector was not easier to use than needle and syringe. Parental refusal related to frequent polio vaccination campaigns was the biggest challenge. In addition, novelty of the device posed a challenge to teams as they needed to reassure parents about safety of the device. To take full advantage of the ability to take injectable vaccines door-to-door during vaccination campaigns using a needle-free jet injector device, tailored social mobilization efforts are needed ahead of campaigns.
背景
为了在脊髓灰质炎疫苗接种活动中实现高覆盖率，采用了上门逐户的策略来接种口服脊髓灰质炎疫苗。上门接种注射用疫苗需要一支熟练的劳动力队伍，并且增加了被针刺伤的风险。无针注射装置为接种注射用疫苗提供了一种比针和注射器更安全的选择。我们评估了在上门接种活动中使用无针注射装置接种注射用脊髓灰质炎疫苗的可行性和可接受性。
方法
接种小组使用 Pharmajet® 无针肌肉内射流注射器为 766 户家庭中 6-59 个月大的儿童接种注射用脊髓灰质炎疫苗。收集了关于在上门活动中使用射流注射器的可行性以及照顾者和接种者对射流注射器的可接受性的数据。
结果
共接种了 993 针。接种者在 16%（n=158）的注射中面临设备准备方面的挑战；挑战与注射器加载问题以及没有平坦的表面用于注射器的设置有关。在疫苗接种活动后接受采访的 32 名接种者中，该设备的主要优势是不存在锐器处理（91%），而主要的缺点是父母（90%）不接受，这与疫苗有关，而不是与设备有关。
结论
无针射流注射器可用于上门活动。81%的接种者表示，与针和注射器相比，射流注射器使用起来并不更容易，因此其可接受性较低。与频繁的脊髓灰质炎疫苗接种活动有关的家长拒绝是最大的挑战。此外，由于团队需要向家长保证设备的安全性，因此该设备的新颖性对团队构成了挑战。为了充分利用在接种活动期间使用无针射流注射器进行上门接种注射用疫苗的能力，需要在活动前进行有针对性的社会动员工作。
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