Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines Manila, Philippines.
Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, United States.
Vaccine. 2018 Nov 19;36(48):7399-7407. doi: 10.1016/j.vaccine.2018.09.028. Epub 2018 Oct 24.
The introduction of inactivated poliovirus vaccine (IPV) to the Philippines' national immunization schedule meant the addition of a third injectable vaccine at a child's 14-week immunization visit. Although previous studies have shown that providing multiple vaccines at the same time affected neither the risk of severe adverse events nor vaccine efficacy, concerns were raised that providing three injections at a single visit, with two injections in one leg, might be unacceptable to health care providers (HCP) and infant caregivers.
We conducted pre- and post-IPV introduction surveys on the acceptance and acceptability of the additional injectable vaccine in three of the Philippines' 17 administrative regions. Regions 3 and 6 were included in the pre-introduction phase and Regions 3, 6 and 10 were included in the post-introduction phase. Thirty public health centers (PHCs) were randomly sampled from each region. HCPs and infant caregivers were interviewed. In addition, vaccination records from a minimum of 20 eligible children pre-introduction and 10 children post-introduction per PHC were reviewed.
We interviewed 89 HCPs and 286 infant caregivers during the pre-introduction phase and 137 HCPs and 455 caregivers during the post-introduction phase. Among 986 vaccination records reviewed post-introduction, 84% (n = 826) of children received all three recommended injections at one visit, with a range from 61% (209/342) in Region 10 to 100% (328/328) in Region 3. The proportion of HCPs reporting that they had administered three or more injectable vaccines and the proportion of caregivers that would be comfortable with their child receiving three or more injectable vaccines at one visit increased from pre- to post-introduction (p < 0.0001 for both). Eighty-seven percent of HCPs that had administered three or more injectable vaccines post-introduction reported being comfortable or very comfortable with the number of vaccines they had administered.
菲律宾国家免疫计划引入灭活脊髓灰质炎病毒疫苗（IPV）意味着在儿童 14 周的免疫接种访问时增加了第三种可注射疫苗。尽管先前的研究表明，同时接种多种疫苗既不会影响严重不良事件的风险，也不会影响疫苗的功效，但有人担心，在一次访问中提供三次注射，在一条腿上进行两次注射，可能无法被医疗保健提供者（HCP）和婴儿护理人员接受。
我们在菲律宾 17 个行政区中的 3 个地区进行了 IPV 引入前后的调查，以了解额外可注射疫苗的接受程度和可接受性。第 3 区和第 6 区被纳入了引入前阶段，第 3 区、第 6 区和第 10 区被纳入了引入后阶段。从每个地区随机抽取 30 个公共卫生中心（PHC）进行抽样。对 HCP 和婴儿护理人员进行了访谈。此外，还审查了每个 PHC 至少 20 名符合条件的儿童在引入前和 10 名儿童在引入后的接种记录。
我们在引入前阶段采访了 89 名 HCP 和 286 名婴儿护理人员，在引入后阶段采访了 137 名 HCP 和 455 名护理人员。在引入后审查的 986 份接种记录中，84%（n=826）的儿童在一次访问中接受了所有推荐的三种注射，范围从第 10 区的 61%（209/342）到第 3 区的 100%（328/328）。报告接种了三种或更多可注射疫苗的 HCP 比例以及愿意让其子女一次接受三种或更多可注射疫苗的护理人员比例均从引入前增加到了引入后（均 p<0.0001）。引入后报告接种了三种或更多可注射疫苗的 87%的 HCP 表示对他们接种的疫苗数量感到舒适或非常舒适。
