Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, No. 3399 Binsheng Road, Binjiang District, Hangzhou, People's Republic of China.
BMC Public Health. 2018 Nov 27;18(1):1298. doi: 10.1186/s12889-018-6226-7.
This study was aimed to assess the coverage of two doses of measles vaccine and identify the determinants of the delayed vaccination.
A cluster survey among 1386 children aged 24-35 months was conducted. Characteristics on demographic and socio-economic and vaccination records was collected. The overall coverage was defined as the proportion of children receiving the first dose of measles vaccination and the second dose of measles vaccination by 24 months of age. The age-appropriate coverage was defined as the proportion of children receiving the measles vaccine doses within one month after its relevant due date. Timeliness was evaluated with the Kaplan-Meier analysis. Cox proportional hazard regression was adopted to identify determinants of the delayed vaccination.
The overall coverage was 96.9% for the first dose of measles vaccine and 93.9% for the second dose of measles vaccine. The age-appropriate coverage of the first and the second dose of measles vaccine was 76.6 and 68.2%, respectively. Household having more than one child, non-local children were associated with the delayed vaccination for the first and the second dose of measles vaccine. Children delivered at home, younger mothers, low maternal education background, mothers with a fixed job, and low household income were associated with the delayed vaccination for the second dose of measles vaccine.
The coverage of measles vaccine had been improved for both the first and the second dose, while the timeliness still needed improvement. We suggested the policy-makers pay more attention to the reasons for non-vaccination and determinants of delayed vaccination when planning efforts to ensure the high age-appropriate coverage of measles vaccination.
本研究旨在评估两剂麻疹疫苗的覆盖率，并确定延迟接种的决定因素。
对 1386 名 24-35 月龄儿童进行了一项聚类调查。收集了人口统计学、社会经济和疫苗接种记录的特征。总覆盖率定义为接受第一剂麻疹疫苗和第二剂麻疹疫苗的儿童比例，在 24 月龄时。适时覆盖率定义为在相关到期日后一个月内接受麻疹疫苗剂量的儿童比例。采用 Kaplan-Meier 分析评估及时性。采用 Cox 比例风险回归分析确定延迟接种的决定因素。
第一剂麻疹疫苗的总覆盖率为 96.9%，第二剂麻疹疫苗的总覆盖率为 93.9%。第一剂和第二剂麻疹疫苗的适时覆盖率分别为 76.6%和 68.2%。有多个孩子的家庭、非本地儿童与第一剂和第二剂麻疹疫苗的延迟接种有关。在家分娩、母亲年龄较小、母亲受教育程度较低、母亲有固定工作和家庭收入较低与第二剂麻疹疫苗的延迟接种有关。
第一剂和第二剂麻疹疫苗的覆盖率均有所提高，但及时性仍需提高。我们建议决策者在规划确保麻疹疫苗高适时覆盖率的努力时，更加关注未接种疫苗的原因和延迟接种的决定因素。
