Health Sciences Unit, Faculty of Social Sciences, Tampere University, Finland.
Health Sciences Unit, Faculty of Social Sciences, Tampere University, Finland; Infectious Diseases and Vaccines, Department of Health Protection, National Institute for Health and Welfare, Helsinki, Finland.
Vaccine. 2019 May 21;37(23):3078-3087. doi: 10.1016/j.vaccine.2019.04.058. Epub 2019 Apr 28.
Vellore district in southern India was selected for intensified immunization efforts through India's Mission Indradhanush campaign based on 74% coverage in the National Family Health Survey in 2015. As rural households rely almost entirely on the Universal Immunization Program (UIP), we assessed routine immunization coverage and factors associated with vaccination status of children in rural Vellore.
We conducted a cross-sectional household survey among parents or primary caretakers of children aged 12-23 months during August-September 2017 using two-stage, EPI cluster sampling. We verified vaccination histories from vaccination cards and collected data on sociodemographic and non-socio-demographic characteristics by using mobile data capture. Associations with vaccination status were examined with univariate and multivariate logistic regression models.
A total of 643 children were included. Coverage of BCG, third dose pentavalent/DPT, measles/MR vaccines and full vaccination (BCG, three doses of polio and pentavalent/DPT and measles/MR vaccines) among children with vaccination cards (n = 606) was 94%, 96%, 93% and 84%, respectively. Of children with vaccination cards, 70.8% had received all recommended doses according to the UIP schedule. No socio-demographic differences were identified, but parents' familiarity with the schedule (Adjusted Prevalence Odds Ratio (aPOR): 2.06, 95%CI = 1.26-3.38) and receiving information on recommended vaccinations during antenatal visits (aPOR: 2.16, 95% CI = 1.13-4.12) were significantly associated with full vaccination status of the children.
We found higher UIP antigen coverage and proportion of fully vaccinated children than previously reported from rural Vellore. However, adherence to the recommended schedule was still not optimal. Our study highlights the potential of improving parental awareness of vaccination schedule and targeting health education interventions at pregnant women during antenatal visits to sustain and improve routine immunization coverage.
印度南部的维洛尔区在 2015 年国家家庭健康调查中覆盖率为 74%，因此被选为印度 Mission Indradhanush 运动强化免疫的目标地区。由于农村家庭几乎完全依赖于普遍免疫计划（UIP），我们评估了农村维洛尔地区儿童常规免疫接种的覆盖率以及与接种状况相关的因素。
我们于 2017 年 8 月至 9 月期间，使用两阶段、EPI 聚类抽样，对 12-23 月龄儿童的父母或主要照顾者进行了横断面家庭调查。我们从疫苗接种卡中核实了疫苗接种史，并通过移动数据采集收集了社会人口统计学和非社会人口统计学特征的数据。使用单变量和多变量逻辑回归模型来检验与疫苗接种状况的相关性。
共纳入 643 名儿童。在有疫苗接种卡的儿童（n=606）中，BCG、第三剂五联疫苗/DPT、麻疹/MR 疫苗和完全接种（BCG、三剂脊髓灰质炎和五联疫苗/DPT 以及麻疹/MR 疫苗）的覆盖率分别为 94%、96%、93%和 84%。在有疫苗接种卡的儿童中，根据 UIP 时间表，70.8%的儿童接受了所有推荐剂量。没有发现社会人口统计学差异，但父母对时间表的熟悉程度（调整后的患病率优势比（aPOR）：2.06，95%CI=1.26-3.38）和在产前检查中获得推荐疫苗接种信息（aPOR：2.16，95%CI=1.13-4.12）与儿童的完全接种状况显著相关。
我们发现，与之前报道的农村维洛尔地区相比，UIP 抗原覆盖率和完全接种疫苗的儿童比例更高。然而，对推荐时间表的遵守仍然不理想。我们的研究强调了提高父母对疫苗接种时间表的认识并在产前检查期间针对孕妇开展健康教育干预的潜力，以维持和提高常规免疫接种覆盖率。
