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美国联邦政府资助的医疗中心所服务的儿科患者中的流感疫苗接种情况。

Influenza vaccination among U.S. pediatric patients receiving care from federally funded health centers.

机构信息

U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, Office of Epidemiology and Research, Rockville MD, United States.

U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Primary Health Care, Office of Quality Improvement, Rockville MD, United States.

出版信息

Vaccine. 2020 Sep 3;38(39):6120-6126. doi: 10.1016/j.vaccine.2020.07.021. Epub 2020 Jul 24.

Abstract

INTRODUCTION

During the 2018-2019 influenza season, vaccination coverage among U.S. children was 62.6%. The purpose of this study was to estimate the prevalence of influenza vaccinations among pediatric patients seen in U.S. health centers, and to explore potential disparities in vaccination coverage among subpopulations. Funded by the Health Resources and Services Administration (HRSA) within the U.S. Department of Health and Human Services, these health centers provide primary and preventive care to underserved and vulnerable individuals and families in order to reduce health disparities based on economic, geographic, or cultural barriers.

METHODS

Cross-sectional data, analyzed in 2019, came from the most recent waves of the Health Center Patient Survey (2009, 2014). The sample consisted of children ages 2-17 years receiving care from HRSA-funded health centers. The outcome of interest was self- or parent-reported receipt of influenza vaccine in the past year. Multivariable logistic regression was used to estimate the adjusted prevalence rate ratios for the association between demographic characteristics (age, sex, race/ethnicity, poverty level, urban/rural residence, geographic region), health-related variables (receipt of well-child check-up, asthma diagnosis), and influenza vaccination.

RESULTS

Influenza vaccination coverage among pediatric health center patients increased from 46.6% in 2009 to 67.8% in 2014. In the adjusted model for 2014, there were few statistically significant differences in vaccination coverage among subpopulation groups, however American Indian/Alaska Native children had 31% increased vaccination coverage compared with non-Hispanic White children (aPRR: 1.31, 95% CI: 1.02-1.60) and children living in the South had 26% decreased vaccination coverage compared with those living in the Northeast (aPRR: 0.74, 95% CI: 0.54-0.93).

CONCLUSIONS

Influenza vaccination coverage among pediatric health center patients in 2014 exceeded the national average (as of 2018-2019), and few differences were found among at-risk subpopulations. HRSA-funded health centers are well-positioned to further increase the vaccination rate among children living in underserved communities.

摘要

引言

在 2018-2019 年流感季节,美国儿童的疫苗接种率为 62.6%。本研究的目的是估计美国健康中心就诊的儿科患者中流感疫苗的接种率,并探讨亚人群中疫苗接种率的潜在差异。这些健康中心由美国卫生与公众服务部下属的卫生资源与服务管理局(HRSA)资助,为服务不足和弱势群体以及有经济、地理或文化障碍的个人和家庭提供初级和预防保健,以减少基于经济、地理或文化障碍的健康差异。

方法

横断面数据来自最近的两次健康中心患者调查(2009 年和 2014 年),并于 2019 年进行了分析。样本由在 HRSA 资助的健康中心接受治疗的 2-17 岁儿童组成。感兴趣的结果是自我报告或父母报告过去一年中接种流感疫苗的情况。多变量逻辑回归用于估计人口统计学特征(年龄、性别、种族/族裔、贫困水平、城乡居住、地理区域)、与健康相关的变量(接受儿童健康检查、哮喘诊断)与流感疫苗接种之间的关联的调整后患病率比。

结果

儿科健康中心患者的流感疫苗接种率从 2009 年的 46.6%上升到 2014 年的 67.8%。在 2014 年的调整模型中,亚人群组的疫苗接种率差异很小,但与非西班牙裔白人儿童相比,美洲印第安人/阿拉斯加原住民儿童的疫苗接种率增加了 31%(调整后患病率比:1.31,95%可信区间:1.02-1.60),与居住在东北部的儿童相比,居住在南部的儿童的疫苗接种率降低了 26%(调整后患病率比:0.74,95%可信区间:0.54-0.93)。

结论

2014 年儿科健康中心患者的流感疫苗接种率超过了全国平均水平(截至 2018-2019 年),而高危亚人群之间的差异很小。HRSA 资助的健康中心有很好的机会进一步提高服务不足社区儿童的疫苗接种率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/356f/7378489/cc3f069217a5/gr1_lrg.jpg

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