日本金泽市自费轮状病毒疫苗接种状况的决定因素，包括社会经济因素、家长认知和儿童特征。
Determinants of self-paid rotavirus vaccination status in Kanazawa, Japan, including socioeconomic factors, parents' perception, and children's characteristics.
机构信息
Department of Preventive Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
Health Affairs Department, Kanazawa City, 1-1-1 Hirosaka, Kanazawa, Ishikawa, 920-8577, Japan.
出版信息
BMC Infect Dis. 2020 Sep 29;20(1):712. doi: 10.1186/s12879-020-05424-6.
BACKGROUND
Japan's National Immunization Program does not cover rotavirus vaccine and no government subsidies are available. This study aimed to measure the uptake of and determinants that influenced self-paid rotavirus vaccination, including socioeconomic status and relative poverty.
METHODS
We conducted a cross-sectional study at health check-ups for all children aged 18 months in Kanazawa, Japan, between December 2017 and July 2018. Community nurses collected information on self-paid vaccination history, parents' perceptions of and recommendations for rotavirus vaccine, and socioeconomic status in interviews using a unified questionnaire. We used multivariable logistic regression to assess vaccine uptake and possible determinants.
RESULTS
In total, 1282 participants were enrolled. The estimated rotavirus vaccine coverage was 72.9%. Perceptions that rotavirus gastroenteritis was serious and that the rotavirus vaccine was effective, pediatricians' recommendations, information from the city office, magazine and Internet articles, and higher parental education level were associated with higher rotavirus vaccine uptake. Lower household income was associated with decreased rotavirus vaccine uptake. Vaccine expense, fear of adverse reactions to the vaccine, number of household members and siblings, and children's characteristics were not correlated with rotavirus vaccination. Poverty was associated with decreased rotavirus vaccine uptake, even after adjustment for other determinants (adjusted odds ratio 0.49, 95% confidence interval: 0.26-0.90).
CONCLUSION
Parents' perceptions, socioeconomic status, relative poverty, and pediatricians' recommendations are determinants of vaccination. This study suggests that appropriate information about rotavirus vaccine, subsidies for those of lower socioeconomic status, and national recommendations are necessary to achieve higher coverage.
背景
日本的国家免疫计划不涵盖轮状病毒疫苗，也没有政府补贴。本研究旨在衡量自费轮状病毒疫苗接种的接种率及其影响因素，包括社会经济地位和相对贫困。
方法
我们在 2017 年 12 月至 2018 年 7 月期间，在日本金泽市对所有 18 个月大的儿童进行健康检查时进行了一项横断面研究。社区护士使用统一的问卷进行访谈，收集有关自费疫苗接种史、父母对轮状病毒疫苗的看法和建议以及社会经济地位的信息。我们使用多变量逻辑回归来评估疫苗接种率和可能的决定因素。
结果
共纳入 1282 名参与者。估计轮状病毒疫苗覆盖率为 72.9%。认为轮状病毒胃肠炎严重且轮状病毒疫苗有效的看法、儿科医生的建议、市办公室的信息、杂志和互联网文章以及父母较高的教育水平与较高的轮状病毒疫苗接种率相关。较低的家庭收入与轮状病毒疫苗接种率降低相关。疫苗费用、对疫苗不良反应的恐惧、家庭成员和兄弟姐妹的数量以及儿童的特征与轮状病毒疫苗接种无关。贫困与轮状病毒疫苗接种率降低相关，即使在调整了其他决定因素后也是如此（调整后的优势比 0.49，95%置信区间：0.26-0.90）。
结论
父母的看法、社会经济地位、相对贫困和儿科医生的建议是接种的决定因素。本研究表明，需要提供有关轮状病毒疫苗的适当信息、为社会经济地位较低的人提供补贴以及国家建议，以实现更高的覆盖率。
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