Expanded Program on Immunization Department, Yunnan Provincial Center for Disease Control and Prevention, Kunming, China.
National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China.
PLoS One. 2020 Oct 21;15(10):e0240733. doi: 10.1371/journal.pone.0240733. eCollection 2020.
Border areas are at high risk of measles epidemics. This study aimed to evaluate the effectiveness of the implementation of the routine two-dose measles containing vaccine (MCV) program in border counties of Southwest China.
Data used in the study were derived from a cross-sectional survey among 1,467 children aged 8 to 84 months from five border counties of Yunnan Province, Southwest China in 2016. The participants were recruited using a multistage sampling method. Primary guardians of the children were interviewed to collect information on vaccination history, socio-economic status, and knowledge about immunization. Both coverage and timely coverage for the first (MCV1) and the second (MCV2) dose of MCV were calculated. The Kaplan-Meier method was performed to estimate the cumulative coverage of MCV, and Log-rank tests were adopted to compare the differences across counties and birth cohorts. Univariate and multivariate logistic regression models were used to investigate the predictors of delayed MCV1 vaccination.
The coverage for MCV1 and MCV2 were 97.5% and 93.4%, respectively. However, only 63.8% and 84.0% of the children received MCV1 or MCV2 on time. Significant differences in the cumulative coverage were detected across counties and birth cohorts. Results of the multivariate logistic regression analysis indicated that children whose primary guardian knew the schedule of MCV were less likely to receive MCV1 late (OR = 0.63, P<0.01). For the guardians, doctors at vaccination units were the primary and also the most desired source of vaccination information.
Although the coverage for MCV is high in border areas of Southwest China, the timeliness of MCV vaccination seems suboptimal. Tailored information from local health professionals may help to reduce untimely vaccination.
边境地区麻疹流行的风险较高。本研究旨在评估中国西南部边境县常规两剂含麻疹疫苗（MCV）接种计划的实施效果。
本研究使用的数据来自 2016 年中国西南部云南省五个边境县 1467 名 8-84 月龄儿童的横断面调查。采用多阶段抽样方法招募参与者。通过访谈儿童的主要监护人，收集疫苗接种史、社会经济状况和免疫知识等信息。计算了第一剂（MCV1）和第二剂（MCV2）MCV 的首针和及时接种率。采用 Kaplan-Meier 法估计 MCV 的累积接种率，并采用 Log-rank 检验比较各县和出生队列之间的差异。采用单因素和多因素逻辑回归模型调查了 MCV1 延迟接种的预测因素。
MCV1 和 MCV2 的接种率分别为 97.5%和 93.4%，但只有 63.8%和 84.0%的儿童按时接种了 MCV1 或 MCV2。各县和出生队列之间的累积接种率存在显著差异。多因素逻辑回归分析结果表明，主要监护人知道 MCV 接种时间表的儿童，MCV1 接种延迟的可能性较小（OR=0.63，P<0.01）。对于监护人来说，接种单位的医生是他们获取接种信息的首要来源，也是他们最希望获取信息的来源。
尽管中国西南部边境地区 MCV 的接种率较高，但 MCV 接种的及时性似乎并不理想。来自当地卫生专业人员的有针对性的信息可能有助于减少非及时接种。
