Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, Guangxi Zhuang Autonomous Region, PR China.
Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, Guangxi Zhuang Autonomous Region, PR China.
Vaccine. 2021 Jun 2;39(24):3236-3249. doi: 10.1016/j.vaccine.2021.04.048. Epub 2021 May 7.
Vaccination coverage is widely used as metric of vaccination programme performance. However, VPDs outbreaks were reported in areas with high vaccination coverage. Timeliness and completeness have been considered more important assessment indicators of routine vaccination than overall vaccination coverage, but little is known in rural China. This study aimed to assess the timeliness and completeness of serial routine vaccinations among children in rural Southwest China.
A multi-stage stratified cluster survey was conducted among 1062 children aged 18-48 months in rural Guangxi. Vaccination status was obtained from child's vaccination certificate. We calculated timely vaccination coverage, complete vaccination coverage, timely-and-complete vaccination coverage and 95% CI for routine vaccination through weighted estimation analysis. Weighted Kaplan-Meier analyses were applied to estimate the median delay periods for each dose of serial routine vaccines, including one-dose BCG, three-dose HepB, three-dose OPV, four-dose DTP, two-dose MCV, two-dose JEV and two-dose MPV-A. Complete coverage, and timely-and-complete coverage for combined 5-vaccine series were calculated.
For each dose of routine vaccines, overall vaccination coverages were over 90%, but timely vaccination coverage ranged from the lowest of 44.4% for JEV1 to the highest of 92.5% for MPV-A1. For multi-dose routine vaccines, complete vaccination coverages varied from the lowest of 92.9% for MCV to the highest of 100% for HepB, and timely-and-complete vaccination coverages were lower than 80%, ranging from the lowest of 30% for JEV to the highest of 77.2% for MPV-A. For combined 5-vaccine series, complete coverage was 77%, while timely-and-complete coverage was 12.1%. MPV-A1 had the longest median delay of 176 days, but BCG and HepB1 had the shortest of 1 day.
The overall coverages of serial routine vaccinations were high, but the timeliness and completeness were poor. Relevant agencies of vaccination service should address timeliness-and-completeness into the assessment indicators of routine vaccination service quality.
疫苗接种覆盖率广泛用作疫苗接种计划绩效的指标。然而，在高疫苗接种覆盖率的地区仍有 VPD 爆发的报告。及时和完整已被认为是常规疫苗接种比总体疫苗接种覆盖率更重要的评估指标，但在中国农村地区知之甚少。本研究旨在评估中国西南农村地区儿童系列常规疫苗接种的及时性和完整性。
在广西农村进行了多阶段分层聚类调查，共纳入 1062 名 18-48 月龄儿童。通过儿童预防接种证获得疫苗接种状况。我们通过加权估计分析计算常规疫苗接种的及时接种覆盖率、完全接种覆盖率、及时完整接种覆盖率和 95%CI。加权 Kaplan-Meier 分析用于估计每剂系列常规疫苗的中位数延迟期，包括一剂卡介苗、三剂乙肝疫苗、三剂 OPV、四剂 DTP、两剂 MCV、两剂 JEV 和两剂 MPV-A。计算了五联疫苗系列的完全覆盖率和及时完整覆盖率。
对于每剂常规疫苗，总体接种率均超过 90%，但及时接种率从 JEV1 的最低 44.4%到 MPV-A1 的最高 92.5%不等。对于多剂常规疫苗，完全接种率从 MCV 的最低 92.9%到乙肝疫苗的最高 100%不等，及时完整接种率低于 80%，从 JEV 的最低 30%到 MPV-A 的最高 77.2%不等。对于联合五联疫苗系列，完全覆盖率为 77%，及时完整覆盖率为 12.1%。MPV-A1 的中位延迟时间最长为 176 天，但卡介苗和乙肝疫苗 1 的最短为 1 天。
系列常规疫苗接种的总体覆盖率较高，但及时性和完整性较差。疫苗接种服务的相关机构应将及时性和完整性纳入常规疫苗接种服务质量评估指标。
