通过引入包括幼儿园免疫接种会议在内的混合交付模式，在威尔士的一个地区开展了一项改善儿童流感疫苗接种率和公平性的试点干预措施。
A pilot intervention to improve uptake and equality of childhood influenza vaccination in an area of Wales, through the introduction of a mixed delivery model including nursery school immunisation sessions.
机构信息
Vaccine Preventable Disease Programme and Communicable Disease Surveillance Centre, Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff CF10 4BZ, Wales, UK.
Vaccine Preventable Disease Programme and Communicable Disease Surveillance Centre, Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff CF10 4BZ, Wales, UK; Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, Swansea, Wales, UK.
出版信息
Vaccine. 2023 May 2;41(18):2990-2995. doi: 10.1016/j.vaccine.2023.03.075. Epub 2023 Apr 8.
The schools-based influenza vaccination programme has seen consistently high uptake in Wales, however coverage in pre-school two and three-year olds is lower. One health board area (Cwm Taf University Health Board (UHB)) developed an intervention to offer live attenuated influenza vaccine (LAIV) for three-year olds attending nursery schools alongside the existing general practice (GP) programme. During the pilot, sessions were delivered by health visitors, working with school nurses. The mixed delivery model led to vaccination data being recorded in two separate data systems. To evaluate the impact of the pilot on overall vaccine uptake, data linkage was carried out within the Secure Anonymised Information Linkage (SAIL) Databank. Overall influenza vaccine uptake was calculated for each health board in Wales for two and three-year olds for the 2015-16, 2016-17, and 2017-18 influenza programmes. Uptake in two-year olds in Cwm Taf UHB and also uptake in three-year olds in other health boards in Wales were the comparison groups. Uptake of influenza vaccine in the 2015-16 (pre-intervention) period was 41.0% for three-year olds in Cwm Taf UHB. Following the intervention, coverage increased to 70.7% and 71.5% for 2016-17 and 2017-18 respectively. The same increases in uptake were not seen in two-year olds in Cwm Taf UHB or in three-year olds in non-intervention health boards. In Cwm Taf UHB resident three-year olds in 2015-16 there was an inequality gap in the uptake of 17.4 percentage points between the most and least deprived areas. Uptake increased across all deprivation quintiles in 2016-17 and 2017-18; and the inequality gap decreased to 10.3 and 13.4 percentage points respectively. Influenza vaccination uptake and equality of uptake in three-year olds can be improved by adopting a mixed delivery model across nursery school based immunisation sessions with the additional option of influenza vaccination at GPs.
基于学校的流感疫苗接种计划在威尔士一直保持着较高的参与率，然而，学前两至三岁儿童的接种率较低。一个卫生委员会区域（Cwm Taf 大学保健委员会（UHB））制定了一项干预措施，为在幼儿园就读的三岁儿童提供减毒活流感疫苗（LAIV），同时保留现有的全科医生（GP）计划。在试点期间，由健康访问者与学校护士合作提供服务。这种混合交付模式导致接种数据记录在两个独立的数据系统中。为了评估该试点对整体疫苗接种率的影响，在安全匿名信息链接（SAIL）数据库中进行了数据链接。对于 2015-16、2016-17 和 2017-18 流感计划，为威尔士的每个卫生委员会计算了两岁和三岁儿童的总体流感疫苗接种率。Cwm Taf UHB 的两岁儿童接种率和威尔士其他卫生委员会的三岁儿童接种率作为比较组。在 2015-16 年（干预前）期间，Cwm Taf UHB 的三岁儿童流感疫苗接种率为 41.0%。干预后，2016-17 年和 2017-18 年的覆盖率分别增加到 70.7%和 71.5%。Cwm Taf UHB 的两岁儿童或非干预卫生委员会的三岁儿童并未出现同样的接种率上升。在 2015-16 年，Cwm Taf UHB 的本地三岁儿童在最贫困和最不贫困地区之间的接种率差距为 17.4 个百分点。在 2016-17 年和 2017-18 年，所有贫困五分位数的接种率都有所增加；不平等差距分别缩小到 10.3 和 13.4 个百分点。通过在幼儿园免疫接种中采用混合交付模式，并在全科医生处提供流感疫苗接种的额外选择，可以提高三岁儿童的流感疫苗接种率和接种率的公平性。
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