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2022 年 8 月纽约州脊髓灰质炎疫情:对立即公共卫生应对措施的定性评估和提高疫苗接种率的优先事项。

Poliovirus outbreak in New York State, August 2022: qualitative assessment of immediate public health responses and priorities for improving vaccine coverage.

机构信息

Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK.

The Vaccine Centre, Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK.

出版信息

Epidemiol Infect. 2023 Jul 12;151:e120. doi: 10.1017/S0950268823001127.

Abstract

In 2022, a case of paralysis was reported in an unvaccinated adult in Rockland County (RC), New York. Genetically linked detections of vaccine-derived poliovirus type 2 (VDPV2) were reported in multiple New York counties, England, Israel, and Canada. The aims of this qualitative study were to: i) review immediate public health responses in New York to assess the challenges in addressing gaps in vaccination coverage; ii) inform a longer-term strategy to improving vaccination coverage in under-vaccinated communities, and iii) collect data to support comparative evaluations of transnational poliovirus outbreaks. Twenty-three semi-structured interviews were conducted with public health professionals, healthcare professionals, and community partners. Results indicate that i) addressing suboptimal vaccination coverage in RC remains a significant challenge after recent disease outbreaks; ii) the poliovirus outbreak was not unexpected and effort should be invested to engage mothers, the key decision-makers on childhood vaccination; iii) healthcare providers (especially paediatricians) received technical support during the outbreak, and may require resources and guidance to effectively contribute to longer-term vaccine engagement strategies; vi) data systems strengthening is required to help track under-vaccinated children. Public health departments should prioritize long-term investments in appropriate communication strategies, countering misinformation, and promoting the importance of the routine immunization schedule.

摘要

2022 年,纽约罗克兰县(RC)报告了一例未接种疫苗的成年人瘫痪病例。在多个纽约县、英国、以色列和加拿大都报告了与疫苗衍生脊髓灰质炎病毒 2 型(VDPV2)相关的基因检测。本定性研究的目的是:i)审查纽约对疫情的即时公共卫生反应,评估解决疫苗接种覆盖率差距的挑战;ii)为改善未充分接种疫苗社区的疫苗接种覆盖率提供长期战略;iii)收集数据,支持对跨国脊髓灰质炎病毒爆发的比较评估。对 23 名公共卫生专业人员、医疗保健专业人员和社区合作伙伴进行了半结构化访谈。结果表明:i)在最近发生疾病爆发后,解决 RC 地区疫苗接种率不理想的问题仍然是一个重大挑战;ii)脊髓灰质炎病毒爆发并非意料之外,应投入精力让母亲们参与进来,她们是儿童疫苗接种的关键决策者;iii)医疗保健提供者(尤其是儿科医生)在疫情爆发期间得到了技术支持,可能需要资源和指导,以有效参与长期疫苗接种战略;iv)需要加强数据系统,以帮助跟踪未充分接种疫苗的儿童。公共卫生部门应优先对适当的沟通策略、纠正错误信息和宣传常规免疫接种时间表进行长期投资。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aebe/10468811/eaed5344db5e/S0950268823001127_fig1.jpg

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