Sherrod J L, Kane R, Cherry J D, Fricker J, Maples K
J Pediatr. 1983 Feb;102(2):186-90. doi: 10.1016/s0022-3476(83)80516-2.
In 1976 the recommended time for routine measles immunization was changed from 12 to greater than or equal to 15 months of age. Because of the known decrease in compliance with immunizations given during the second year of life and the scheduling of an additional visit close to the time of the diphtheria-tetanus-pertussis (DTP) booster immunization, the potential benefit from this change might be offset by a decrease in compliance in securing both measles vaccination and DTP booster immunization. A study of the change in immunization compliance was carried out in a county health facility and in a prepaid medical group practice. Charts of 795 infants (395 born before and 400 born after the change) were reviewed to assess the rates of compliance with measles and with DTP immunizations. Administration of measles vaccine at a scheduled time decreased by 10% (0.05 less than P less than 0.06) at the public health facility after the change in 1976 and by 13% at the prepaid group practice (P less than 0.01). This difference evened out in the public health facility patients by age 2 years, but a 9% decrease was still apparent at the prepaid medical group. A similar pattern was seen in compliance with the DTP booster immunization at each site. Any benefit derived by an increased measles seroconversion rate apparently was offset by an overall decrease in compliance for both measles and DTP booster immunizations.
1976年，常规麻疹免疫接种的推荐时间从12个月龄改为大于或等于15个月龄。鉴于已知在生命的第二年进行免疫接种的依从性会降低，并且在接近白喉-破伤风-百日咳（DTP）加强免疫接种时间安排了额外的就诊，这一变化带来的潜在益处可能会因确保麻疹疫苗接种和DTP加强免疫接种的依从性降低而被抵消。在一个县卫生机构和一个预付医疗集团诊所开展了一项关于免疫接种依从性变化的研究。查阅了795名婴儿（395名在时间变化之前出生，400名在时间变化之后出生）的病历，以评估麻疹和DTP免疫接种的依从率。1976年时间变化后，在公共卫生机构，按计划时间接种麻疹疫苗的比例下降了10%（0.05＜P＜0.06），在预付医疗集团诊所下降了13%（P＜0.01）。在公共卫生机构，到2岁时这种差异趋于平衡，但在预付医疗集团仍有9%的下降明显可见。在每个地点，DTP加强免疫接种的依从性也呈现类似模式。麻疹血清转化率提高所带来的任何益处显然都被麻疹和DTP加强免疫接种的总体依从性下降所抵消。
