Fielding J E, Cumberland W G, Pettitt L
Department of Health Policy Analysis and Planning, Johnson & Johnson, Los Angeles, CA.
JAMA. 1994 Feb 16;271(7):525-30.
To assess immunization levels for children of employees of a large corporation.
A mail survey of a random sample of employees on the immunization history of one child per family.
US employees of Johnson & Johnson.
1500 employees with children born between 1984 and 1991.
Coverage rates for recommended vaccines at different ages up to 6 years.
Only 45.2% and 55.3% of the study children at ages 2 and 6 years were current for all recommended immunizations (65.1% and 70.3%, respectively, excluding the Haemophilus influenzae type b vaccine). Using the minimum standard required by many states for school entry, the coverage level at age 6 years was 90.4%. Factors associated with higher immunization rates at age 2 years were the corporate health plan (choices), higher pay level, greater parental formal education, white race, and knowing when to initiate immunization. Lower immunization rates at age 2 years were associated with delayed receipt of the first dose of diphtheria, tetanus, and pertussis vaccine, use of city or county clinics, employee-reported barriers of difficulty leaving work, and provider access problems, but not cost of services. After adjusting for the effects of other variables through logistic regression, race, pay level, and plan choice were no longer significant. Modeling with the remaining variables predicted rates of adequate immunization at age 2 years from 15% to 81%.
Even in this relatively affluent group with good insurance (including immunizations), preschool immunization rates did not reach public health goals. Changing modifiable factors, such as knowing when to initiate immunization, enabling parents to leave work more easily, and improving provider access, might improve preschool immunization rates.
评估一家大型公司员工子女的免疫接种水平。
对员工进行邮件调查，随机抽取样本，了解每个家庭一名子女的免疫接种史。
美国强生公司的员工。
1500名有1984年至1991年间出生子女的员工。
6岁以下不同年龄段推荐疫苗的接种率。
在2岁和6岁的研究儿童中，分别只有45.2%和55.3%完成了所有推荐的免疫接种（排除b型流感嗜血杆菌疫苗后，分别为65.1%和70.3%）。按照许多州入学所需的最低标准，6岁时的接种水平为90.4%。与2岁时较高免疫接种率相关的因素包括公司健康计划（选择）、较高的薪资水平、父母较高的正规教育程度、白人种族以及知道何时开始免疫接种。2岁时较低的免疫接种率与白喉、破伤风和百日咳疫苗首剂接种延迟、使用城市或县诊所、员工报告的难以离岗障碍以及就医问题有关，但与服务费用无关。通过逻辑回归调整其他变量的影响后，种族、薪资水平和计划选择不再具有统计学意义。对其余变量进行建模预测，2岁时充分免疫接种率在15%至81%之间。
即使在这个相对富裕且有良好保险（包括免疫接种）的群体中，学龄前儿童免疫接种率仍未达到公共卫生目标。改变可改变的因素，如知道何时开始免疫接种、使父母更容易离岗以及改善就医条件，可能会提高学龄前儿童免疫接种率。
