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1991 - 1992年冬季,莱斯特郡65岁以上居家老人的流感免疫接种情况。

Immunisation against influenza among people aged over 65 living at home in Leicestershire during winter 1991-2.

作者信息

Nicholson K G

出版信息

BMJ. 1993 Apr 10;306(6883):974-6. doi: 10.1136/bmj.306.6883.974.

Abstract

OBJECTIVES

To assess the size of the elderly population for whom influenza vaccine is indicated and how many are vaccinated.

DESIGN

Cohort questionnaire study.

SETTING

Leicestershire general practices.

SUBJECTS

800 elderly subjects selected a random from the Leicestershire family health services authority list who were not living in residential care, 565 of whom returned a questionnaire.

MAIN OUTCOME MEASURES

Patient profile, vaccine offers, vaccination status, and reasons for not accepting vaccine.

RESULTS

170 of 334 (51%) people aged 65-74 years and 106 of 205 (52%) aged > or = 75 years had one or more medical indications for influenza vaccine. 195 people were offered vaccine, 49 of whom had no risk factor. 152 offers were made opportunistically during visits to the practice and only six were made in writing or by telephone. Overall 113 of 266 patients with known medical indications were immunised. Vaccine was accepted by 148 of 189 (78%) offered it, and, as judged by acceptance in sequential years, influenza vaccine was well tolerated. The main reasons for not being vaccinated were misconception about risk status and inadequate advice from doctors.

CONCLUSIONS

The prevalence of medical indications for vaccine is not large enough to justify a policy of universal immunisation. Most patients offered vaccine accept it and tolerate it well. Improved targeting and education is needed to increase immunisation of people at risk.

摘要

目的

评估有指征接种流感疫苗的老年人群规模以及实际接种人数。

设计

队列问卷调查研究。

地点

莱斯特郡的全科医疗诊所。

研究对象

从莱斯特郡家庭健康服务机构名单中随机选取800名不住在养老院的老年受试者,其中565人返回了问卷。

主要观察指标

患者概况、疫苗提供情况、接种状况以及不接受疫苗的原因。

结果

在334名65 - 74岁的人群中,170人(51%)以及在205名75岁及以上的人群中,106人(52%)有一项或多项接种流感疫苗的医学指征。195人被提供了疫苗,其中49人没有危险因素。152次疫苗提供是在患者就诊时随机进行的,只有6次是以书面或电话形式提供的。总体而言,在266名有已知医学指征的患者中,113人接种了疫苗。在189名被提供疫苗的患者中,148人(78%)接受了疫苗,并且从连续几年的接受情况判断,流感疫苗耐受性良好。未接种疫苗的主要原因是对风险状况的误解以及医生提供的建议不足。

结论

疫苗接种医学指征的流行率不足以证明普遍免疫政策的合理性。大多数被提供疫苗的患者接受了疫苗且耐受性良好。需要改进目标定位和教育,以提高高危人群的疫苗接种率。

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