Hutchins S S, Gindler J S, Atkinson W L, Mihalek E, Ewert D, LeBaron C E, Swint E B, Hadler S C
Division of Immunization, Centers for Disease Control and Prevention, Atlanta, Ga. 30333.
Am J Public Health. 1993 Jun;83(6):862-7. doi: 10.2105/ajph.83.6.862.
In 1989 and 1990 the United States experienced a measles epidemic with more than 18,000 and 27,000 reported cases, respectively. Nearly half of all persons with measles were unvaccinated preschool children under 5 years of age. We sought to identify potential sites for vaccine delivery.
Preschool children with measles were surveyed in five inner cities with measles outbreaks in 1989 to 1990 to assess the children's use of health care services and federal assistance programs before contracting measles.
Of 972 case children surveyed, 618 (64%) were eligible for measles vaccination at measles onset. Of those, 93% had previously visited a health care provider (private physician, public clinic, hospital emergency department, or hospital outpatient department) and 65% were enrolled in a federal assistance program (AFDC, WIC, or food stamps). Based on parent-reported reasons for health care visits, in Dallas and New York City, health care providers of 24% of 172 children may have missed at least one opportunity to administer measles vaccine.
Many potential opportunities exist to raise the vaccination coverage of unvaccinated preschool children. These opportunities depend on (1) health care providers taking advantage of all opportunities to vaccinate, and (2) immunization services being linked to federal assistance programs.
1989年和1990年，美国经历了麻疹疫情，报告病例分别超过18000例和27000例。所有麻疹患者中近一半是5岁以下未接种疫苗的学龄前儿童。我们试图确定可能提供疫苗的地点。
对1989年至1990年麻疹疫情爆发的五个内城区患有麻疹的学龄前儿童进行调查，以评估这些儿童在感染麻疹之前对医疗服务和联邦援助项目的利用情况。
在接受调查的972名患病儿童中，618名（64%）在患麻疹时符合麻疹疫苗接种条件。其中，93%的儿童此前曾就诊于医疗服务提供者（私人医生、公共诊所、医院急诊科或医院门诊部），65%的儿童参加了联邦援助项目（对有子女家庭的补助、妇女、婴儿与儿童营养计划或食品券）。根据家长报告的就诊原因，在达拉斯和纽约市，172名儿童中有24%的医疗服务提供者可能至少错过一次接种麻疹疫苗的机会。
提高未接种疫苗的学龄前儿童的疫苗接种覆盖率存在许多潜在机会。这些机会取决于：（1）医疗服务提供者利用所有机会进行疫苗接种；（2）免疫服务与联邦援助项目挂钩。
