Bradford B J, Benedum K J, Heald P A, Petrie S E
Department of Pediatrics, Mercy Hospital of Pittsburgh, Mercy Children's Medical Center, PA 15219, USA.
Clin Pediatr (Phila). 1996 May;35(5):237-42. doi: 10.1177/000992289603500502.
The objective of the study was to examine the immunization status of children entering school as of September 1990 in two selected school districts in the Pittsburgh area. Immunization levels were determined by review of the students' school health/immunization records using AAP recommendations for age-appropriate vaccines for these children at the onset of the study. A telephone survey of parents was then conducted. Reasons for lack of adequate immunizations and demographic data were examined in the survey. Two hundred eighty-one records were reviewed. Only 122 (43%) of children were fully immunized (FI) according to the recommendations used. From the total, 237 (84%) families were successfully contacted by telephone; 109 (46%) children from this subset were FI. Both districts were similar for immunization status and demographic data. Seventy-one percent of the children were missing DTP, 48% HIB, and 44% OPV. All children had at least one MMR. The mean age of the children was 5.4 years (SD = 0.35). Potential missed opportunities for immunization were identified. Ninety-six percent (n = 237) of students not fully immunized (NFI) had seen a physician at least once within the past year and 65% within the past six months. Parental lack of knowledge for the need for vaccines was the reason most often identified by parents (58%) for their child's missing vaccine(s). A significant number of children in this study were found to be lacking recommended immunizations for age at entry to school despite a recent physician visit. Although many were still within the recommended age range for receiving needed immunizations, a large number of their parents stated that they did not know further vaccines were needed. Contrary to previous reports, cost, access, illness, and mobility were not identified by parents as reasons for missing vaccines in their children. Future efforts targeting immunization must emphasize better education of parents and physicians.
该研究的目的是调查匹兹堡地区两个选定学区截至1990年9月入学儿童的免疫状况。通过审查学生的学校健康/免疫记录来确定免疫水平，审查时采用美国儿科学会针对这些儿童在研究开始时适用年龄疫苗的建议。随后对家长进行了电话调查。在调查中检查了未充分免疫的原因和人口统计学数据。共审查了281份记录。根据所采用的建议，只有122名（43%）儿童完全免疫（FI）。总共237个（84%）家庭通过电话成功联系；该子集中有109名（46%）儿童完全免疫。两个学区在免疫状况和人口统计学数据方面相似。71%的儿童未接种百白破疫苗，48%未接种b型流感嗜血杆菌疫苗，44%未接种口服脊髓灰质炎疫苗。所有儿童至少接种过一剂麻腮风疫苗。儿童的平均年龄为5.4岁（标准差=0.35）。确定了潜在的免疫接种错失机会。96%（n=237）未完全免疫（NFI）的学生在过去一年中至少看过一次医生，65%在过去六个月内看过。家长表示，孩子未接种疫苗最常见的原因是他们对疫苗需求缺乏了解（58%）。研究发现，尽管近期看过医生，但该研究中有相当数量的儿童在入学时仍未接种建议的疫苗。尽管许多儿童仍在建议的接种所需疫苗的年龄范围内，但大量家长表示他们不知道还需要接种其他疫苗。与之前的报告相反，家长并未将费用、就医便利性、疾病和流动性作为孩子未接种疫苗的原因。未来针对免疫接种的努力必须强调对家长和医生进行更好的教育。
