Bell L M, Pritchard M, Anderko R, Levenson R
Divisions of Immunologic and Infectious Diseases, Children's Hospital of Philadelphia, University of Pennsylvania, USA.
Pediatrics. 1997 Aug;100(2 Pt 1):192-6. doi: 10.1542/peds.100.2.192.
The Standards for Pediatric Immunization Practices suggest that hospitalization be viewed as an opportunity to vaccinate children. The purpose of the present study is 1) to determine the immunization status of an urban population of hospitalized preschool-aged children, 2) to study the impact of an immunization program designed to vaccinate hospitalized 0 to 2-year-old children who are underimmunized at admission, and 3) to make immunization a routine part of care for the hospitalized child.
Prospective evaluation of the immunization status of hospitalized 0 to 2-year-old residents of Philadelphia admitted to an urban children's hospital was performed. With verification of the child's immunization record through the primary care provider (PCP), needed immunizations were given and records were forwarded to notify the PCP. Educational information was provided to families and health care providers.
The percentage of children fully immunized on admission compared with the percentage at the time of discharge. Results. Two thousand three hundred twenty-nine children from 0 to 2 years of age were hospitalized during the 22-month study period. Immunization records were verified in 86% (2006), requiring an average of 1.5 phone calls to the PCP. The mean patient age was 10 months. Average hospital length of stay was 4 days. On admission, 49% (980) of the 2006 study patients were fully immunized. The remaining 51% (1026) were eligible for vaccination. Immunizations were delayed greater than or equal to 2 months in 18% (355) of the children. Neither type of health care insurance nor site of primary care affected the immunization status of those evaluated at the time of admission. Sixty-six percent (N = 674) of eligible patients received at least one vaccination before hospital discharge. Medical contraindications accounted for only 4% of the reasons eligible patients were not immunized. Of the 2006 children evaluated, the percentage of those fully vaccinated for age increased significantly from 44% on admission to 70% on discharge.
As a result of this program, there was a significant improvement in vaccination percentage at the time of hospital discharge in this group of urban preschool-aged children. The development of an immunization program to vaccinate hospitalized preschool children is an opportunity to immunize in the urban setting where there is a high prevalence of underimmunization. In addition, it provides an opening for educational programs for families, nurses, and housestaff and linkage to the community PCPs.
《儿科免疫接种实践标准》表明，应将住院视为为儿童接种疫苗的契机。本研究的目的是：1）确定城市中住院学龄前儿童的免疫接种状况；2）研究一项免疫接种计划对入院时免疫接种不足的0至2岁住院儿童的影响；3）使免疫接种成为住院儿童护理的常规组成部分。
对入住一家城市儿童医院的费城0至2岁住院居民的免疫接种状况进行前瞻性评估。通过初级保健提供者（PCP）核实儿童的免疫接种记录，给予所需的免疫接种，并将记录转发给PCP以进行通知。向家庭和医疗保健提供者提供教育信息。
入院时完全免疫的儿童百分比与出院时的百分比进行比较。结果。在为期22个月的研究期间，有2329名0至2岁的儿童住院。86%（2006名）的儿童免疫接种记录得到核实，平均需要给PCP打1.5个电话。患者的平均年龄为10个月。平均住院天数为4天。入院时，2006名研究患者中有49%（980名）完全免疫。其余51%（1026名）有资格接种疫苗。18%（355名）的儿童免疫接种延迟大于或等于2个月。医疗保险类型和初级保健地点均未影响入院时接受评估的儿童的免疫接种状况。66%（N = 674）的符合条件的患者在出院前接受了至少一次免疫接种。医学禁忌仅占符合条件的患者未进行免疫接种原因的4%。在接受评估的2006名儿童中，按年龄完全接种疫苗的儿童百分比从入院时的44%显著增加到出院时的70%。
由于该计划，这组城市学龄前儿童出院时的疫苗接种率有了显著提高。制定一项为住院学龄前儿童接种疫苗的免疫接种计划是在免疫接种率普遍较低的城市环境中进行免疫接种的一个契机。此外，它为针对家庭、护士和住院医生的教育计划以及与社区PCP的联系提供了一个开端。
