中国六省份儿童LLR株轮状病毒口服减毒活疫苗接种现状分析

Analysis of vaccination situation of orial live attenuated rotavirus vaccine （LLR strain） among children in 6 provinces of China

目的分析中国6个省份儿童LLR株轮状病毒口服减毒活疫苗（轮状病毒疫苗）接种情况。方法于2014年，采用多阶段分层随机抽样方法，从儿童预防接种信息系统中抽取我国广东省、江苏省、重庆市、江西省、黑龙江省和甘肃省的共12个县区内2008年1月1日至2012年12月31日期间出生的儿童为对象，以每年为1个出生队列，每个出生队列至少选取10名儿童开展调查，现场查看接种证，对儿童接种信息进行核实，共606名。采用问卷调查的方式，将儿童预防接种证信息与儿童预防接种信息管理系统数据进行核对，调查内容包括基本情况（省、县、姓名、性别、出生日期等）和轮状病毒疫苗的接种情况（接种时间、剂次等）。结果606名儿童中，男性为340名，2008-2012年出生的儿童分别为121、124、122、119和120名，轮状病毒疫苗第1、2剂次接种率分别为32．8％（199名）和9．7％（59名），由于2011和2012年出生儿童尚未达到第3剂次接种时间，不计入第3剂次的应种数，367名2008i2010年出生儿童中第3剂次接种率为3．5％（13名）。高、中、低人均可支配收入地区第1剂次疫苗接种率分别为45．0％（91名）、37．7％（77名）、15．5％（31名）（X^2=43．15，P〈0．001）；199名接种第1剂次疫苗儿童的月龄主要集中在2-21月龄，其中5～13月龄为接种高峰（66．8％，133名）。59名至少接种了2剂次疫苗儿童中，2剂次时间间隔主要集中在12～13个月（42．4％，25名）；13名接种了3剂次疫苗儿童中，第2和3剂次间隔12个月者较多（5名）。2008--2014年271剂次轮状病毒疫苗中，在6-8月份接种给儿童的数量较多，占34．7％（94剂次）；88剂次与其他18种疫苗同时被接种，占32．5％，18种疫苗中，以灭活疫苗为主，主要为百日咳、百喉、破伤风混合疫苗（30剂次）、b型流感嗜血杆菌疫苗（14剂次）、A群流脑疫苗（10剂次）。结论轮状病毒疫苗接种比例较低，且接种月龄较晚，接种模式与WHO建议的免疫程序差异较大。建议在小月龄儿童中开展轮状病毒疫苗的常规免疫接种。

Objective To analyze vaccination situation of oral live attenuated rotavirus vaccine （LLR strain） among children from six provinces in China. Methods In 2014, we selected 12 counties in Guangdong, Jiangsu, Chongqing, Jiangxi, Heilongjiang and Gansu provinces by using stratified cluster random sampling method and extract information of children born from January 1, 2008 to December 31, 2012 from Children＇s Immunization Information System. We investigated ten children of each birth cohort in each county by checking the vaccination certification, and a total of 606 children were investigated. A survey was conducted to check the information of the children＇s vaccination certification with the data of Children＇s Immunization Information System by questionnaire including the basic information （province, county, name, gender, birth date, ete） and the rotavirus vaccination （vaccination date, dose, etc） to analyze the rotavirus vaccination situation. Results 340 of 606 children were male. There were 121, 124, 122, 119 and 120 children born in 2008-2012, respectively. The proportions of the first and the second dose of rotavirus vaccination were 32.8% （199） and 9.7% （59）. The proportion of the third dose of rotavirus vaccination among children born between 2008 and 2010 was 3.5% （13） since children born in 2011 and 2012 did not reach the age of third dose vaccination. The proportion of the first dose of rotavirus vaccination in high, middle and low per capita disposable income areas was 45.0% （91）, 37.7% （77） and 15.5% （31） respectively （X2= 43.15, P〈 0.001）. Among 199 children vaccinated with the first dose of vaccine, the vaccination age mainly concentrated in 2 to 21 months, of which the peak was 5 to 13 months （66.8%, 133）. The intervals between 2 doses of vaccination were mainly from 12 to 13 months （42.4%, 25） among the 59 children who received at least 2 doses of vaccine. In the 13 children vaccinated with 3 doses, the intervals between the second and the third dose were 12 months （5）. Of the 271 doses of rotavirns vaccine vaccinated during 2008-2014, 34.7% （94 doses） were vaccinated in June-August, 88 were vaccinated simultaneously with 18 other vaccines, accounting for 32.5% of the total. Of the 18 other vaccines, inactivated vaccines such as diphtheria vaccine （30 doses）, Hih vaccine （14 doses）, group A meningitis vaccine （10 doses） were predominant. Condusion The proportion of rotavirus vaccination was low and the vaccination age was relatively late. The vaccination mode was different from the recommendation of WHO. It is recommended that routine immunization of rotavirus vaccines should be carried out in early-months of children.