北京市2004年外来儿童强化查漏补种活动分析

Evaluation of Efficacy of Supplementary Immunization of Polio Vaccine Among Floating Children in Beijing During 1994-2001

目的掌握北京市外来儿童预防接种状况，以制定科学的免疫预防策略。方法对北京市2004年强化免疫活动中口服脊髓灰质炎（脊灰）减毒活疫苗（OPV）、麻疹减毒活疫苗（MV）、百白破联合疫苗（DPT）、流行性乙型脑炎疫苗（JEV）免疫状况，以及卡介苗（BCG）、OPV、MV、DPT接种率进行分析。结果①共调查外来儿童168010人，建卡率74．9％，建证率80．5％，两指标均随年龄的增加而下降；②OPV漏种率22．0％，零剂次免疫率为17．8％，两指标均随年龄的增加而上升，部分外来人口流入地区上述指标高于全市水平；“服苗后无记录”为零剂次免疫儿童主要原因，构成比随年龄的增加而上升。③MV、DPT、JEV零剂次免疫率分别为13．1％、13．6％、14．6％，补种前迁出率23．7％～28．3％。④调查流动儿童聚居地BCG、OPV、DPT、MV合格接种率60％～70％，流动儿童散居地均〉90％，全程免疫覆盖率分别为54．4％和87．6％。结论大年龄组外来儿童免疫预防管理薄弱，外来儿童预防接种卡（证）丢失造成接种信息中断，应加快建立预防接种信息化管理系统。外来人口分布的变化使流入地免疫规划管理负荷加大，应提高原有的人员配置和管理水平。流动儿童聚居地区免疫规划管理难度大，强化免疫效果难以保持，应探索外来儿童免疫规划常规管理长效机制。

Objective To eliminate blank spots in SNIDs. Methods Four vaccinations, OPV, MV, DPY, Japanese encephalitis vaccine were carried out in addition to supplementary intake of OPV in 2004 SNIDS. A survey on floating children＇s immunization rate was also undertaken in conjunction with quality evaluation. Results The survey showed：①Among 178 010 pre-school age floating children, 74.9 % had immunization cards and 80.5 % had immunization certificates. Both rates declined as age increased. ② The drop-out rate of OPV was 22.0 %. Zero inoculation rate was 17.8 %. Both were positively related with age and were higher in some inflowing areas than city-wide average level. The loss of intake record was the main reason for zero inoculation, which was directly related with children＇s age.③ The zero inoculation rate of MV DPT and Japanese Encephalitis vaccine were 13.05%, 13.60%, and 14.59%, respectively. 23.67% to 28.26% of children moved to another place before receiving supplementary inoculation. ④The investigation of routine immunization rate showed that the eligibility rate of BCG, DPT, MV and OPV lied between 60% -70% in the region where floating children lived in compact community. The eligibility rate was over 90 % in dispersing floating children. The full eligibility rates in above two areas were 54.43 % and 87.56 %, respectively. Conclusion The analysis indicated that management on older floating children immunization was weak and inefficient. In light of the discontinuation of immunization data due to the loss of inoculation cards/certificates, information management system for planned immunization should be built up as soon as possible. To cope with the difficulties caused by changes in distribution of floating population, low eligibilty rate in compact community and ineffective maintenance of reinforced immunization, more efforts should be made in areas of and management improvement. proper staffing It was also suggested that we should find out a long-term mechanism on planned routine immunization for floating children.