舟山市定海区儿童国家免疫规划五种疫苗及时接种率及其影响因素的调查分析

Analysis on Children Timely Vaccination Coverage and Influencing Factors of 5 Kinds of Expanded Program for Immunization (EPI) Vaccine in Dinghai District of Zhoushan Municipal

目的了解舟山市定海区儿童国家免疫规划(National Immunization Program,NIP)五种疫苗[乙型肝炎疫苗(Hepatitis B Vaccine,HepB)、卡介苗(Bacillus Calmette Guerin,BCG)、口服脊髓灰质炎减毒活疫苗(Oral PoliomyelitisAttenuated Live Vaccine,OPV)、百日咳-白喉-破伤风联合疫苗(Diphtheria,Tetanus,Pertussis Combined Vaccine,DPT)、麻疹减毒活疫苗(Measles Attenuated Live Vaccine,MV)]及时接种情况,分析影响因素,提出改进措施。方法对2005～2007年出生的4258名常住儿童和394名流动儿童的预防接种资料及相关数据进行分析。结果常住儿童的BCG、HepB、OPV、DPT、MV的及时接种率,分别为22.26%、95.02%、90.82%、91.40%、95.40%;流动儿童的BCG、HepB、OPV、DPT、MV及时接种率,分别为48.73%、74.37%、76.40%、80.46%、84.52%。除BCG及时接种率普遍较低外,其余NIP四种疫苗常住儿童及时接种率明显高于流动儿童。经Logistic二分类回归分析显示:接种时间安排不合适、接种时等待时间太长、无时间带孩子去接种疫苗、接种地点太远四项因素,对及时接种NIP五种疫苗有影响。结论落实"谁接生,谁接种BCG和HepB",提高出生后第一剂NIP疫苗的及时接种率;供方要缩短预防接种周期,提高服务的可及性,受方(特别是流动儿童家长/监护人)要提高预防接种意识,主动接受预防接种,共同提高NIP疫苗及时接种率。

Objective To understand the timely coverage of 5kinds of EPI vaccine in Dinghai District,including hepatitis B vaccine（HepB）,bacillus calmette guerin vaccine（BCG）,oral poliomyelitis attenuated live vaccin（eOPV）,Diphtheria-Pertussis-Tetanus Combined Vaccin（eDPT）, Measles attenuated live vaccin（eMV）,and to analyze the influence factors so as to formulate measures to improve the coverage.Methods Analyzing the immunization data and related information of 4258 resident children and 394 floating population born during 2005-2007.Results Timely coverage rate of BCG,HepB,OPV,DPT,MV were 22.26%,95.02%,90.82%,91.40%,95.40% respectively and 48.73%,74.37%,76.40%,80.46%,84.52,for floating population.Except for the timely BCG coverage rate was low for resident and floating populations,the timely vaccination rates for other 4 kinds of NIP vaccines in the resident were significantly higher than those in the floating population.The logistic regression analysis showed that inappropriate timing of vaccination,long time waiting for inoculation,lacking of time for the families,long distance from the vaccination sites were four factors that affected the timely immunization of NIP vaccines.Conclusion Implementing the strategy of midwife being responsible for BCG and HepB vaccination can improve the timely coverage of the first dose HepB and BCG;Shorten running inteval of vaccination and available service from the supplier,improve immunization awareness and initiative of the recipients （especially for the floating children’sparent/guardian）will be useful to increase the timely NIP vaccine coverage rates.