云南省本地儿童与流动儿童口服脊髓灰质炎疫苗免疫状况分析

Analysis of the Oral Poliomyelitis Vaccine Immunization Status of Mobile Resident Children and Permanent Resident Children in Yunnan Province

为了解云南省本地儿童和流动儿童口服脊髓灰质炎疫苗(OPV)的免疫状况,在5个地区(市、州)进行了OPV强化免疫快速评估及相关调查。结果显示流动儿童OPV的免疫状况与本地儿童有较大差距:①本地儿童和流动儿童在免疫服务机构的选择上有明显差别,本地儿童接受OPV免疫主要通过乡村医生入户(常规免疫5981%,强化免疫5852%),流动儿童则主要是通过临时服苗点(强化免疫5921%)、县(区、市)卫生防疫站(常规免疫2601%)等,两者差异有显著的统计学意义(χ2=52967,P<0001);②既往服苗史,流动儿童OPV≥3剂次儿童的比例(4150%)比本地儿童(6220%)低,而零剂次免疫儿童的比例(2404%)较本地儿童(1164%)高;③流动儿童两轮OPV强化免疫服苗率(7259%、7377%)比本地儿童(8924%、8885%)低;④来自省外的流动儿童OPV≥3剂次服苗率(3220%)低于来自省内的流动儿童(4378%);⑤流动儿童随着在本地居住时间的延长,零剂次免疫儿童的比例逐渐减少,OPV≥3剂次服苗率逐渐增加。分析提示,流动儿童的OPV免疫存在较多薄弱环节和问题,仍然是今后消灭脊髓灰质炎工作的重点和难点,需进一步采取针对性措施加以改进和加强。

In order to analyse the oral poliomyelitis vaccine (OPV) immunization status of mobile resident children and permanent resident children, a rapid evaluation of immunization coverage rate on National Immunization Days (NIDs) and the related investigations were conducted in 5 adminstrative districts (prefectures, cities) . The results showed: (1) 59.8% and 58.52% of the permanent resident children, mainly inoculated by village-doctors at their homes, received routine vaccination and NIDs supplementary immunization, respectively. But the mobile resident children were immunizated at the provisional immunization places of NIDs (NIDs, 59.21%) and routinely at some epidemic prevention stations of county level (routine, 26.1%). There was a significant difference between the two groups; (2) The analysis of immunization history showed that the vaccination rate of mobile resident children receiving≥3 OPV doses was lower (41.50%) than that of local children (62.20%), the rate of zero dose OPV immunization of mobile resident children was far higher (24.04%) than that of local children (11.64%); (3) The immunization coverage rate of NIDs of mobile resident children was lower (72.5% for 1st oral adminstration, 73.77% for 2nd) than that of local children (89.24% for 1st adminstration, 88.85% for 2nd); (4) The≥3 OPV dose immunization rate of mobile resident children from other provinces was lower (32.20%) than those in Yunnan Province (43.78%); (5) The longer the mobile children stayed, the higher the ≥3 OPV dose immunization rate. These data indicated that, in the final stage of polio eradication program there were still some problems in the immunization of mobile resident children that should be emphasized and improved for poliomyelitis control strategy.