中国扩大国家免疫规划疫苗接种率调查分析

National Immunization Coverage Survey in China after Integrated more Vaccines into EPI Since 2008

目的了解1～2岁儿童扩大国家免疫规划(National Immunization Program,NIP)疫苗接种率现况,特别是2008年新纳入NIP疫苗接种率情况。方法采用分层整群随机抽样方法,结合各地麻疹发病率水平随机抽取全国32个县、160个乡、480个村的4681名儿童,入户问卷调查1～2岁儿童NIP疫苗接种情况。结果调查儿童1剂卡介苗(Bacilli Calmette-Guerin Vaccine,BCG)、3剂口服脊髓灰质炎减毒活疫苗(Oral Poliom yelitis Attenuated Live Vaccine,OPV3)、3剂白喉-破伤风-百日咳联合疫苗(Diphtheria,Tetanus and Pertussis Combined Vaccine,DTP3)、1剂含麻疹成分疫苗(Measles-containing Vaccine,MCV1)(以上简称四苗)、3剂乙型肝炎疫苗(Hepatitis B Vaccine,HepB3)(以上简称五苗)的全程免疫接种率分别为99.79%、99.74%、99.44%、99.42%、99.49%,四苗和五苗的全程接种率为98.95%、98.74%。第4剂DTP(DTP4)、第2剂MCV(MCV2)免疫接种率分别为91.05%、93.35%。NIP新增疫苗A群脑膜炎球菌多糖疫苗(Group A Meningococcal Polysaccharide Vaccine,MPV-A)第1剂(MPV-A1)、甲型肝炎疫苗(Hepatitis A Vaccine,HepA)、流行性乙型脑炎疫苗(Japanese Encephalitis Vaccine,JEV)第1剂(JEV1)免疫接种率均>90%,第2剂JEV(JEV2)免疫接种率89.49%。东、中部地区儿童建预防接种证率、DTP3、MCV1、四苗全程、五苗全程、DTP4、MCV2、JEV、MPV-A、HepA接种率与西部地区相比差异均有统计学意义(2=4.618～486.907,P均<0.05),东部地区儿童第2剂MPV-A(MPV-A2)、JEV2、HepA免疫接种率与中部地区相比差异均有统计学意义(2=13.099～24.285,P均<0.05)。结论 NIP非新增疫苗基础免疫(初种)接种率>90%,但其加强免疫(复种)接种率相对较低。NIP新增疫苗接种率>85%,但NIP新增疫苗接种率地区间差异明显。

Objective To understand the immunization status of children aged 1-2 years vaccinated by vaccines of the national expanded program on immunization（EPI）,especially for those children vaccinated by new vaccines integrated into NEPI since 2008. Methods Stratified cluster sampling was used to identify the random samples. 4681 children from 32 counties,160 villages and 480 villages were randomly sampled in this survey. Results One dose of Bacilli Calmette-Guerin vaccine（BCG）,three doses of oral poliomyelitis attenuated live vaccine（OPV3）,three doses of diphtheria,tetanus and pertussis combined vaccine（DTP3）,the first dose of measles-containing vaccine（MCV1）and three doses of hepatitis B vaccine（HepB3）coverage for target children were 99.79%,99.74%,99.44%,99.42%,99.49% respectively,and the coverage of children fully vaccinated by the first four vaccines or five vaccines mentioned above were 98.95% and 98.74% respectively. The immunization coverage of the fourth dose of DTP（DTP4） and the second dose of MCV（MCV2）were 91.05% and 93.35%respectively for all surveyed children. The coverage of group A meningococcal polysaccharide vaccine（MPV-A1）,hepatitis A vaccine（HepA）and the first dose of Japanese encephalitis vaccine（JEV1）introduced from 2008 were above 90%,but the coverage of second dose of JEV（JEV2）was 89.49%. The percentage of children who have immunization cards,and coverage of DTP3,MCV1,DTP4,MCV2,JEV,MPV-A,HepA in the eastern and central China were all significant higher than those in the western China （χ2=4.618-486.907,P0.05）. The pecentage of children vaccinated by the second dose of MPV-A（MPV-A2）,JEV2,HepA in the eastern China were all significant higher than in the middle area（χ2=13.099-24.285,P0.05）. Coneiusions Primary immunization coverage of original EPI vaccines was overall above 90%, but booster immunization coverage was relatively low. The coverage of new vaccines integrated into EPI after 2008 were overall above 85%, and there is significant differences on the coverage of new integrated vaccines in different areas of China.