乙肝疫苗首针及时接种与乙肝疫苗百白破疫苗和麻疹疫苗全程免疫关系的研究

Association between timely initiation of the first dose of hepatitis B vaccine and completion of the hepatitis B,diphtheria-tetanus-pertussis and measles vaccine series in Fujian,China

目的研究及时接种乙肝疫苗首针与完成乙肝疫苗、百白破疫苗和麻疹疫苗全程免疫的关系。方法利用2006年全国乙肝血清流调福建省资料,采用χ2检验比较组间各因素差异,logistic回归分析探讨影响完成3种疫苗全程免疫的影响因素,分层分析研究乙肝疫苗政策对上述关系的影响。结果本研究共有1 443名儿童纳入分析,χ2检验显示,乙肝疫苗首针接种不及时与及时组间（〉24hvs.≤24h）儿童完成3种疫苗全程免疫不同,及时组儿童显著高于不及时组儿童（χ2值分别为457.29,、42.96和74.95,P值均〈0.001）。logistic回归分析显示,及时接种乙肝疫苗首针者完成乙肝、百白破和麻疹疫苗全程免疫的OR值（95%CI）分别为24.36（14.46～41.05）、1.71（1.28～2.29）和2.35（1.68～3.30）。城区儿童完成百白破、麻疹疫苗的OR值分别为0.59（0.45～0.77）和0.36（0.26～0.48）。分层分析显示,乙肝疫苗政策有效降低了及时接种乙肝首针与完成乙肝全程免疫的关系（政策实施前后OR分别为68.09和5.67,差异有统计学意义P〈0.001）。结论及时接种乙肝首针能提高乙肝、百白破和麻疹疫苗全程免疫。

Objective To study the association between timely initiation of the first dose of hepatitis B vaccine and completion of the hepatitis B, diphtheria-tetanus-pertussis （DPT） and measles vaccine series in Fujian, China. Methods A cross-sectional survey was conducted in Fujian in 2006, which was a part of the China National Hepatitis Serosurvey. Chi-square test was used to compare coverage rates of completion of the hepati tis B, DPT and measles vaccine series between two groups of childrens with different initiating time of the first dose hepatitis B vaccine （~〉 24 vs. 424 hours） . Binary logistic regression was used to analyze the association between timely initiation of the first dose hepatitis B vaccine and completion of the hepatitis B, DPT and mea- sles vaccine series. Results A total of 1 443 children were included in the study. Coverage rates of completion of the hepatitis B, DPT, and measles vaccine series among children with initiating hepatitis B vaccine 424 h were significantly higher compared with those ~ 24 h （ X2 = 457.29, 42.96, 74.95, respectively P 0. 001） . Multivariate logistic regression analysis indicated that, odds ratios （ORs） for completion of the hepatitis B, DPT, and measles vaccine series were 24.36 （95%, CI： 14.46-41.05）, 1.71 （1.28-2.29） and 2.35 （1.68 3.30） among children with timely initiation for the first dose. Children who lived in town, born in town- ship hospitals or at home, were less likely to complete the vaccine series. The association between timely initiation and completion of hepatitis B vaccine has been weaken by the free vaccine policy （ORs = 68.09 and 5.67 before and after the policy, P〈0. 001）. Conclusions Timely initiation of hepatitis B vaccine is associ- ated with increased likelihood to complete the hepatitis B, DPT and measles vaccine series.