甘肃省镇原县儿童国家免疫规划疫苗接种率及影响因素调查分析

Coverage Rates and Influencing Factors of Vaccines in the National Immunization Program among Children in Zhenyuan County,Gansu Province

目的了解镇原县儿童国家免疫规划（NIP）疫苗接种率,探讨其影响因素,为制定干预措施提供科学依据。方法采取批质量保证抽样方法（LQAS）在全县19个乡镇和社区各抽取5个行政村,每个村入户调查42名2-3岁儿童NIP疫苗接种情况。结果 798名调查儿童的建卡率、建证率、卡证符合率分别为99.00%、92.48%、74.44%。卡介苗（BCG）、口服脊髓灰质炎减毒活疫苗（OPV）、百白破联合疫苗（DTP）、含麻疹成分疫苗（MCV）、乙型肝炎疫苗（Hep B）、A群脑膜炎球菌多糖疫苗（MPV-A）、乙型脑炎疫苗（JEV）、甲型肝炎疫苗（Hep A）等8种NIP疫苗全程接种率为80.83%、合格接种率为57.64%;Hep B1及时接种率92.24%;各疫苗基础免疫合格接种率在79.20%-99.87%之间,加强免疫在74.69%-84.96%之间;3个乡（15.79%）NIP疫苗全程接种率≥90%。Logistic回归显示,调查地类型、出生地点、户籍、前往接种点交通方式以及单程所需时间等影响儿童接种率。结论镇原县儿童NIP疫苗合格接种率较低,应加强流动儿童以及边远地区、交通不便儿童的NIP疫苗接种工作。

Objective To determine coverage rates of vaccines in the National Immunization Program（ NIP）among children in Zhenyuan,and their influencing factors,and to provide scientific evidence for intervention measures to improve coverage. Methods Lot Quality Assurance Sampling（ LQAS） was used to select 5 villages in each of 19 townships and to obtain immunization records of 42 children aged 2-3 years in each village.Results Among 798 participating children,99. 00% possessed immunization cards and 92. 48% had immunization certificates. The concordance rate between cards and certificates was 74. 44%. Among participants,80. 83% were fully immunized and 57. 64% completed fully-qualified（ on-time） immunization of 8 NIP vaccines： Bacillus Calmette-Guerin vaccine（ BCG）,oral poliomyelitis vaccine（ OPV）,diphtheria,pertussis and tetanus combined vaccine（ DTP）,measles-containing vaccine（ MCV）,hepatitis B vaccine（ Hep B）,group A meningococcal polysaccharide vaccine（ MPV-A）,Japanese encephalitis vaccine（ JEV）,and hepatitis A vaccine（ Hep A）. Among study participants,92. 24% completed timely birth-dose immunization of Hep B1. Coverage rates of primary and booster immunization ranged from 79. 20%-99. 87% and 74. 69%-84. 96%,respectively. There were 3（ 15. 79%） townships with a full immunization coverage ≥90%. Logistic regression showed that area type,birth place,residence,transportation,and time to immunization clinic had impact on coverages. Conclusions Coverage rates of full immunization of NIP vaccines among children in Zhenyuan were low. We should strengthen immunization of NIP vaccines among migrant children and children in remote or difficult-to-reach areas.