山东省宁阳县入托入学儿童预防接种证查验新措施的实施效果评价

Effect of New Procedures for Immunization Certificate Inspections at Kindergarten and School Entry in Ningyang County of Shandong Province

目的探讨提高儿童入托入学预防接种证查验率和疫苗补种率的有效方法。方法在山东省宁阳县2014年儿童入托入学接种证查验活动中,实施加强部门合作、提早行动、简化查验程序等新措施;分析2013-2015年入托入学儿童预防接种补种情况和免疫规划（EPI）针对传染病发病情况。结果实施新措施后儿童入托入学接种证查验覆盖率由2013年的78.17%提高到2015年的100%,疫苗补种率由23.25%提高到89.19%,疫苗全程接种率由76.07%提高到97.99%,儿童需补种率由38.93%降至18.60%;4种常见EPI针对传染病（百日咳、麻疹、风疹、流行性腮腺炎）总发病率由1 220.75/10万降低到67.94/10万。结论新措施显著提高了宁阳县入托入学儿童预防接种证查验的效果以及EPI疫苗接种率,降低了托幼机构和中小学校的常见EPI针对疾病的发病率。

Objective To explore effective ways to conduct immunization certificate inspections at kindergarten and school entry for increasing compliance with inspection and immunization coverage levels.Methods New measures,including multi-sector cooperation,early initiation,and simplified processes,were implemented during immunization certificate inspections in 2014 in Ningyang county of Shandong province. We evaluated coverage levels of vaccines in the Expanded Program on Immunization（ EPI） and the incidences of EPI targeted diseases in kindergartens and primary / secondary schools. Results After implementation of new procedures,the proportion of schools participating in the record check increased from 78. 17% in 2013 to 100% in 2015. The proportion of children needing one or more doses of vaccine who received the missing vaccines increased from 23. 25% to 89. 19%; full immunization coverage with all EPI vaccines increased from 76. 07% to 97. 99%; the proportion of children in need of one or more vaccines at school entry decreased from 38. 93% in 2013 to 18. 60% in 2015; and the total incidences of4 common EPI target diseases（ pertussis,measles,mumps and rubella） decreased from 1 220. 75 to67. 94 per 100 000 population. Conclusions The new procedures significantly improved the effect of immunization certificate inspections,increased coverage rates of EPI vaccines,and reduced the incidences of common EPI target diseases in kindergartens and schools.