2013年媒体报道乙型肝炎疫苗事件前后中国8个省医院出生新生儿首剂乙型肝炎疫苗接种率与医护人员疫苗信任度调查

Coverage of the first hepatitis B vaccine dose among newborns,and hospital healthcare workers' confidence in vaccines before and after media reports of the 2013 hepatitis B vaccine event in China

目的了解2013年媒体报道乙型肝炎疫苗(Hepatitis B Vaccination,HepB)事件对医院出生新生儿首剂HepB接种的影响,评估事件后医护人员的疫苗信任度。方法在中国8个省每个省随机选择1家省级、2家市级、6家县级医院,调查2013年11月下旬-2014年3月中旬新生儿出生后24h内接种HepB情况和医护人员对HepB事件的看法。结果共调查100家医院、52 850名新生儿。HepB事件发生后,HBsAg阳性、阴性母亲所生新生儿接种率分别从98.0%降至93.3%、从95.2%降至88.7%;事件结束后2个月,接种率分别上升至98.7%和93.8%。各省新生儿出生后24h内HepB接种率在事件发生后均有不同程度下降,HBsAg阴性母亲所生新生儿24h内首剂HepB接种率随时间变化更明显。所调查的医护人员对事件的知晓率为100%,知晓途径主要是网络和电视;其中77.3%认为国产疫苗安全,21.5%认为事件中的婴儿死亡与接种HepB有关联。结论 HepB事件导致医院出生新生儿HepB首剂及时接种率、医护人员对HepB的信心下降。应进一步宣传HepB接种相关知识,以保证新生儿首剂HepB接种率和医护人员的疫苗信任度。

Objective To determine the impact of media reports about the 2013 hepatitis B vaccine （HepB） event on the HepB birth dose for infants born in hospitals, and to assess healthcare workers＇ confidence in vaccines. Methods We selected 1 provincial, 2 prefectural and 6 county hospitals in each of 8 provinces to evaluate coverage of HepB given to hospital-born babies from December, 2013 to March, 2014. We assessed hospital-based healthcare workers＇ confidence in vaccines. Results We studied a total of 52 850 newborns from 100 hospitals. After the hepatitis B event, coverage of the first dose of HepB decreased from 98. 0% to 93.3% among newborns whose mother was hepatitis B surface antigen （HBsAg） positive, and from 95. 2% to 88. 7% among newborns whose mother was HBsAg negative. Two months after the event, the respective coverage rates increased to 98. 7% and 93.8%. The coverage rates of vaccination with 24h of birth declined in each province by different degrees, and changes of coverage rates were larger among newborns whose negative. We found that mother was HBsAg 100% of healthcare workers were aware of the hepatitis B event, and that their main channels of information were the In- ternet and television. 77. 3% of healthcare workers believed that domestic vaccines were safe, and 21.5% believed that HepB vaccination was related to the infant deaths in the event. Conclusions The HepB event reduced coverage of the first dose HepB among newborns and confidence of healtheare workers in vaccines. We should further strengthen health ed- ucation about HepB immunization to ensure high coverage of the first HepB dose among newborns and confidence of heahhcare workers about the hepatitis B prevention strategies.