广东省2013年以乡镇为单位免疫规划疫苗接种率调查分析

Coverage of national immunization program vaccines at the township level in Guangdong province,2013

目的了解广东省2013年以乡镇为单位适龄儿童国家免疫规划（NIP）疫苗接种情况。方法按系统随机抽样抽取全省20个地市、26个县区、34个乡镇，采用批质量保证抽样方法（LQAs）在每个乡镇抽取42名2-3岁儿童开展NIP疫苗接种入户调查，评价以乡镇为单位接种率。结果在1428名调查儿童中，除百白破联合疫苗第4剂次（DTP。）、A群脑膜炎球菌多糖疫苗第2剂次（MPV-A2）和甲型肝炎减毒活疫苗（HepA-L）外，其他NIP疫苗接种率均在95％以上。卡介苗（BCG）、3剂次乙型肝炎疫苗（HepB1-3）、3剂次脊髓灰质炎减毒活疫苗（OPV1-3）、DTP1-3、含麻疹成分疫苗第1剂次（MCV、）接种率t〉90％的乡镇比例在90％以上，16个乡镇17剂次NIP疫苗有漏种。本地儿童BCG、DTP4、MPV-A2、HepA-L接种率高于非本地儿童；珠三角地区DTP1、MCV1-2、MPV-A1-2、乙型脑炎疫苗第1剂次（JEV1）接种率高于经济欠发达地区。结论全省适龄儿童NIP疫苗接种率总体保持较高水平，但以乡镇为单位接种率在疫苗／剂次之间存在较大差别。需加强薄弱地区预防接种服务管理，进一步提高NIP疫苗接种率。

Objective To determine coverage of national immunization program （NIP） vaccines at the township level of Guangdong province in 2013. Methods We selected 34 townships from 26 counties of 20 prefectures by systematic random sampling, and we selected 42 2-3 year old children from each town- ship by lot quality assurance sampling （LQAS） for analyzing the vaccination coverage at the township lev- el. Results Among 1 428 subjects, coverage rates were above 95% for all NIP vaccines other than the fourth dose of diphtheria, tetanus, and pertnssis combined vaccine （DTP4） , the second dose of group A meningococcal polysaccharide vaccine （MPV-A2）＇ and hepatitis A attenuated live vaccine （HepA-L）. The percentage of townships with ~〉90% coverage for Bacilli Calmene-Gu6rin vaccine （ BCG）, 3 doses of hepatitis B vaccine （ HepBl-3 ）, 3 doses of oral poliomyelitis attenuated live vaccine （ OPV1-3 ）, 3 doses of diphtheria, tetanus, and pertussis combined vaccine （ DTP1-3 ） , and the first dose of measles-contai- ning vaccine （ MCV1 ）, were all ≥90%. Missed immunization occurred in 17 NIP vaccine schedule do- ses in 16 townships. Coverage levels of BCG, DTP4, MPV-A2, and HepA-L were higher among local children than among migrant children. Coverage levels of DTP4, MVC1-2, MPV-A1-2, and the first dose of Japanese encephalitis vaccine （ JEV1 ） were higher in the Pearl River Delta than in poorly-developed are- as. Conclusions Coverage levels of NIP vaccines were generally high in Guangdong, but varied by vaccine dose at the township level. We should improve immunization service management in weak areas to further increase coverage.