宁波市60岁以上老年人群扩大流感疫苗接种社区干预研究

Community intervention research of influenza vaccination for elderly people over 60 years old in Ningbo

目的研究扩大试点地区60岁以上老年人流感疫苗接种情况,评价综合干预措施效果,为流感疫苗接种策略的制定提供科学依据。方法以宁波市鄞州区石碶街道≥60岁老年人为研究对象开展综合社区干预试验,比较干预前后不同人群的接种率、因呼吸道疾病就诊次数等指标差异,并对未接种人群进行回访调查。结果试点地区干预后目标人群接种率较干预前明显上升,干预第一年和第二年接种率分别为19.08%和18.26%,高于相邻非试点乡镇。目标人群因上呼吸道疾病就诊的人均门诊次数由3.07次下降到0.52次,差异有统计学意义(t=6.81,P<0.01)。回访调查结果显示老年人未接种疫苗的主要原因是"自认身体好,无须接种"及"不相信医务人员接种建议",另有43.62%的老年人愿意在下一接种季节接种流感疫苗。结论扩大流感疫苗社区综合干预,能够有效提高目标人群流感疫苗接种率,降低因上呼吸道疾病门诊就诊次数,取得了较好的保护效果。

Objective To expand seasonal influenza vaccine coverage among adults over 60 years old and evaluate the effect of comprehensive intervention measures which could provide scientific evidence for the formulation of influenza vaccination immunization strategy. Methods Elderly people over 60 years old in Shiqi township in Ningbo as the research object were carried out integrated community intervention experiment. The rate of vaccination of different population,the number of visits to respiratory diseases were compared before and after intervention and a return visit investigation was conducted on unvaccinated people. Results At the end of the research,the coverage rate among adults over 60 years old in the intervention township in the first year and second year were19. 08% and 18. 26% respectively,both significantly higher than pre-intervention and non-intervention township. The frequency of visiting hospital with respiratory diseases had reduced from 3. 07 to 0. 52 and the difference was statistically significant（ t = 6. 81,P 0. 01）. The main reasons for target population rejecting to vaccinate included excessive self-confident on their health and lack of trust on the recommendation from HCW. Moreover,43. 62% of respondent were willing to get vaccinated in the next vaccination season. Conclusion The community comprehensive intervention measures on immunization of influenza vaccine could effectively improve the vaccine coverage rate among adults over 60 years old,and significantly reduce the frequency of visiting hospital with respiratory diseases.