合肥市2015年农村留守儿童免疫规划疫苗预防接种及影响因素研究

Use of National Immunization Program vaccines and factors influencing vaccination coverage among left-behind children in rural areas of Hefei city,2015

目的了解合肥市农村留守儿童国家免疫规划（NIP）疫苗的接种现状及影响因素。方法采用容量比例概率抽样法,选择5个县（市）、30个农村行政村的0-6岁留守儿童与非留守儿童各300名,调查NIP疫苗的合格与及时接种率,采用Logistic回归分析留守儿童的接种影响因素。结果留守儿童与非留守儿童卡介苗（BCG）、首剂乙型肝炎疫苗（HepB1）、3剂次HepB（HepB1-3）、3剂次脊髓灰质炎减毒活疫苗（OPV1-3）、3剂次无细胞百白破联合疫苗（DTaP1-3）、首剂含麻疹成分疫苗（MCV1）及时接种率分别为62.0%vs 66.7%、91.0%vs 99.0%、75.7%vs79.3%、66.4%vs 66.6%、66.3%vs 61.3%、74.0%vs 72.8%;OPV1-3、DTaP1-3、MCV1、2剂次A群脑膜炎球菌多糖疫苗（MPV-A1-2）、首剂乙型脑炎减毒活疫苗（JEV-L1）、首剂甲型肝炎减毒活疫苗（HepA-L1）合格接种率分别为98.0%vs 98.0%、97.0%vs 95.0%、96.6%vs 96.1%、80.9%vs 77.6%、91.5%vs 87.3%、89.6%vs 87.7%;第4剂OPV（OPV4）、第2剂MCV（MCV2）、第4剂DTaP（DTa P4）、首剂A群C群脑膜炎球菌多糖疫苗（MPV-AC1）、第2剂MPV-AC（MPV-AC2）、第2剂JEV-L（JEV-L2）合格接种率分别为92.9%vs 96.2%、95.7%vs 91.6%、94.2%vs93.7%、64.2%vs 94.0%、93.8%vs 82.6%、96.4%vs 93.6%。Logistic回归分析显示,年龄越小、女性、家庭收入较低或较高、父亲文化程度高等因素有利于留守儿童的合格接种。结论合肥市农村留守儿童预防接种总体上不差于非留守儿童;需加强部分留守儿童的疫苗合格接种。

Objective To explore coverage of National Immunization Program（ NIP） vaccines and factors influencing coverage among rural,left-behind children in Hefei city. Methods We used proportional probability sampling to select 300 left-behind children and 300 non-left-behind children,aged 0-6 years,from 30 villages of 5 counties. We evaluated timely and qualified coverage rates of NIP vaccines and determined factors influencing coverage among the left-behind children using logistic regression. Results Comparing left-behind and non-left-behind children,timely coverage rates of Bacillus Calmette-Guerin vaccine（ BCG）,the first dose of hepatitis B vaccine（ HepB1）,3 doses of HepB（ HepB1-3）,3 doses of oral polio vaccine（ OPV1-3）, 3 doses of diphtheria, tetanus and acellular combined vaccine（ DTa P1-3）,and the first dose of measles containing vaccine（ MCV1） were 62. 0% vs 66. 7%,91. 0% vs 99. 0%,75. 7% vs 79. 3%,66. 4% vs 66. 6%,66. 3% vs 61. 3%,and 74. 0% vs 72. 8%.Comparing left-behind and non-left-behind children,qualified coverage rates of OPV1-3,DTa P1-3,MCV1,2 doses of group A meningococcal polysaccharide vaccine（ MPV-A1-2）,the first dose of Japanese encephalitis live vaccine（ JEV-L1）,and the first dose of hepatitis A live vaccine（ HepA-L1）were 98. 0% vs 98. 0%,97. 0% vs 95. 0%,96. 6% vs 96. 1%,80. 9% vs 77. 6%,91. 5% vs 87. 3%,and 89. 6% vs 87. 7%. Qualified coverage rates of the fourth dose of OPV（ OPV4）,the second dose of MCV（ MCV2）,the fourth dose of DTa P（ DTaP4）,the first dose of group A and C meningococcal polysaccharide vaccine（ MPV-AC1）,the second dose of MPV-AC（ MPV-AC2）,and the second dose of JEV-L（ JEV-L2） were 92. 9% vs 96. 2%,95. 7% vs 91. 6%,94. 2% vs 93. 7%,64. 2% vs 94. 0%,93. 8% vs 82. 6%,and 96. 4% vs 93. 6%. Logistic regression showed that young age,female gender,family income,and father＇s education were associate with qualified vaccination of left-behind children.Conclusions Vaccination coverage levels among left-behind children were not significantly less than among non-left-behind children. We should improve qualified immunization for left-behind children.