武汉市洪山区二价脊髓灰质炎减毒活疫苗损耗系数分析

Analysis on the loss coefficient of bivalent live attenuated oral polio vaccine in Hongshan District of Wuhan City

目的分析武汉市洪山区二价脊髓灰质炎减毒活疫苗(bOPV)损耗系数,了解其损耗原因及影响因素,为科学制定疫苗使用计划,规范疫苗管理提供依据。方法利用湖北省免疫规划信息系统及疫苗出入库管理系统等数据,设计专用调查表了解洪山区各预防接种单位bOPV接种及使用情况,采用描述性统计分析方法计算损耗系数。结果洪山区25家预防接种单位bOPV损耗系数为1.69。区卫计委直属门诊(1.35)和大型医院承办社区门诊(2.01)损耗系数之间的差异有统计学意义;bOPV接种周期1次/周(1.57)和2~6次/周(1.94)损耗系数之间的差异有统计学意义;疫苗启用废弃时间按<4 h(1.86)和>4 h(1.61)损耗系数之间的差异有统计学意义。做损耗系数相关因素的多因素回归分析发现,不同的门诊属性比接种周期和接种台数量对损耗因素的影响更大。2016和2017年损耗系数分别为2.09和1.75,经比较,两者差异有统计学意义。结论洪山区bOPV管理及使用比较规范,可通过加强监管考核、设置集中接种、规范宣传培训等手段进一步减少疫苗损耗。

Objective To analyze the loss coefficient of bivalent live attenuated oral polio vaccine(bOPV)in Hongshan District,and understand the causes and influencing factors,and to provide a basis for scientifically formulating vaccine use plans and regulating vaccine management.Methods Using the data of Hubei Province Immunization Planning Information System and Hongshan District Vaccination Storage and Management System,a special questionnaire was designed to understand the vaccination and use of bOPV in various immunization units in Hongshan District.A descriptive statistical analysis method was used to calculate the loss coefficient.Results The bOPV loss coefficient of 25 vaccination units in Hongshan District was 1.69.The difference of the loss coefficient between the out-patient clinics of the District Health and Family Planning Committee(1.35)and the community clinics undertaken by large hospitals(2.01)was statistically significant.The difference of the loss coefficient between the inoculation once a week(1.57)and 2-6 times per week(1.94)was statistically significant.In terms of vaccine-disabled time,the two groups of<4 hours and>4 hours had different calculated loss coefficients 1.86 and 1.61,respectively,and the difference was statistically significant.Multivariate regression analysis of the factors related to the loss coefficients found that different outpatient attributes had a greater impact on the loss coefficient than the inoculation cycle and the number of inoculation stations.The loss coefficient for 2016 and 2017 was 2.09 and 1.75,respectively.The difference was statistically significant.Conclusion The management and use of live attenuated bivalent polio vaccine in Hongshan District was relatively standardized.The vaccine loss can by further reduced by strengthening supervision and assessment,setting up centralized vaccination and standardizing publicity and training.