北京地区感染性腹泻儿童LLR株轮状病毒疫苗接种情况及影响因素分析

Vaccination status and factors associated with rotavirus vaccine(LLR strain)coverage among children in Beijing

目的了解北京地区感染性腹泻儿童兰州羔羊轮状病毒(Lanzhou lamb rotavirus,LLR)株轮状病毒疫苗接种情况,分析轮状病毒疫苗接种影响因素。方法在北京的6个区各选一家医院,每月收集前30名年龄在2月龄至5岁首次就诊的感染性腹泻患者一般信息,在预防接种信息管理系统上核对轮状病毒疫苗接种信息,对LLR株轮状病毒疫苗接种比例、接种时间进行比较分析,采用非条件logistic回归分析轮状病毒疫苗接种影响因素。结果共纳入2078名儿童,其中接种一剂、两剂及三剂疫苗分别有308名(14.8%)、76名(3.7%)和11名(0.5%)。以2016年2月至2017年1月出生儿童组为参照,2010年12月至2014年1月出生的儿童具有最高的疫苗接种比例(OR=1.972;95%CI:1.361~2.858)及最高的12月龄内第一剂疫苗接种比例(OR=6.478;95%CI:3.050~13.762)。随着儿童出生时间向后推移,轮状病毒疫苗接种比例(x^(2)=30.300,P<0.01)和12月龄内完成第一剂疫苗接种比例逐渐降低(x^(2)=32.439,P<0.01)。结论北京地区LLR株轮状病毒疫苗接种比例呈下降趋势,疫苗接种比例与儿童所在地区密切相关。建议加强大众健康宣传,提高防病观念,同时加强基层接种门诊针对非免疫规划疫苗宣传推广的规范管理,提高接种服务质量。

Objective To understand the status of rotavirus vaccination among children born in Beijing from December 2010 to January 2017,and to analyze the factors affecting rotavirus vaccination.Methods Six hospitals in six districts of Beijing were selected.The general information of the first 30 patients of the month,who were aged from 2 months to 5 years old,visited hospital for the first time and diagnosed as infectious diarrhea,were collected.The information of rotavirus vaccination was confirmed with the Children Vaccination Information Management System.Vaccination rates and inoculation time of rotavirus vaccine(LLR strain)were compared and analyzed.Unconditional logistic regression was used to analysis the factors influencing rotavirus vaccination.Results A total of 2078 children were enrolled in this study.Three hundred and eight subjects(14.8%)received one dose of vaccine,76(3.7%)received two doses,and 11(0.5%)received three doses.Using the children born from February 2016 to January 2017 as control,children born from December 2010 to January 2014 had the highest vaccination rate(OR=1.972;95%CI:1.361-2.858)and the highest rate of first-dose vaccination within 12 months after birth(OR=6.478;95%CI:3.050-13.762).The rotavirus vaccination rate(x^(2)=30.300,P<0.01)and the vaccination rate of the first-dose vaccination within 12 months after birth(x^(2)=32.439,P<0.01)decreased gradually along with time of birth goes by.Conclusions The vaccination rate of rotavirus vaccine in Beijing has decreased since 2010.The vaccination rate and inoculation time were closely related to the location of the children.Health education should be strengthened to improve the awareness of disease prevention.Meanwhile,standardized management of vaccination clinics for the promotion of class-two vaccines as well as the quality of vaccination services should be improved.