2020—2021年流感流行季3省基层医务人员流感疫苗接种现状及影响因素研究

Status, recommendation behavior and influencing factors of influenza vaccination among primary health care workers: a cross-section survey

目的了解基层医务人员流感疫苗接种现状及其影响因素,为提高基层医务人员流感疫苗接种率提供依据。方法采用多阶段分层整群抽样,于2020年12月对A、B、C 3省的9个城市共31家社区卫生服务中心、27家乡镇卫生院的基层医务人员开展自填式电子问卷调查,采用多因素Logistic回归模型分析影响接种现状的相关因素。结果共纳入有效问卷3856份。2019—2020年和2020—2021年流感季基层医务人员流感疫苗接种率分别为39.3%和59.5%。多因素Logistic回归分析结果显示,基层医务人员为女性(OR=1.419,95%CI:1.156~1.742)、年龄在30~39岁(OR=1.335,95%CI:1.077~1.654)和50岁及以上(OR=1.717,95%CI:1.226~2.404)、所在机构为社区卫生服务中心(OR=1.353,95%CI:1.149~1.595)、职业为护士(OR=1.465,95%CI:1.112~1.931)、在预防保健科室(OR=2.052,95%CI:1.582~2.661)、知识得分较高(OR=1.110,95%CI:1.008~1.222)、所在单位要求(OR=3.187,95%CI:2.385~4.259)或不要求但鼓励接种(OR=1.548,95%CI:1.185~2.021)、所在单位有医务人员免费接种流感疫苗政策(OR=4.449,95%CI:3.716~5.327)、所在单位提供接种流感疫苗服务(OR=3.319,95%CI:2.094~5.262)、参加过流感和流感疫苗的培训/健康宣传(OR=1.288,95%CI:1.034~1.604)、知晓本地基层医务人员流感疫苗接种的政策(OR=1.294,95%CI:1.049~1.598)等因素促进基层医务人员流感疫苗接种。结论2020—2021年流感季,基层医务人员流感疫苗接种率较上一年度有较大提高,但仍有待提升。针对性的流感及流感疫苗相关健康教育、流感疫苗接种优惠或免费政策、提高预防接种可及性可能是促进基层医务人员流感疫苗接种的有效方法。

Objective To investigate the status of influenza vaccination,recommendation behavior to others and related factors among primary medical staff,and provide evidence to increase the vaccination rate and recommendation intention in this population.Methods In December 2020,we conducted a cross-sectional survey in primary medical staff from 31 community health service center and 27 township health center with multi-stage stratified cluster sampling.These primary medical staff from three provinces and nine cities took part in the survey by filling out an electronic questionnaire.Multi-factor Logistic regression model was used to analyze the relevant factors affecting the current situation of vaccination.Results 3856 questionnaires were valid.In 2019—2020 and 2020-2021 flu seasons,the vaccination coverage rate of primary-level medical staff was 39.3 percent and 59.5 percent,respectively.According to the results of multi-factor Logistic regression analysis,being female(OR=1.419,95%CI:1.156-1.742),aged between 30 and 39(OR=1.335,95%CI:1.077-1.654),and 50 years old and above(OR=1.717,95%CI:1.226-2.404),in community Health Service Center(OR=1.353,95%CI:1.149-1.595),being nurse(OR=1.465,95%CI:1.112-1.931),in the preventive care department(OR=2.052,95%CI:1.582~2.661),higher knowledge scores(OR=1.110,95%CI:1.008-1.222),work units required(OR=3.187,95%CI:2.385-4.259)or encouraged(OR=1.548,95%CI:1.185-2.021)immunization,free influenza vaccination policy(OR=4.449,95%CI:3.716-5.327),work units provided influenza vaccination service(OR=3.319,95%CI:2.094-5.262),attended on influenza and flow vaccine training/health promotion(OR=1.288,95%CI:1.034-1.604),awareness of the local influenza vaccination policy for primary health care workers(OR=1.294,95%CI:1.049-1.598)were positive factors for influenza vaccination.Conclusion The influenza vaccine coverage rate of primary medical staff in 2020-2021 influenza season is significantly higher than that in 2019-2020 influenza season,but it is still low,and the recommended rate is high.Targeted influenza and influenza vaccine-related health education,preferential or free policies,and improved vaccination accessibility are effective ways to promote influenza vaccination among primary health care workers.