儿童家长四种非免疫规划疫苗犹豫调查

Investigation on hesitancy for four non-Expanded Program on Immunization vaccines among parents of children

目的了解中国儿童家长对B型流感嗜血杆菌疫苗(Haemophilus influenzae type b vaccine,Hib)、水痘疫苗、DTaP-IPV-Hib五联疫苗、流感疫苗四种非免疫规划疫苗犹豫情况。方法2021年6月展开横断面研究,对0~6岁儿童家长的四种非免疫规划疫苗犹豫情况开展线上调查。利用logistics回归模型分析非免疫规划疫苗犹豫的影响因素。结果本研究10916名家长中,Hib、水痘疫苗、五联疫苗和流感疫苗的疫苗犹豫分别有3846名(35.23%)、1769名(16.21%)、4349名(39.84%)和3050名(27.94%)。多因素分析结果显示,地域、收入和同时接种多种疫苗的意愿是四种疫苗共同的影响因素。中部地区儿童家长四种疫苗犹豫发生可能性高于其他地区(OR=1.07,95%CI:0.96~1.20,P=0.01;OR=1.15,95%CI:1.00~1.33,P<0.01;OR=1.19,95%CI:1.07~1.34,P<0.01;OR=1.10,95%CI:0.98~1.24,P<0.01)。家庭人均年收入>10万的儿童家长对四种疫苗犹豫比例低于中、低收入组(OR=0.62,95%CI:0.56~0.69,P<0.01;OR=0.63,95%CI:0.54~0.73,P<0.01;OR=0.56,95%CI:0.50~0.62,P<0.01;OR=0.66,95%CI:0.59~0.74,P<0.01)。支持同时接种多种疫苗的家长疫苗犹豫比例低于反对组(OR=0.63,95%CI:0.58~0.69,P<0.01;OR=0.64,95%CI:0.57~0.72,P<0.01;OR=0.64,95%CI:0.58~0.69,P<0.01;OR=0.69,95%CI:0.63~0.76,P<0.01)。结论我国0~6岁儿童家长对Hib、五联疫苗的疫苗犹豫现象较水痘疫苗和流感疫苗更为普遍,建议增加Hib疫苗的宣传,制定相关策略提高民众对Hib疫苗的接种意愿。

Objective To understand the situation of vaccine hesitancy among parents in China for four nonExpanded Program on Immunization(non-EPI)vaccines,including Haemophilus influenzae type b vaccine(Hib),varicella vaccine(VarV),DTaP-IPV-Hib vaccine(pentavalent vaccine),and influenza vaccine(Flu).Methods In 2021 June,a cross-sectional online survey was conducted among parents of children aged 0-6 years in China to collect information on their vaccine hesitancy for four non-EPI vaccines.Logistic regression model was used to identify the influencing factors of vaccine hesitancy.Results A total of 10916 parents were surveyed.The hesitancy prevalence for Hib,VarV,pentavalent vaccine and Flu vaccine were 35.23%(3846/10916),16.21%(1769/10916),39.84%(4349/10916),and 27.94%(3050/10916),respectively.Multivariable analysis showed that geographical area,income and willingness toward co-vaccination were major influencing factors of hesitancy for four vaccines.Parents from central area were more likely to have vaccine hesitancy compared with other areas(OR=1.07,95%CI:0.96-1.20,P=0.01;OR=1.15,95%CI:1.00-1.33, P<0.01;OR=1.19,95%CI:1.07-1.34, P<0.01;OR=1.10,95%CI:0.98-1.24, P<0.01).Parents in family with annual income per person 100000 RMB had lower level of hesitancy than middle and lower income groups(OR=0.62,95%CI:0.56-0.69, P<0.01;OR=0.63,95%CI:0.54-0.73, P<0.01;OR=0.56,95%CI:0.50-0.62, P<0.01;OR=0.66,95%CI:0.59-0.74, P<0.01).Parents willing to receive co-vaccination had lower level of hesitancy compared with the co-vaccination opposite group(OR=0.63,95%CI:0.58-0.69, P<0.01;OR=0.64,95%CI:0.57-0.72, P<0.01;OR=0.64,95%CI:0.58-0.69, P<0.01;OR=0.69,95%CI:0.63-0.76, P<0.01).Conclusions Among parents aged 0-6 years in China,hesitancy for Hib,pentavalent vaccine may be more common than that for VarV and Flu vaccine.It is suggested to increase the publicity of Hib vaccine and develop strategies to elevate the public's willingness toward immunization with Hib vaccine.