2017-2019年上海市某儿科医院疫苗咨询门诊特殊健康状态儿童疫苗接种现状

Vaccination status of children with underlying medical conditions who visited a vaccination consultation clinic of a pediatric hospital in Shanghai,2017-2019

目的评价特殊健康状态儿童疫苗接种现状。方法在上海市某儿科医院疫苗咨询门诊收集2017-2019年就诊的特殊健康状态儿童既往接种信息,开展疫苗接种评估和推荐,随访再接种情况和预防接种不良事件(Adverse event following immunization,AEFI),分析疫苗接种现状、接种推荐依从性和AEFI发生率。结果共纳入9559例0-17岁特殊健康状态儿童,其中0-5岁儿童占92.9%;6种最常见疾病(神经系统疾病、早产、先天性心脏病、血液病、既往AEFI史和肛周脓肿)儿童占73.4%。在有明确接种记录的儿童中按免疫程序完成疫苗接种者占5.9%(454/7637)。在疫苗接种评估儿童中推荐按免疫程序常规接种者占85.1%(8132/9559)。在随访儿童中遵照推荐进行疫苗接种者占87.3%(804/921),AEFI发生率为1.7%(14/804),无严重AEFI发生。结论特殊健康状态儿童在门诊咨询之前疫苗接种率低,疫苗接种推荐的依从性良好,特殊健康状态儿童在原发病稳定时可安全接种疫苗。

Objective To explore the vaccination status of children with underlying medical conditions.Methods We selected children with underlying medical conditions who visited a vaccination consultation clinic of a pediatric hospital in Shanghai during 2017-2019 to collect data on vaccination histories,vaccination evaluations,and recommendations,and followed up evaluated children for compliance with recommendations and occurrence of adverse events following immunization(AEFI).We analyzed pre-evaluation vaccination histories,compliance with vaccination recommendation,and AEFI incidence.Results A total of 9559 subjects aged 0-17 years were included in the study,among which 92.9%were under 6 years old and 73.4%had one or more of six common medical conditions:neuromuscular disorder,premature birth,congenital heart disease,hematological disease,previous AEFI history,and perianal abscess.Among subjects with vaccination records,5.9%(454/7637)had previously received all age-eligible vaccine doses in the immunization schedule.Among all subjects,85.1%(8132/9559)were recommended to continue vaccination according to the immunization schedule.Among subjects followed up,87.3%(804/921)received vaccines in compliance with recommendations,and among subjects vaccinated,1.7%(14/804)had an AEFI and none had a serious adverse event.Conclusions Vaccination coverage was low among children with underlying medical conditions before clinic consultation.Most of the children evaluated received vaccines in compliance with vaccination recommendations and may be vaccinated safely when underlying medical conditions are stable.