某市预防接种人员对非免疫规划疫苗推荐意愿及影响因素分析

Analysis on the Willingness of Vaccinators to Recommend Non-Immunization Program Vaccines and Its Influencing Factors in a City

目的探讨某市预防接种医务人员对非免疫规划(expanded program on immunization,EPI)疫苗推荐意愿及影响因素。方法选取2021年8月—2022年12月聊城市疾病预防控制中心免疫规划管理所500名预防接种医务人员为研究对象。调查医务人员非EPI疫苗推荐意愿,并采用多因素logistic回归分析影响医务人员非EPI疫苗推荐意愿的危险因素。结果纳入的500名调查对象中,非EPI疫苗的推荐意愿率为65.20%(326/500),其中流感疫苗(flu vaccine,FLU)、水痘减毒活疫苗(live attenuated varicella vaccine,VarV)、b型流感嗜血杆菌疫苗(Haemophilusinfluenzae type b vaccine,Hib)、乙型肝炎疫苗(hepatitis B vaccine,HepB)的推荐意愿率分别为88.60%(443/500)、84.00%(420/500)、79.00%(395/500)和77.20%(386/500),其他5种非EPI疫苗的推荐意愿率为36.60%~58.00%。单因素分析显示,工作年限、收入是否与非EPI疫苗接种量有关、是否经历疫苗负性事件、是否认为预防接种工作有风险、疫苗接种流程、接种工作量及被推荐者态度不同者非EPI疫苗推荐意愿率比较差异有统计学意义(P<0.05);不同性别、年龄、文化程度、职称、工作岗位、非EPI疫苗知识是否知晓者非EPI疫苗推荐意愿率比较差异无统计学意义(P>0.05)。多因素logistic回归分析显示,工作年限(OR=4.008,95%CI1.528~10.934)、经历疫苗负性事件(OR=4.870,95%CI 1.328~17.859)、疫苗接种流程(OR=5.275,95%CI1.541~18.063)、接种工作量(OR=4.773,95%CI1.413~16.122)及被推荐者态度(OR=5.778,95%CI1.772~18.838)是预防接种医务人员非EPI疫苗推荐意愿的影响因素(P<0.05)。结论某市预防接种医务人员非EPI疫苗推荐意愿总体处于较低水平,且工作年限、经历疫苗负性事件、疫苗接种流程、接种工作量及被推荐者态度均是其主要影响因素,建议完善非EPI疫苗预防接种保障措施,以提高预防接种医务人员非EPI疫苗推荐意愿。

Objective To explore the willingness of medical personnel to recommend non-expanded program on immunization(EPI)vaccines in a city and its influencing factors.Methods A total of 500 vaccination medical workers of institute for the management of immunization programmes,Liaocheng Center for Disease Control and Prevention from August 2021 to December 2022 were selected as the study objects.The intention of medical staff to recommend non-EPI vaccines was investigated,and the risk factors affecting the intention to recommend non-EPI vaccines were analyzed by multivariate logistic regression.Results Among the 500 participants,the recommended willingness rate for non-EPI vaccines was 65.20%(326/500).Among them,the recommendation intention rates of influenza vaccine(FLU),live attenuated varicella vaccine(VarV),Haemophilus influenzae type b vaccine(Hib)and hepatitis B vaccine(HepB)were 88.60%(443/500),84.00%(420/500),79.00%(395/500)and 77.20%(386/500),respectively.The recommended willingness rates for the other five non-EPI vaccines ranged from 36.60%to 58.00%.Univariate analysis showed that whether working years and income were related to the amount of non-EPI vaccine vaccination,whether negative vaccine events were experienced,whether vaccination work was considered risky,vaccination process,vaccination workload,and the willingness rate of non-EPI vaccine recommendation were different,with statistical significance(P<0.05).There was no significant difference in the willingness to recommend non-EPI vaccines among different gender,age,educational level,professional title,job position,and knowledge of non-EPI vaccines(P>0.05).Multivariate logistic regression analysis showed that years of work(OR=4.008,95%CI 1.528 to 10.934),experiences with negative vaccine events(OR=4.870,95%CI 1.328 to 17.859),vaccination process(OR=5.275,95%CI 1.541 to 18.063),vaccination workload(OR=4.773,95%CI1.413 to 16.122),and recommended attitude(OR=5.778,95%CI 1.772 to 18.838)were the influencing factors of non EPI vaccine recommendation willingness among medical staff receiving preventive vaccination(P<0.05).Conclusion The overall willingness of medical staff in a city to recommend non EPI vaccines is at a low level,and their work experience,negative vaccine events,vaccination process,vaccination workload,and recommended attitudes are the main influencing factors.It is recommended to improve the guarantee measures for non EPI vaccine vaccination to increase the willingness of medical staff to recommend non EPI vaccines.