中国三个省12-23月龄儿童13价肺炎球菌多糖结合疫苗未全程接种影响因素的病例对照研究

A case-control study of factors influencing incomplete vaccination with 13-valent pneumococcal polysaccharide conjugate vaccine among children 12-23 months of age in three provinces of China

目的了解12-23月龄儿童13价肺炎球菌多糖结合疫苗(13-valent pneumococcal polysaccharide conjugate vaccine,PCV13)未全程接种影响因素。方法在中国3个省12个县区选择已接种≥1剂次PCV13的12-23月龄儿童,采用病例对照设计分为1-2剂次、3剂次和全程(4剂次)接种组,对儿童监护人(父亲或母亲)开展问卷调查,采用多因素Logistic回归模型分析未全程(1-2剂次和3剂次)接种的影响因素。结果1-2剂次、3剂次和全程接种组分别纳入研究对象301例、258例和332例。与全程接种组相比,1-2剂次接种组监护人低学历、忘记带儿童接种疫苗、认为无需全程接种也可提供保护、认为儿童超龄无法接种、认为肺炎不严重的比例更高;3剂次接种组城市居住地、监护人认为儿童超龄无法接种、监护人忘记带儿童接种、儿童第3剂次接种年龄>6月龄的比例更高。结论12-23月龄儿童PCV13未全程接种主要受监护人对疫苗接种相关认知态度的影响,尽早完成3剂次接种可促进全程接种。需加强监护人PCV13相关知识健康教育和儿童疫苗接种提醒。

Objective To determine factors associated with incomplete vaccination with 13-valent pneumococcal conjugate vaccine(PCV13)in children aged 12-23 months.Methods We enrolled children aged 12-23 months who had received≥1 dose of PCV13 from 12 counties/districts in 3 provinces of China and divided them into 1-2-dose,3-dose,and full-series(4-dose)vaccination groups for a questionnaire-based survey.We used multivariate logistic regression models to identify factors influencing non-full-series(1-2-and 3-dose)vaccination.Results We enrolled 301,258,and 332 subjects into 1-2-dose,3-dose,and full-series vaccination groups,respectively.Compared with the full-series vaccination group,the 1-2-dose group had a higher proportion of guardians who had low education level,who forgot to bring their child for vaccination,who believed that non-full-series vaccination could provide protection,who believed that their child was too old to be vaccinated,and who believed that pneumonia was not serious;the 3-dose group had a higher proportion of children who lived in rural areas,whose guardians believed that children were too old to be vaccinated,whose guardians forgot to bring their child for vaccination,and who were>6 months of age when receiving the 3rd dose of PCV13.Conclusions Non-full-series vaccination with PCV13 in children aged 12-23 months was mainly influenced by guardians’attitudes towards vaccination;early completion of three doses of vaccination might promote full-series vaccination.We should strengthen health education about PCV13 vaccination for guardians and childhood vaccination reminder practices.