中国目前计划免疫工作中存在的问题及今后研究方向——云南省2001年12月口服脊髓灰质炎疫苗强化免疫时接种率快速调查结果分析

An Analysis on Immunization Coverage Rate and the Reasons for Failure

20 0 1年 1 2月开展口服脊髓灰质炎 (脊灰 )疫苗 (OPV)强化免疫活动后 ,在中国云南省的 5个市场对 1 64名 0～ 3岁的儿童进行了接种率调查。结果显示 :1 54名 (93 9% )儿童接受了本次的强化免疫 ,零剂次免疫儿童数为 2 9人 (1 7 7% ) ,31名儿童 (1 8 9% )未接受过常规免疫服务。流动人口既往OPV强化免疫和常规免疫接种率低于常住人口 (强化免疫 :Fisher′sexacttest,P =0 0 4 4 ;常规免疫 :Fisher′sexacttest,P =0 0 1 8)。在流动人口中无暂住证人口本次强化免疫、既往OPV强化免疫及常规免疫的接种率低于有暂住证人口 (SNIDs:Fisher’sexacttest,P =0 0 4 7;OPV :χ2 =6 753 ,P =0 0 0 9;常规免疫 :χ2 =5 62 2 ,P =0 0 1 8)。≥ 2岁儿童既往OPV的接种率高于 1岁儿童 (Fisher’sexacttest,p =0 0 0 6)。未接种原因有“不知预防接种必要性”、发热等轻度疾病、不能承担接种费用、到接种点的距离等。为提高接种率 ,需要对流动人口尤其是无暂住证的人口采取对策 ,对居民特别是流动人口的信息、教育和传播 (IEC)

A survey on immunization coverage rate was conducted at five markets in Yunnan Province in December 2001 after the SNIDs(national supplementary immunization days)for oral polio vaccine(OPV). A total of 164 children aged 0 to 3 year old were surveyed 154 children(94%)had received OPV during the SNIDs Twenty nine children(17 7%)never received OPV(both routine and SNID)in the past and 31 children(18 9%)reported had never received other routine immunization in the past The type of residence,the registration for temporary resident(holding resident permit)and the age all affected their immunization status The floating population was less likely to receive OPV and routine immunization in the past as compared to the resident(OPV:Fisher's exact test;p=0 044,Routine immunization:Fisher's exact test;P=0 018) Among the floating population,the children without temporary resident permit were less likely to receive OPV during the SNIDs this time or OPV in the past and routine immunization in the past as compared to the children having temporary resident permit(SNIDs:Fisher's exact test;P=0 047,OPV:Chi square=6 753,p=0 009,Routine immunization;Chi square=5 622,p=0 018) Children aged over 2 year old were more likely to receive OPV in the past as compared to the children aged 1 to 2 year old(Fisher's exact test;p=0 006) The reasons for not receiving immunization were'did not know that immunization was necessary',a mild illness such as fever, cost and the distance to the clinic. To improve the immunization coverage rate, it is important to include the floating population,especially the children without temporary resident permission,into the national EPI system,the IEC(information,education and communication)on immunization for the public,especially the floating population and reconsideration of contraindication for immunization are necessary.