卡普兰-迈耶（Kaplan-Meier）法在首剂含麻疹成分疫苗接种率评估中的应用

目的应用卡普兰-迈耶（Kaplan—Meier）法,快速评估首剂含麻疹成分疫苗（First Dose Measles-containing Vaccine,MCV．）的接种率。方法在A、B两省8个县（区、市,下同）,每个调查县随机抽取5个乡（镇、街道,下同）,备份各乡辖区内预防接种单位客户端数据库,利用预防接种单位客户端督导工具“数据质量模块”,对客户端数据质量进行评价,采用Kaplan-Meier法对预防接种单位MCV．接种数据进行分析。结果共对比了1674剂MCV。预防接种记录,预防接种单位客户端中MCV1接种信息与现场调查MCV1接种信息一致率为97．7％,一致率〉95％的乡有34个,占85．0％。A、B省8月龄儿童MCV1及时接种率分别为46．7％、39．9％,12月龄时点累积接种率分别为87．1％[95％可信区间（Confidence Interval,CI）：86．8％～87．4％]与73．5％（95％CI：73．2％-73．8％）。2个省儿童MCV1时点累积接种率在8—10月龄呈现较快增长,而在上述时点后增长速率缓慢。经对数秩检验,不同预防接种服务周期乡的儿童,MCV1接种率的差异有统计学意义（x2=175．848,P〈0．0001）。结论Kaplan—Meier法直观地展现MCV1接种率随时间变化的整个过程,可用于快速评估预防接种单位MCV1接种率。     

广东省2003～2004年脊髓灰质炎疫苗强化免疫活动效果分析

目的 了解广东省2003～2004年脊髓灰质炎(脊灰)疫苗强化免疫活动效果。方法 按强化免疫活动实施方案于2003年12月5～6日和2004年1月5～6日在广东省全省范围开展脊灰疫苗强化免疫活动,逐级进行资料汇总上报,并采用随机原则进行现场快速评估。结果 全省各地上报第一轮应接种对象2701029人,已接种2625039人,接种率为97．2％;第二轮应接种对象2769745人,已接种2693545人,接种率为97．2％。现场快速评估,第一轮共调查7947名对象,接种率为97．1％,上卡率为92．9％;第二轮共调查7539名对象,接种率为98．2％,上卡率为94．1％。结论 两轮强化免疫活动的脊髓灰质炎疫苗接种率均达到95％以上的目标。今后应继续加强对流动儿童的免疫接种工作。     

2007年四川省部分地区麻疹强化免疫接种分析

目的对2007年四川省部分地区实施麻疹疫苗（MV）强化免疫的接种率进行分析,为2008年17个市州开展麻疹强免提供经验,加速麻疹控制与消除的工作进展。方法综合分析强化免疫期间的现场调查和各地上报的项目总结和报表等资料。结果强化免疫共计接种目标儿童3980978人,报告接种率和快速评估接种率均〉95％,2者无统计学差异（X^2=3．75,P〉0．05）;接种目标儿童数〉摸底调查时统计的应种儿童数（3937372人）〉2006年四川省计免／冷链基本情况报表报告的儿童数（3610323人）。以疫苗使用情况进行估算,其接种率达到96．33％,与报告接种率比较D值=2．45％;以省统计局提供的人口数进行估算,接种率达到91．95％．与报告接种率比较D值=6．83％;以2006年四川省计免／冷链基本情况报表的人口数进行估算,其接种率达到110．27％,与报告接种率比较D值=11．49％。结论该次麻疹疫苗强化免疫达到了预期目标。     

广元市地震灾区风疹疫苗群体性预防接种实施效果分析

目的评估广元市地震灾区风疹疫苗(Rubella Vaccine,Rub/vac)群体性预防接种实施效果。方法 通过总结广元市地震灾区Rub/vac群体性预防接种工作实施情况和对比接种前后风疹发病状况,评价其实施效果。结果截至2008-10-31,7个地震县区共报告接种Rub/vac 418 257人,接种率达92.80%,2009年广元市风疹发病率为3.46/10万,相比接种前(2007年为66.12/10万)下降了94.77%。结论广元市地震灾区风疹疫苗群体性预防接种达到了预期结果。     

四川省地震灾区甲型肝炎疫苗和流行性乙型脑炎减毒活疫苗群体性预防接种分析

目的 评价四川省地震灾区甲型肝炎(甲肝)疫苗(Hepatitis A Vaccine,HepA)、流行性乙型脑炎(乙脑)减毒活疫苗(Japanese Encephalitis Vaccine,LivedEV-1)群体性预防接种.方法 对报告和现场调查的HepA、JEV-1接种数据进行分析.结果 四川省地震灾区6个市(州)21个县(区、市),截止到2008年6月10日,共报告接种HepA399 075人,接种JEV-1 137 543人,估算接种率分别为91.96％、88.85％.现场快速调查HepA应种1825人,实种1783人,接种率97.70％;JEV-1应种912人,实种869人,接种率95.29％.结论 四川省地震灾区HepA、JEV-1群体性预防接种达到了预期结果.     

南通开发区2005—2006年度脊灰疫苗强化免疫活动效果评价

目的了解南通市开发区2005-2006年度脊髓灰质炎疫苗强化免疫活动效果，为今后计划免疫工作提供依据。方法按照脊髓灰质炎强化免疫活动实施方案于2005年12月5、6日和2006年1月5、6日在全区范围内开展了2轮脊灰疫苗强化免疫活动，并在每轮服苗结束后进行了现场快速评估。结果2轮报告接种率分别为98．44％、98．57％，均达到95％以上的目标。通过零剂次儿童分析，发现零剂次儿童主要集中分布在〈1岁组儿童（96．08％），并且流动儿童中零剂次免疫儿童占全部零剂次免疫儿童的75．00％。现场快速评估调查外来居住〈3月龄的流动儿童接种率分别只有58．82％和43．75％，且现场快速评估接种率低于报告接种率。结论2轮强化免疫活动取得了较好的成绩，但消除脊髓灰质炎是一项长期而艰巨的任务，需要不懈的努力。零剂次儿童是强化免疫的重点。流动儿童接种率偏低，今后应继续加强儿童预防接种工作，特别是流动儿童预防接种工作。     

2006年博白县麻疹疫苗强化免疫情况调查

[目的]分析博白县2006年麻疹疫苗（MV）强化免疫效果,探讨控制麻疹策略。[方法32006年对8月至10岁儿童实施MV强化免疫活动。综合分析MV强化免疫现场调查资料、评估报告、法定传染病报告系统资料。[结果]博白县2006年MV强化免疫共接种目标儿童235782人,报告接种率95．20％,快速评估接种率95．71％,免疫后人群麻疹IgG抗体阳性率为97．54％,保护率达90．16％。[结论]博白县2006年MV强化免疫成效显著。维持高水平常规免疫接种率,适时开展MV强化免疫和后续免疫．是有效控制麻疹的措施。     

兰州市2006年新入托、入学儿童预防接种状况分析

目的了解2006年兰州市8县（区）新入托、新入学儿童预防接种情况，对发现的问题提出建议和措施。方法按照卫生部、教育部《关于做好入托、入学儿童预防接种证查验工作的通知》（卫疾控发[2005]408号）和兰州市卫生局、教育局关于转发甘肃省卫生厅、教育厅转发卫生部、教育部《关于做好入托、入学儿童预防接种证查验工作的通知》的要求，对2006年兰州市辖区内所有托幼机构新入托、学前班儿童，小学一年级新生及其二年级至六年级新转入学生的计划免疫预防接种情况进行调查分析。结果2006年兰州市新入托、新入学儿童预防接种证持证率为91．97％；持证儿童合格接种率97．26％；卡介苗（BCG）、乙肝疫苗（HepB3）、脊髓灰质炎疫苗（OPV3）、百白破疫苗（DPT3）、麻疹疫苗（MV）的合格接种率分别为95．92％、94．32％、94．59％、95．49％、93．09％。结论2006年兰州市新入学、入托儿童的免疫预防接种证持证率和持证儿童的合格接种率均偏低，卡介苗（BCG）、乙肝疫苗（HepB3）、脊髓灰质炎疫苗（OPV3）、百白破疫苗（DPT3）、麻疹疫苗（MV）五种疫苗的合格接种率也相对较低。针对这一问题，建议各级卫生、教育部门应根据职责分工，共同做好预防接种工作，提高学生的身体素质。     

连云港市2009年麻疹疫苗强化免疫工作评价

[目的]评估连云港市麻疹疫苗强化免疫的接种率情况及预防麻疹的效果.[方法]综合分析麻疹疫苗强化免疫报告接种率、估算目标儿童应种数、现场调查接种率及法定传染病报告系统的疫情资料. [结果]本次麻疹疫苗强化免疫全市共接种目标儿童838 281人,大干统计局、计划免疫年报和儿童预防接种信息管理系统提供目标儿童应种数817 178人、825 604人;报告接种率为98.87％,现场评估共调查适龄儿童2 746人,调查接种率为97.89％.共报告疑似预防接种异常反应130例,发生率为1.55/万.接种“零剂次”儿童25 678人.强化免疫后经过1个最长潜伏期,麻疹发病数明显减少,报告病例中8月龄至14周岁儿童所占构成比降低了36.58％. [结论]连云港市2009年麻疹疫苗强化免疫接种率达到95％目标要求,强化免疫效果明显,有效降低麻疹发病率.     

湖州市流动儿童接种率及其影响因素调查

目的：了解浙北地区湖州市流动儿童免疫规划疫苗预防接种现状及影响因素。方法：2004年7月采用％PPS〉法整群随机抽样法开展免疫接种率及其影响因素的调查,共调查1-6岁流动儿童501名．接种记录按《预防接种工作规范》进行统计。结果：建证率91．02％。卡介苗（BCG）、口服脊髓灰质炎减毒活疫苗（OPV）、百白破联合疫苗（DPT）、麻疹减毒活疫苗（MV）、乙型肝炎疫苗（HepB）接种率分别为79．44％、711．65％、65．07％、64．07％、78．04％,五苗全程接种率58．08％。结论：流动儿童各种疫苗的接种率较低,家长文化水平较低,缺乏免疫预防相关知识,预防接种意识薄弱。     

2017—2018年北京市丰台区小学生流感疫苗接种及保护效果评价

目的 了解2017—2018年北京市丰台区小学生流感疫苗接种情况,分析流感疫苗接种在发生流感聚集性疫情时的保护作用。方法 选取2017年北京市丰台区小学集中接种免费流感疫苗资料和2017—2018年流感流行季发生的流感聚集性疫情调查资料,进行疫苗接种率和流感疫苗保护效果分析。 结果 2017年北京市丰台区107所小学及其分校集中接种免费流感疫苗,在册学生共71 103人,接种人数35 721人,疫苗接种率为50.24%。2017—2018年流感流行季期间,全区共23所小学上报经实验室检测确认的流感聚集性疫情39起,共报告408例病例,发生流感聚集性疫情数量越多、规模越大、疫情发生后产生续发病例的学校,疫苗接种率越低。接种组小学生在流感聚集疫情发生时发病率为22.70%,未接种组发病率为30.30%,疫苗保护率为25.11%,效果指数为1.34。 结论 接种流感疫苗可减少流感聚集性疫情的发生和扩散,在流感聚集性疫情发生时对学生有一定的保护作用,应加强健康教育和公众交流,进一步提高流感疫苗的接种率。     

Influenza vaccine uptake in the elderly population: Individual and general practitioner’s determinants in Central Italy,Lazio region, 2016–2017 season

BackgroundElderly people are a priority target group for influenza vaccination and their decision to be vaccinated might partly depend on advice received from general practitioners (GP). This study aims to investigate the association between influenza vaccine uptake in the elderly residents in the Lazio region of Italy and the demographic and professional characteristics of their GPs, taking simultaneously into account the elderly’s individual characteristics.MethodsWe used data retrieved from different administrative sources to retrospectively analyse the cohort of 1,255,657 elderly residents aged ≥65 years who were alive and registered in the regional healthcare service at the beginning of the 2016–2017 influenza vaccination campaign (1 Oct. 2016–31 Jan. 2017). We assessed influenza vaccine uptake at the end of the vaccination campaign and evaluated its association with both individual and GP-related characteristics through a multilevel Poisson regression models accounting for clustering at physician level.ResultsOverall, vaccination coverage at the end of vaccination campaign was 50.6%. Elderly residents who were male, older, vaccinated in the previous seasons, living in smaller provinces, and spending more money for specialist medical care showed a significantly increased probability to be vaccinated. Vaccine uptake was also significantly higher in the elderly residents assisted by GPs who got master’s degree more recently, assisted a relatively high proportion of elderly patients, received influenza vaccination, had a computer assistant, and were associated with other physicians.ConclusionsOur results indicate that influenza vaccination coverage in the elderly residents of the Lazio region is still unsatisfactorily low. We identified several determinants of influenza vaccine uptake, related to both individual and GP characteristics. Understanding how GP characteristics affected influenza vaccine uptake in the elderly population might provide insight on GPs’ attitudes and concerns regarding influenza vaccination, allowing the implementation of targeted evidence-based interventions to sensitise GPs and increase vaccination coverage.     

Low vaccination coverage for seasonal influenza and pneumococcal disease among adults at-risk and health care workers in Ireland, 2013: The key role of GPs in recommending vaccination

The World Health Organization (WHO), and European Agencies recommend influenza vaccination for individuals at-risk due to age (≥65 years), underlying diseases, pregnancy and for health care workers (HCWs) in Europe. Pneumococcal vaccine is recommended for those at-risk of pneumococcal disease. In Ireland, vaccination uptake among at-risk adults is not routinely available. In 2013, we conducted a national survey among Irish residents ≥18 years of age, to estimate size and vaccination coverage of at-risk groups, and identify predictive factors for influenza vaccination.We used computer assisted telephone interviews to collect self-reported information on health, vaccination status, attitudes towards vaccination. We calculated prevalence and prevalence ratios (PR) using binomial regression.Overall, 1770 individuals participated. For influenza, among those aged 18–64 years, 22% (325/1485) [95%CI: 17%–20%] were at-risk; 28% [95%CI: 23%–33%] were vaccinated. Among those aged ≥65 years, 60% [95%CI: 54%–66%] were vaccinated. Influenza vaccine uptake among HCWs was 28% [95%CI: 21%–35%]. For pneumococcal disease, among those aged 18–64 years, 18% [95%CI: 16%–20%] were at-risk; 16% [95%CI: 12%–21%] reported ever-vaccination; among those aged ≥65 years, 36% [95%CI: 30%–42%] reported ever-vaccination. Main reasons for not receiving influenza vaccine were perceptions of not being at-risk, or not thinking of it; and among HCWs thinking that vaccination was not necessary or they were not at-risk. At-risk individuals were more likely to be vaccinated if their doctor had recommended it (PR 3.2; [95%CI: 2.4%-4.4%]) or they had access to free medical care or free vaccination services (PR 2.0; [95%CI: 1.5%-2.8%]).Vaccination coverage for both influenza and pneumococcal vaccines in at-risk individuals aged 18–64 years was very low. Influenza vaccination coverage among individuals ≥65 years was moderate. Influenza vaccination status was associated with GP vaccination recommendation and free access to vaccination services. Doctors should identify and recommend vaccination to at-risk patients to improve uptake.     

Determinants of influenza and pertussis vaccine uptake in pregnant women in Ireland: A cross-sectional survey in 2017/18 influenza season

In Ireland seasonal influenza and pertussis vaccination during pregnancy is recommended and every year national campaigns are organised to raise awareness and improve uptake. We estimated influenza and pertussis vaccine uptake and identified factors associated with vaccination status in pregnant women in 2017/18.We conducted a face-to-face omnibus survey, with quota sampling, among women aged 18–55 years and collected socio-demographic characteristics, self-reported vaccination status, awareness of vaccine campaigns, and attitudes towards vaccination. Sample was weighted to ensure representativeness with the target population. We performed univariate and multivariable logistic regression analyses on survey data.Overall, 241 pregnant women were enrolled. Influenza and pertussis vaccine uptake was 61.7% and 49.9%, respectively. Awareness of vaccine campaign and socio-economic status (SES) were associated with both influenza and pertussis vaccine uptake. The association between SES and uptake of vaccines differed by awareness. Women aware of the influenza vaccine campaign and with mid and low SES were less likely to be vaccinated, compared to those with high SES (aOR = 0.46; 95%CI: 0.22–0.97; aOR = 0.27; 95%CI: 0.12–0.60, respectively); women not aware of the pertussis vaccine campaign and with mid and low SES were less likely to be vaccinated, compared to those aware and with high SES (aOR = 0.15; 95%CI: 0.04–0.48; aOR = 0.05; 95%CI: 0.01–0.24, respectively).General practitioner (GP) recommendation was the main reason for receiving influenza vaccine (39.2%), and 71.8% of women were recommended pertussis vaccination from their GPs.The survey reports moderate uptake of vaccines among pregnant women, inequalities in uptake by SES and identifies GPs as primary source for vaccine recommendation. We recommend multifaceted campaigns, by engaging GPs, to target all socio-economic groups.     

Vaccination coverage survey versus administrative data in the assessment of mass yellow fever immunization in internally displaced persons--Liberia, 2004

Yellow fever (YF) is a mosquito-borne vaccine-preventable disease with high mortality. In West Africa, low population immunity increases the risk of epidemic transmission. A cluster survey was conducted to determine the effectiveness of a mass immunization campaign using 17D YF vaccine in internally displaced person (IDP) camps following a reported outbreak of YF in Liberia in February 2004. Administrative data of vaccination coverage were reviewed. A cluster sample size was determined among 17,384 shelters using an 80% vaccination coverage threshold. A questionnaire eliciting demographic information, household size, and vaccination status was distributed to randomly selected IDPs. Data were analyzed to compare vaccination coverage rates of administrative versus survey data. Among 87,000 persons estimated living in IDP camps, administrative data recorded 49,395 (57%) YF vaccinated persons. A total of 237 IDPs were surveyed. Of survey respondents, 215 (91.9%, 95% CI 88.4-95.4) reported being vaccinated during the campaign and 196 (83.5%, 95% CI 78.6-88.5) possessed a valid campaign vaccination card. The median number of IDPs living in a shelter was 4 (range, 1-8) and 69,536 persons overall were estimated to be living in IDP camps. Coverage rates from a rapid survey exceeded 90% by self-report and 80% by evidence of a vaccination card, indicating that the YF immunization campaign was effective. Survey results suggested that administrative data overestimated the camp population by at least 20%. An emergency, mop-up vaccination campaign was avoided. Coverage surveys can be vital in the evaluation of emergency vaccination campaigns by influencing both imminent and future immunization strategies.     

Relationship between intention of novel influenza A (H1N1) vaccination and vaccination coverage rate

We carried out this study to describe the difference between intention to receive vaccine against influenza A (H1N1) before the vaccination campaign and actual vaccine coverage rate after vaccination campaign; and to find out the factors affecting the acceptability. We analyzed data on intention to receive vaccine against influenza A (H1N1) and actual vaccination coverage rate from IR (immunization registry). In a survey of pre-vaccination, the sample size was 1042 and the survey results were weighted with gender and age distribution for sample distribution to be similar to population distribution. Although the intention to receive vaccine against influenza A (H1N1) was high, the actual vaccination coverage was lower than their intention. The factors affecting their intention were the degree of fear for novel influenza A (H1N1), the possibility to be infected with the virus, priority for production of novel influenza vaccine between timing and safety, and belief for effectiveness of novel influenza vaccine. Besides 2009 influenza A (H1N1) vaccination experience developing to resolve the effecting factors on intentions to receive vaccine, which would be the effective way to prepare for anther pandemic in the future.     

Measles epidemic in Romania, 1996-1998: assessment of vaccine effectiveness by case-control and cohort studies

A measles epidemic occurred in Romania with 32,915 cases and 21 deaths reported between November 1996 and June 1998, despite high vaccination coverage since the early 1980s. Most cases were unvaccinated children aged <2 years and vaccinated school-aged children. A case-control study among preschool children and a cohort study among primary-school children were conducted to estimate effectiveness of Romanian-produced measles vaccine, and to evaluate age at vaccination and waning immunity as risk factors for vaccine failure. Both studies indicated that measles vaccine was highly effective. One dose reduced the risk for measles by 89% (95% confidence interval (CI) 85, 91); two doses reduced the risk by 96% (95% CI 92, 98). Children vaccinated at <1 year of age were not at increased risk for measles compared with children vaccinated at > or =1 year. Waning immunity was not identified as a risk factor since vaccine effectiveness was similar for children vaccinated 6-8, 9-11, and 12-14 years in the past. Because specific groups were not at risk for vaccine failure, an immunization campaign that targets all school-aged children who lack two doses may be an effective strategy for preventing outbreaks. A mass campaign followed by increased first-dose coverage should provide the population immunity required to interrupt indigenous measles virus transmission in Romania.     

Mass measles vaccination in urban Burkina Faso, 1998

OBJECTIVE: To assess the impact of the National Immunization Days (NIDs) on measles vaccine coverage in Burkina Faso in 1998. METHODS: During the week after the campaign, in which measles vaccine was offered to children aged 9-59 months in six cities regardless of vaccination history, a cluster survey was conducted in Ouagadougou and Bobo Dioulasso, the country's two largest cities. Interviewers visited the parents of 1267 children aged up to 59 months and examined vaccination cards. We analysed the data using cluster sample methodology for the 1041 children who were aged 9-59 months. FINDINGS: A total of 604 (57%) children had received routine measles vaccination prior to the campaign, and 823 (79%) were vaccinated during the NIDs. Among those who had previously had a routine vaccination, 484 (81%) were revaccinated during the NIDs. Among those not previously vaccinated, 339 (78%) received one dose during the NIDs. After the campaign, 943 (91%) children had received at least one dose of measles vaccine. Better socioeconomic status was associated with a higher chance of having been vaccinated routinely, but it was not associated with NID coverage. CONCLUSION: The mass campaign enabled a substantial increase in measles vaccine coverage to be made because it reached a high proportion of children who were difficult to reach through routine methods.     

Coverages and factors associated with influenza vaccination among subjects with chronic respiratory diseases in Spain

BACKGROUND: The main influenza complications particularly affect patients over the age of 65 years and those with associated chronic diseases, such as respiratory disorders. This study aims to assess vaccination coverage among Spanish children and adults with chronic respiratory diseases (CRDs), and to describe the factors associated with vaccination in 2003. METHODS: We analysed 28,113 records of individuals (6869 children and 21,244 adults) included in the Spanish National Health Survey (NHS) for 2003. As a dependent variable, we used the reply ('yes' or 'no') to the question: 'Did you have a 'flu shot in the latest campaign?' We calculated influenza vaccine coverage as the percentage of individuals with a respiratory disorder (asthma and/or chronic bronchitis and/or emphysema) who reported having been vaccinated against influenza in the most recent campaign. We analysed the influence of sociodemographic, health-status, medical visits and lifestyle variables on vaccination. RESULTS: Vaccination coverage was 19.9% in children and 54.7% in adults suffering CRD. In both age groups, coverages were significantly higher than those observed for non-CRD sufferers. Among adults, older age, not smoking and medical visits to their physician in the preceding 2 weeks were the variables independently and significantly associated with a higher likelihood of receiving the vaccine. Among children, financial factors influence vaccination. CONCLUSIONS: Vaccination coverage among children with CRDs is very low. Also among adult CRD sufferers, vaccination remains below the desired level, thereby making it necessary for strategies to be implemented aimed at improving the use of influenza vaccine.