当前国内季节性流感疫苗与新型冠状病毒肺炎疫苗同时接种的思考

流感是一种由流感病毒引起的传染性呼吸道疾病。老年人、婴幼儿和患有基础疾病人群,出现严重临床症状和并发症的风险更高。新型冠状病毒与流感病毒的共同感染和流行可导致新型冠状病毒肺炎的预防、诊断、控制、治疗和康复复杂化。季节性流感疫苗和新型冠状病毒肺炎疫苗在目标人群、接种时间、接种单位都有重叠,虽然目前流感疫苗与新型冠状病毒肺...     

海曙区老年人群肺炎疫苗接种意愿及影响因素分析

目的了解海曙区家庭医生签约门诊老年人群肺炎疫苗接种意愿及影响因素。方法采用分层随机抽样方法对宁波市海曙区两个社区卫生服务中心和两个镇卫生院签约门诊管理的65岁以上老年人进行肺炎疫苗接种意愿调查,对数据进行χ~2检验、二分类多因素Logistic回归分析。结果在568名调查对象中,32.92%签约门诊老年人表示愿意接种肺炎疫苗,5.99%签约门诊老年人表示曾经接种了肺炎疫苗。多因素Logistic回归分析结果显示,65～74年龄组、有医保历年余额、有肺炎疫苗免疫史、有流感疫苗免疫史、两种以上慢性病患病史、签约门诊医务人员推荐接种是老年人群肺炎疫苗接种意愿的影响因素。结论海曙区家庭医生签约门诊老年人群肺炎疫苗接种意愿较低,应开展肺炎疫苗接种知识宣传、签约门诊肺炎疫苗接种健康处方等干预措施提高老年人群的肺炎疫苗接种意愿,从而提高老年人群的肺炎疫苗接种率。     

上海市闵行区50岁以上人群流感、肺炎、带状疱疹疫苗接种意愿及其相关因素分析

目的:了解上海市闵行区50岁以上人群对流感、肺炎、带状疱疹及其疫苗的认知程度,分析不同支付情景下的接种意愿及其相关因素。方法:于2020年12月,采用分层随机抽样的方法,将上海市闵行区13个街道/镇的1 672名50~69岁人群纳入研究。采用问卷调查的方法收集调查对象基本情况,流感、肺炎、带状疱疹及其疫苗的认知水平、接...     

上海市老年人肺炎疫苗接种意愿及影响因素分析

目的了解上海市老年人肺炎疫苗接种的意愿,分析影响接种的因素,为制定相关的干预措施,提高老年人肺炎疫苗接种率,降低社区老年人肺炎球菌相关疾病的发生提供依据。方法通过分层随机抽样的方法,选取年龄≥60岁上海市户籍老年人,自拟《老年人群肺炎疫苗知晓情况及接种意愿调查表》进行问卷调查,采用多元Logistic回归分析方法,分析接种肺炎疫苗意愿的影响因素。结果共有3 569名调查对象完成问卷调查(合格率96.41%);36.0%(n=1 283)老年人表示愿意接种肺炎疫苗。多因素Logistic回归分析显示,高年龄组接种意愿低(OR=0.37,95%CI:0.28~0.51),不认为肺炎是一种严重疾病组接种意愿低(OR=0.81,95%CI:0.66~0.99),不认为肺炎可以被预防组接种意愿低(OR=0.61,95%CI:0.47~0.80)。结论老年人对肺炎疫苗的认知是影响其是否愿意接种的重要因素,对肺炎疫苗加强针对性的宣传对提高肺炎疫苗接种率具有重要作用。     

老年人群肺炎疫苗接种的影响因素分析

目的研究影响老年人接种肺炎疫苗的因素．提出促进老年人疫苗接种的策略和政策性建议。方法对与老年人接种肺炎疫苗的相关人群包括医务人员、街道市政科工作人员及预防接种门诊工作人员进行一对一深入访谈。结果除预防接种门诊工作人员外，其余相关人群对肺炎疫苗认知度低，影响肺炎疫苗接种的主要原因是宣传力度不够和疫苗价格太贵。结论加强有针对性的宣传对促进肺炎疫苗的接种具有重要作用。降低价格、纳入医保对肺炎疫苗的接种也具有促进作用。     

东营市东营区流感季初中及以下学生流感疫苗接种现状及影响因素分析

目的 了解东营市东营区流感季初中及以下学生流感疫苗接种现状,探讨影响学生流感疫苗接种的主要因素。方法 于2023年3-4月通过问卷星平台,使用电子问卷对东营市东营区4家数字化预防接种门诊辖区的初中及以下学生家长进行流感疫苗接种认知现状问卷调查,收集接种流感疫苗情况、家长性别、学校类别、户籍所在地、是否独生子女、家长与学生关系、家长年龄、家长职业、家长文化程度、家庭平均月收入、是否担心新冠与流感双流行等信息,采用多因素logistic回归分析影响学生流感疫苗接种的因素。结果 调查共回收合格问卷1 818份,其中曾为学生接种过流感疫苗的占比39.93%(726/1 818)。不同学校类别(χ²=26.858,P<0.001)、户籍所在地(χ²=5.113,P=0.024)、家长职业(χ²=124.133,P<0.001)及文化程度(χ²=62.848,P<0.001)、家庭平均月收入(χ²=27.619,P<0.001)、是否担心新型冠状病毒(以下简称新冠)...     

我国规划疫苗接种现状和影响因素浅析

国家免疫规划是预防疾病、拯救人类生命,积极预防病痛,并且为全球健康率提升做贡献的一项重大措施。本文详细对国家免疫规划疫苗接种现状进行分析,而后提出导致现状的各个影响因素,希望可以在以后规划疫苗接种工作中,将各个影响因素放置在较为重要的地位,促使规划疫苗接种率进一步提高,从而妥善完成规划疫苗接种工作,也可为我国五位一体布局工作的顺利完成做出一定保证。     

健康干预对老年人肺炎疫苗接种意愿的影响

目的探讨健康干预对改变老年人肺炎疫苗接种意愿的影响,为相关卫生主管部门制定老年人肺炎球菌疾病防治策略提供参考。方法以分层整群抽样的方式,选择佛山市四区居住半年以上、≥60岁且自愿参加调查的老年人作研究对象,对其进行社区健康干预并采用自制调查表进行干预前后调查。用配对2χ检验、秩和检验、logistic回归分析方法,分析健康干预对老年人肺炎疫苗接种意愿的影响及相关情况。结果以老年人为对象的社区健康干预对老年人接种肺炎疫苗的意愿改变有效果,对收入低、以从事体力劳动为主的老年人效果更明显。结论应注意利用老年人喜闻乐见、易于接触的信息渠道,宣传肺炎及其疫苗的相关知识,明确疫苗对老年人保护作用,提高老年人自我保健意识。     

我国第二类疫苗接种现状及其影响因素研究进展

了解本区非国家免疫规划（NIP）疫苗接种情况,为进一步加强预防接种服务管理和指导社区卫生服务中心开展儿童和成人预防接种门诊建设提供参考。

通过上海市预防接种信息系统收集长宁区社区卫生服务中心2016—2020年非NIP疫苗接种剂次数,并应用描述性方法进行流行病学分析。

2020年长宁区社区卫生服务中心非NIP疫苗接种剂次数、接种剂次数占比和人均接种剂次数分别达115 361剂、63.41%和1 664.54/万人口,非NIP疫苗接种剂次数占比呈明显上升趋势（

Influenza vaccination coverage of population and the factors influencing influenza vaccination in mainland China: A meta-analysis

IntroductionThe best way to prevent influenza is receiving vaccination. However, the influenza vaccination coverage in mainland China was low. A meta-analysis was conducted to estimate the vaccination rates of the population and the factors influencing influenza vaccination in mainland China.MethodsA systematic study was conducted on March 18, 2018, using Chinese language databases including China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, WanFang Database, and English language databases including PubMed, Web of Science, and Cochrane Library. Based on the inclusion and exclusion criteria, the pooled coverage rate and estimated odds ratios (OR) of influencing factors were obtained using data abstraction. Subgroup analysis and meta-regression analysis were also employed to explore the heterogeneity.ResultsThe pooled vaccination coverage rate in 126 included articles was 23.2% (95% confidence interval (CI): 22.8%, 23.7%), and the pooled vaccination rate among the general population was 9.4% (95% CI: 8.0%, 10.9%). The influenza vaccination rate fluctuated from 2005 to 2017. Vaccination rates in 2009–2010 were much higher than other years, pandemic influenza vaccination rate was 37.3% (95% CI: 28.4%, 46.1%) and seasonal influenza vaccination rate was 29.8% (95% CI: 24.6%, 34.9%). In the analysis of influencing factors, those recommended by healthcare workers was the most reported reasons for influenza vaccination with an OR = 5.2 (95% CI: 2.9, 9.4), and following as received influenza vaccination previously, perceived safety of vaccination, perceived effectiveness of vaccination, perceived severity of the disease. Meta-regression analysis indicate that the heterogeneity maybe significantly consistent with the sample size, study population, study region, and vaccination policy.ConclusionCompared with other countries (the United States), vaccination rates were lower in mainland China. There were a few factors influencing the rate, which included vaccination policy, vaccination history and knowledge and attitudes toward influenza and vaccination.     

青海省西宁市医院临床医护人员2016－2017年度流感疫苗接种情况及影响因素分析

目的 了解青海省西宁市临床医护人员2016-2017年度流感疫苗的接种情况及影响因素,初步探索推动西宁市临床医护人员流感疫苗接种措施。方法 随机抽取西宁市4家三级医院,在知情同意的原则下自愿参与完成自填式问卷调查,并访谈医院相关负责人。结果 西宁市三级医院临床医护人员2016-2017年度流感疫苗接种率为5.14%（95%CI：4.80%~5.49%）,多因素分析显示,流感疫苗优先推荐接种人群、接种频次,接种效果的知晓以及职称是主要影响因素。接种组向他人推荐流感疫苗的意愿高于未接种组（χ²=99.57,P<0.001）。结论 西宁市医院临床医护人员流感疫苗接种率低,主要与流感疫苗的认知不足有关。应开展宣传教育,充分发挥示范和影响作用。     

我国6个省份全人群流感疫苗接种及认知情况调查

目的 了解调查地区全年龄组人群流感预防知识的认知及流感疫苗接种情况，探索影响流感疫苗接种的相关因素。方法 采用横断面调查设计，选择北京市、内蒙古自治区、上海市、广东省、云南省和甘肃省6个省份，通过12320卫生热线采用随机数字表拨打电话的抽样方法，于2018年3-5月开展全年龄组人群的流感防控知识、流感疫苗接种情况的电话调查，调查估计样本量为9 438人。结果 本调查应答率为46.4%（10 045/21 658），10 045名调查对象中，"流感和普通感冒有区别"的知晓率为75.3%（7 564/10 045），"流感病毒会引起严重后果"的知晓率为82.0%（8 241/10 045）。出现流感样症状后采取频繁洗手、戴口罩和自我隔离的健康行为率分别为80.4%（7 936/9 873）、75.8%（7 506/9 899）和73.6%（7 228/9 822）。最近1年流感疫苗接种率为5.7%（570/10 037）。最近1年流感疫苗接种率的相关多因素logistic回归分析结果显示，调查对象来自甘肃省或北京市、职业是医务人员或全日制学生、调查对象共同居住人数≥ 2人、出现流感样症状后戴口罩，最近1年流感疫苗接种率相对较高。结论 6个省份调查对象流感相关知识的知晓率、出现流感相关症状后的健康行为率和最近1年流感疫苗接种率均有待进一步提高。应加强流感预防知识和疫苗接种的健康教育，探索流感疫苗免费接种策略。     

上海市静安区社区医务人员流感疫苗接种率及其影响因素

目的 了解上海市静安区社区医务人员流感疫苗接种率及其影响因素.方法 2019年4月,对上海市静安区共15家社区卫生服务中心的所有医务人员进行问卷调查,采用x2检验和多因素Logistic回归分析模型对流感疫苗接种率的影响因素进行单因素和多因素分析.结果 上海市静安区社区医务人员流感疫苗接种率为14.57％,多因素Log...     

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.     

Effectiveness of pneumococcal polysaccharide vaccine against pneumonia and cost analysis for the elderly who receive seasonal influenza vaccine in Japan

To determine the clinical efficacy and cost-saving effect of pneumococcal polysaccharide vaccine (PPV) against community-acquired pneumonia (CAP), an open-label, randomized clinical trial was conducted involving 786 Japanese subjects older than 65 years of age receiving a routine influenza vaccine during the 2-year period. Study subjects were randomly assigned to either a PPV group (n = 394) or to a non-PPV group (n = 392). The incidence, admission and the medical cost for all-cause pneumonia were compared between these two groups. PPV vaccination significantly reduced the incidence of admission for all-cause pneumonia for subjects older than 75 years of age (41.5%, P = 0.039) and for those who had difficulty walking (62.7%, P = 0.005), but not for all study subjects older than 65 years of age (P = 0.183), for the 2-year period. The Kaplan–Meier survival curves for subjects who had difficulty walking free from all-cause pneumonia demonstrated a significant difference (P = 0.0146) between the two groups. PPV vaccination significantly reduced medical costs for all study subjects during the first year period (P = 0.027). Our present data demonstrated that PPV was effective for all-cause pneumonia for study subjects older than 75 years of age, although the effect was not significant for all study subjects older than 65 years of age.     

1 999例0～2岁儿童BCG接种情况及影响因素分析

目的 了解北京市常营社区0-2岁儿童卡介苗（bacillus calmette-guerin vaccine,BCG）接种情况,分析影响接种率的因素,为提高BCG的接种率和及时接种率提供参考。方法 收集母亲孕期管理在常营社区卫生服务中心、分娩日期为2015年1月1日～2016年12月31年、北京分娩、且在北京预防接种BCG的儿童相关接种资料及母亲围产保健资料,计算研究对象BCG接种率和及时率,使用Logistic回归分析影响接种率和及时接种率的因素。结果 北京市常营社区0～2岁儿童BCG接种率为98.8%,及时接种率为86.84%。2016年出生、早产、低出生体重、剖宫产是影响BCG接种率的危险因素;早产、低出生体重、产时有并发症以及剖宫产是影响BCG及时接种率的危险因素。结论 北京市常营社区0～2岁儿童卡介苗接种率和及时接种率仍然有提升空间,加强妇女孕期保健、减少妊娠并发症及不良妊娠结局可以提高儿童BCG的接种率和及时接种率。     

中国流感疫苗应用现状及促进预防接种的政策探讨

流感是一种疫苗可预防性疾病,每年接种流感疫苗是预防流感及其并发症的最有效手段。流感疫苗在我国是二类疫苗,年平均接种率仅2%~3%。接种率低的原因包括公众对流感和流感疫苗认知不足、医务人员极少推荐、接种服务可及性和费用等。为促进我国流感疫苗的预防接种,降低流感对公众的健康危害和经济负担,应考虑采取综合政策措施积极推动流感疫苗预防接种工作,包括采用不同筹资方式和机制,提高重点人群的接种意愿和接种率、改进免疫服务公平性的效果和效率;提高医务人员和公众对流感和疫苗预防的认识,改进临床预防实践,通过制订临床指南、路径、专家共识等多种渠道,推动临床医生对流感疫苗预防接种建议的推荐;加快预防接种工作体系建设,为公众提供更方便、可及和规范的预防接种;加大新型流感疫苗研发支持力度,加快新型流感疫苗上市应用;修订我国药典中"妊娠期妇女为流感疫苗接种禁忌"的条款。     

Attitude,knowledge and factors associated with influenza and pneumococcal vaccine uptake in a large cohort of patients with secondary immune deficiency

BackgroundImmunocompromised patients are at increased risk for severe influenza and invasive pneumococcal diseases. Population-specific vaccine recommendations are thus warranted. This study aimed to estimate the prevalence and predictors of influenza and pneumococcal vaccine uptake in a large cohort of patients with secondary immune deficiency.MethodsAn anonymous online survey was submitted to the members of 11 French associations of immunocompromised patients. The questionnaire included questions concerning underlying disease, care and treatment, flu and pneumococcal vaccine uptake, attitudes and knowledge about vaccination. Factors associated with vaccine uptake were assessed by multivariate logistic regression.ResultsAmong the 10,897 solicited patients, 3653 agreed to participate (33.5%): 75% were female, 20% aged 65+, 79% were followed for an autoimmune disease, 13% were solid organ recipients or waiting for transplantation and 8% were treated for hematological malignancies. 3109 (85%) participants were treated with immunosuppressive therapy. Self-reported vaccine uptake was 59% (95%CI [57–60]) against seasonal influenza and 49% (95%CI [47–50]) against pneumococcal diseases. Better knowledge of and favorable attitudes toward vaccination were positively associated with vaccine uptake while being treated with a biological therapy was negatively associated.ConclusionDespite specific recommendations regarding immunocompromised patients, influenza and pneumococcal vaccination rates do not reach recommended levels. Targeted information campaigns on vaccination toward these populations should be implemented to improve vaccine coverage and thus reduce the burden of infections.     

A formative research-guided educational intervention to improve the knowledge and attitudes of seniors towards influenza and pneumococcal vaccinations

BackgroundAdult influenza and pneumococcal vaccination rates in Singapore are low, and factors influencing knowledge and attitudes of seniors towards influenza, pneumonia and their respective vaccines are not well-known. Our study aims to understand the barriers and facilitators towards getting influenza and pneumococcal vaccinations among seniors in Singapore, and subsequently inform the conduct of a relevant community-based educational intervention, as well as evaluate the intervention outcomes.MethodsWe performed a mixed methods study with two components: Firstly, formative research was conducted among community-dwelling seniors, using focus group discussions (FGDs), to understand their knowledge and attitudes towards influenza, pneumonia and their respective vaccines. Next, a quantitative study was conducted to evaluate knowledge of seniors and the effectiveness of an educational intervention.ResultsFour FGDs were organised with 32 participants, who were predominantly female, of lower educational background, and residing in government rental flats. Participants had varying levels of knowledge and many misconceptions about influenza, pneumonia and their respective vaccinations, with concerns about side effects and vaccine effectiveness. The formative research results were used to inform a community-based educational intervention for seniors. Our subsequent evaluation included 604 elderly participants, mainly from lower educational and socio-economic strata, who initially demonstrated poor knowledge scores (median score 5 out of 9, IQR 4-5). Following our intervention, median knowledge score improved to 7 (IQR 6-8) (p < .0001). Significant improvements in knowledge scores were observed across genders, age strata, education levels, and housing types.DiscussionOur formative research identified knowledge gaps among community-dwelling seniors which affected their attitudes towards vaccination uptake. Key findings were taken into consideration when implementing the educational intervention. Our community-based intervention was effective in improving knowledge and attitudes, and could be used as a cue to action for short-term behaviour changes.