脊髓灰质炎疫苗免疫的研究 Ⅱ.不同剂型的脊髓灰质炎疫苗免疫应答的比较

在江苏武进县农村对2~6月龄未服过脊髓灰质炎疫苗易感儿中,比较液体Ⅰ型,糖丸Ⅰ型和三价糖丸疫苗免疫应答。3种疫苗3次免疫后,抗体阳转率均达到95~100%,无统计学显著性差异,抗体几何平均滴度以液体Ⅰ型最高,液体Ⅰ型与糖丸Ⅰ型、Ⅰ型糖丸与三价糖丸无显著性差异,但三价糖丸与液体Ⅰ型相比有显著性差异。鉴于2~4月龄婴幼儿服用糖丸十分不便,且不易保证服苗效果,建议生产厂家克服困难创造条件尽快将脊灰糖丸剂型改为液体剂型。     

麻疹疫苗及麻腮风联合疫苗免疫成功率监测分析

目的了解实施扩大儿童免疫规划所用麻疹疫苗及麻腮风联合疫苗的免疫效果,为消除麻疹、控制风疹及腮腺炎疫情提供参考依据。方法对120名8月龄儿童、117名18~24月龄儿童分别在麻疹疫苗及麻腮风联合疫苗免疫前及免疫后4周采集血清进行相关抗体测定。结果 8月龄婴儿的麻疹母传抗体已基本消失,麻疹疫苗初免后易感者麻疹抗体阳转率为100%。117名18~24月龄儿童在麻腮风联合疫苗复种前麻疹抗体阳性率已为99.15%,复种后抗体阳性率为100.00%,复种前麻疹抗体活性量为5 077.11 mIU/ml,复种后麻疹抗体活性量为14 410.57 mIU/ml;风疹和腮腺炎抗体阳转率分别为93.91%和96.46%。结论麻疹疫苗的免疫原性良好,现行的麻疹疫苗和8月龄免疫程序、免疫剂量是可行及有效的;麻腮风联合疫苗的复种是有意义的,它能大幅提高麻疹抗体水平,有效保护儿童免受麻疹、流行性腮腺炎、风疹病毒的侵袭。     

消灭脊髓灰质炎免疫方案应用效果

目的 :进一步了解消灭脊髓灰质炎免疫方案的应用效果。方法 :新生儿出生后即按计划免疫程序。 2、 3、 4月龄进行基础免疫 ,4岁龄前的每年 12月 5日和次年的 1月 5日进行 2个轮次的强化服苗 ;观察儿童分别在基础免疫前、后 ,4岁和 7岁龄时采血 ;用微量细胞法测中和抗体。结果 :1990年来疫苗效价 12个批次 ,其效价均符合疫苗总剂量的 5 .6 3;观察儿童经基础免疫后 , ～ 型中和抗体 10 0 %阳转 ,GMRT为 10 5 .93、 10 5 .93、 90 .5 7,强化免疫后 (4岁龄 )为 373.2 5、2 85 .4 8、 2 72 .89;其抗体滴度增长与基础免疫后相比 ,差异有非常显著性 (P<0 .0 1) ;7岁时 3个型中和抗体 GMRT已有下降 ,但其与基础免疫后相比 ,差异无显著性 (P>0 .0 5 )。结论 :国家实施的消灭脊髓灰质炎的疫苗免疫方案可在儿童中建立有效的免疫屏障     

口服三价混合脊髓灰质炎活疫苗免疫效果观察

对40名足三月龄未服苗的健康儿童进行免前及免后连续三次三价混合脊髓灰质炎减毒活疫苗效果观察,结果表明,第一次服苗效果不够理想,Ⅰ～Ⅲ型抗体几何平均滴度从免前3. 2、 3. 1、 2. 7分别升为14. 0、 7. 0、 9. 3,但经第二、三次免疫后抗体水平大幅度上升,Ⅰ型分别上升到107. 2、 589. 2,Ⅱ型上升为62. 3、 201. 7,Ⅲ型分别上升为54. 7和274. 3,抗体阳性率均达到10％,免前三个型均阳性的仅2. 5％,一、二、三次免疫后分别上升为65％、100％、100％。说明我国三价糖丸疫苗免疫效果是最好的,从足三月龄起连续服三次的现行免疫方案是可行的。     

脊髓灰质炎疫苗2种序贯免疫程序不同免疫剂次免疫效果的评估

目的评估脊髓灰质炎疫苗2种序贯程序下不同剂次的免疫效果,为新免疫策略和免疫程序制定提供依据。方法 2016—2017年随机抽取天津市适龄接种脊髓灰质炎疫苗的新生儿128人,分A、B、C 3组,A组42人,B组44人,C组42人。A、B 2组接种1剂脊髓灰质炎灭活疫苗(IPV)和2剂脊髓灰质炎减毒活疫苗(OPV)(I-O-O),C组接种3剂IPV(I-I-I)。各组研究对象分别于接种疫苗后不同时间点采血,采用微量中和试验进行抗体检测,并对抗体阳性率和抗体几何平均滴度水平(GMT)进行分析。结果接种1剂次IPV后,A组Ⅰ型、Ⅱ型、Ⅲ型脊髓灰质炎抗体阳转率分别为69.05%(29人)、71.43%(30人)、71.43%(30人)(P0.05),抗体阳性率分别为97.62%(41人)、95.24%(40人)、80.95%(34人),3型脊髓灰质炎抗体GMT间差异无统计学意义(P0.05);接种OPV2或IPV2后,除B组Ⅲ型阳性率为97.73%(43人)外,B组Ⅰ型、Ⅱ型及C组各型阳性率均达到100%,仅Ⅱ型脊髓灰质炎抗体GMT在B、C组间(B组357.42,C组172.28)差异有统计学意义(P0.05);按I-O-O完成全程接种后,A组各型脊髓灰质炎抗体阳性率均为100%,3型脊髓灰质炎抗体GMT分别为1 075.05、464.67、786.53(P0.05)。结论接种1剂次IPV或接种IPV1+OPV2后各型脊髓灰质炎抗体阳性率未全部达到100%,接种2剂次IPV后各型脊髓灰质炎抗体阳性率均可达到100%;I-O-O序贯程序可以诱导研究对象产生保护性抗体,但在降低脊髓灰质炎的发生可能性方面,I-I-O序贯程序优于I-O-O。     

乙肝疫苗与计划免疫“四苗”联合免疫的研究

为了解乙肝疫苗与计划免疫“四苗”联合免疫的免疫应答情况,我们对254各新生儿和婴儿进行了乙肝疫苗与计划免疫“四苗”联合免疫研究。结果表明,乙肝疫苗与长介苗(BCG)、脊髓灰质炎疫苗(TOPV)、百白破疫苗(DPT)、麻疹疫苗(MV)联合免疫后,结核菌素试验阳转率为78.69%;TOPVⅠ、Ⅱ、Ⅲ类抗体阳转率均在97.05～100%范围内;白喉、破伤风和百日咳抗体阳转率分别为100%、100%和77.27%;麻疹抗体阳转率为100%;抗-HBs阳转率为100%。实验组各抗体阳转率和抗体几何平均滴度亦达到满意的效果。     

不同月龄婴幼儿接种F基因型腮腺炎减毒活疫苗的免疫应答研究

目的探索不同月龄婴幼儿接种F基因型腮腺炎减毒活疫苗(Mumps attenuated live vaccine, MuV)后的免疫应答差异。方法招募无流行性腮腺炎疾病史且未接种过含腮腺炎成分疫苗的8-24月龄健康婴幼儿,接种F基因型MuV,采集免疫前和免疫后28d血标本,检测抗F基因型腮腺炎病毒中和抗体。结果分别招募8-12月龄、13-17月龄、18-24月龄健康儿童132名、104名、99名。3个年龄组儿童MuV免疫后抗F基因型腮腺炎病毒中和抗体阳性率分别为88.6%、90.4%、90.9%(χ~2=0.37,P=0.832),阳转率分别为87.9%、89.4%、89.9%(χ~2=0.27,P=0.874),几何平均滴度分别为1:5.88、1:7.12、1:6.83(H=1.25,P=0.536)。结论不同月龄婴幼儿接种F基因型MuV后均有良好免疫应答。     

金华市6-35月龄儿童肠道病毒71型灭活疫苗免疫原性监测北大核心

目的评价上市肠道病毒71型(Enterovirus 71,EV71)灭活疫苗的免疫原性。方法采用分层随机抽样方法选取金华市6-35月龄健康婴幼儿,接种2剂次EV71疫苗,检测免疫前和免疫后30-45d血清抗EV71中和抗体,分析免疫后抗体阳转率和几何平均滴度(Geometric mean titer,GMT)。结果受试者2剂次EV71疫苗免疫后抗EV71中和抗体阳转率为99.24%(362/364),GMT为1:117.06。6-11、12-23、24-35月龄儿童中和抗体阳转率分别为100%、98.39%、100%(Fisher精确概率法,P=0.244),GMT(1:)分别为103.28、123.95、163.61(F=0.32,P=0.728)。A、B、C生产企业EV71疫苗的中和抗体阳转率分别为100%、98.33%、100%(Fisher精确概率法,P=0.216),GMT(1:)分别为127.75、109.95、113.88(F=1.04,P=0.353)。结论金华市上市EV71疫苗在6-35月龄儿童中均具有良好的免疫原性;建议加强EV71疫苗接种宣传,提高适龄儿童接种率。     

金华市6-35月龄儿童肠道病毒71型灭活疫苗免疫原性监测

目的评价上市肠道病毒71型(Enterovirus 71,EV71)灭活疫苗的免疫原性。方法采用分层随机抽样方法选取金华市6-35月龄健康婴幼儿,接种2剂次EV71疫苗,检测免疫前和免疫后30-45d血清抗EV71中和抗体,分析免疫后抗体阳转率和几何平均滴度(Geometric mean titer, GMT)。结果受试者2剂次EV71疫苗免疫后抗EV71中和抗体阳转率为99.24%(362/364),GMT为1:117.06。6-11、12-23、24-35月龄儿童中和抗体阳转率分别为100%、98.39%、100%(Fisher精确概率法,P=0.244),GMT(1:)分别为103.28、123.95、163.61(F=0.32,P=0.728)。A、B、C生产企业EV71疫苗的中和抗体阳转率分别为100%、98.33%、100%(Fisher精确概率法,P=0.216),GMT(1:)分别为127.75、109.95、113.88(F=1.04,P=0.353)。结论金华市上市EV71疫苗在6-35月龄儿童中均具有良好的免疫原性;建议加强EV71疫苗接种宣传,提高适龄儿童接种率。     

河南油田10年间儿童计划免疫接种率抽样调查

目的:了解河南油田1995~2004年儿童计划免疫接种率,以指导今后儿童计划免疫接种工作。方法:应用SPSS11.0和Excel软件,对河南油田1995~2004年的儿童计划免疫接种率抽样调查资料进行统计汇总,并采用描述法进行分析。结果:12~24月龄儿童计划免疫建证率、建卡率为100%,疫苗接种率分别为卡介苗99.57%、脊髓灰质炎疫苗98.29%、百白破疫苗98.57%、麻疹疫苗98.14%、“四苗”全程覆盖率为96.10%,乙肝疫苗接种率为97.95%,乙肝疫苗首针及时接种率为86.68%。不同年份出生的儿童除百白破疫苗接种率差异无统计学意义外(χ2=13.54,P=0.14),卡介苗、脊灰炎疫苗、麻疹疫苗、“四苗”全程覆盖率、乙肝疫苗接种率和乙肝疫苗首针及时接种率等差异均有显著统计学意义(均P<0.05)。结论:河南油田1995~2004年儿童计划免疫接种率保持较高水平。     

Serological response and poliovirus excretion following different combined oral and inactivated poliovirus vaccines immunization schedules

A controlled study was conducted in Karachi, Pakistan to compare humoral and mucosal immune responses against polioviruses in infants who received oral poliovirus vaccine (OPV) at birth and at 6, 10, and 14 weeks according to the Expanded Program on Immunization (EPI) with infants who received either three doses of inactivated poliovirus vaccine (IPV) at 6, 10, and 14 weeks together with OPV or one additional dose of IPV at 14 weeks together, with the last dose of OPV. A total of 1429 infants were enrolled; 24-week serum specimens were available for 898 infants (63%). They all received a challenge dose of OPV type 3 at 24 weeks of age. The addition of three doses of IPV to three doses of OPV induced a significantly higher percentage of seropositive children at 24 weeks of age for polio 1 (97% versus 89%, P<0.001) and polio 3 (98% versus 92%) compared to the EPI schedule. However, the one supplemental dose of IPV at 14 weeks did not increase the serological response at 24 weeks. Intestinal immunity against the challenge dose was similar in the three groups. Combined schedules of OPV and IPV in the form of diphtheria-pertussis-tetanus-IPV vaccine (DPT-IPV) may be useful to accelerate eradication of polio in developing countries.     

Measuring hepatitis B uptake in a new universal infant program

BACKGROUND: Vancouver-Richmond Health Board has the highest reported rate of hepatitis B in Canada, including an annual average of 25 cases in children under 12 years of age, based on reports from 1994-1997 inclusive. The current provincial adolescent grade-six hepatitis B immunization program does not protect against childhood infection. The regional health board implemented universal infant hepatitis B immunization in September 1998. METHOD: Immunization coverage data were obtained on a random sample of 191 infants born in March 1999 one year after initiation of the program. RESULTS: By eight months of age, 97.9% of children had received some vaccinations. 73.8% of infants had received three doses of hepatitis B vaccine and 12.6% had received two doses. In comparison, 89% had received three doses and 7.9% two doses of DPTP-Hib vaccine. 13.1% of infants had not received any hepatitis B vaccine. For a majority (67%) of these children, their physician's lack of awareness or lack of acceptance of the program constituted the reason for no hepatitis B vaccine uptake. Only one parent cited adverse publicity as the reason for refusing vaccination. INTERPRETATION: This survey reveals a successful first year of the program without harm to the pre-existing childhood vaccination programs. Hepatitis B vaccine uptake can be improved by increased awareness among physicians and parents.     

Immunization coverage among predominantly Hispanic children, aged 2-3 years, in central Los Angeles

PURPOSE: To assess the immunization status of young children in a predominantly Hispanic region in and around downtown Los Angeles, and factors associated with complete immunization by age 24 months. METHODS: The information was gathered in a two-stage cluster survey with probability proportionate to estimated size (PPS) sampling of 30 clusters at the first stage, and simple random sampling of a constant number of children at the second stage. Vaccination coverage was determined by a review of the home immunization (HI) card, or of clinic records. RESULTS: Of the 270 sampled children, 91.5% were Hispanic and 6.7% were Black. Home telephone numbers were not available in 24.8% of the homes, and 34.1% reported having no health insurance. Vaccination coverage was over 90% for the first three doses of Diphtheria, tetanus toxoids and pertussis/ diphtheria, tetanus toxoids and acellular pertussis vaccine (DTP/DTaP)/Diphtheria and tetanus toxoids vaccine (DT), first two doses of poliovirus (Polio) vaccine, first dose of measles, mumps and rubella (MMR) vaccine, and first two doses of hepatitis B (Hep B) vaccine. Yet, by age 24 months, only 72.2% of the children had received the combined series of 4:3:1 (i.e., four DTP/DTaP/DT, three Polio, one MMR). This was further reduced to 64.4% for the combined series of 4:3:1:3:3 (i.e., four DTP/DTaP/ DT, three Polio, one MMR, three Haemophilus influenzae type b (Hib), three Hep B). Factors associated with completed on-time vaccination were having an HI card available during the interview and being enrolled in Supplemental Nutrition Program for Women, Infants and Children (WIC). CONCLUSIONS: While vaccination levels for individual antigens were found to be high, more emphasis needs to be placed on getting preschool children vaccinated on-time according to the Recommended Childhood Immunization Schedule.     

Immunization Status of Children Admitted to a Tertiary-care Hospital of North India: Reasons for Partial Immunization or Non-immunization

Reasons for the low coverage of immunization vary from logistic ones to those dependent on human behaviour. The study was planned to find out: (a) the immunization status of children admitted to a paediatric ward of tertiary-care hospital in Delhi, India and (b) reasons for partial immunization and non-immunization. Parents of 325 consecutively-admitted children aged 12–60 months were interviewed using a semi-structured questionnaire. A child who had missed any of the vaccines given under the national immunization programme till one year of age was classified as partially-immunized while those who had not received any vaccine up to 12 months of age or received only pulse polio vaccine were classified as non-immunized. Reasons for partial/non-immunization were recorded using open-ended questions. Of the 325 children (148 males, 177 females), 58 (17.84%) were completely immunized, 156 (48%) were partially immunized, and 111 (34.15%) were non-immunized. Mothers were the primary respondents in 84% of the cases. The immunization card was available with 31.3% of the patients. All 214 partially- or completely-immunized children received BCG, 207 received OPV/DPT1, 182 received OPV/DPT2, 180 received OPV/DPT3, and 115 received measles vaccines. Most (96%) received pulse polio immunization, including 98 of the 111 non-immunized children. The immunization status varied significantly (p<0.05) with sex, education of parents, urban/rural background, route and place of delivery. On logistic regression, place of delivery [odds ratio (OR): 2.3, 95% confidence interval (CI) 1.3–4.1], maternal education (OR=6.94, 95% CI 3.1–15.1), and religion (OR=1.75, 95% CI 1.2–3.1) were significant (p<0.05). The most common reasons for partial or non-immunization were: inadequate knowledge about immunization or subsequent dose (n=140, 52.4%); belief that vaccine has side-effects (n=77, 28.8%); lack of faith in immunization (n=58, 21.7%); or oral polio vaccine is the only vaccine required (n=56, 20.9%. Most (82.5%) children admitted to a tertiary-care hospital were partially immunized or non-immunized. The immunization status needs to be improved by education, increasing awareness, and counselling of parents and caregivers regarding immunizations and associated misconceptions as observed in the study.Key words: Child, Immunization, Vaccination, India     

An epidemic of poliomyelitis in southern Kerala

An epidemic of poliomyelitis was recognized in May 1987 when there was a sharp increase in the number of children with acute paralytic poliomyelitis admitted to the SAT Hospital in Trivandrum in Kerala State. From May through September, 392 cases were admitted; the total admitted cases in 1987 were 458 in contrast to 119 in 1986. Evidence for type 1 poliovirus infection was found in 33 (85%) of the 39 children in whom virological investigations were done during the epidemic. In addition, evidence for poliovirus type 3 infection was found in four children. Data on the immunization status was available on 231 affected children in the epidemic; 175 (76%) had not received oral polio vaccine (OPV); 55 (24%) had received one or two doses and only one child had received three doses. Thus, lack of immunization was a major risk factor for disease. The estimated vaccine coverage with three doses of OPV in Kerala, based on the quantity of vaccine distributed during the years 1985, 1986 and 1987 were 94%, 100% and 91%, respectively. This outbreak occurred in spite of high vaccine coverage, and it illustrates the need for even higher coverage rates; the usefulness of hospitals as sentinel surveillance centres; the need for decentralized vaccine coverage data in order to prevent build-up of unimmunized susceptible children in any region; and the urgent need of a mechanism to respond to an epidemic quickly, with immunization, in order to curtail it.     

儿童乙型肝炎疫苗免疫和加强免疫后保护性抗体观察

目的评价儿童乙型肝炎(乙肝)疫苗(HepB)免疫后保护性抗体应答水平及乙肝病毒表面抗体(抗-HBs)阴性儿童加强免疫后抗体的变化。方法采取多阶段整群系统抽样方法抽取调查单位和儿童,用固相放射免疫方法检测接种儿童血清乙肝病毒表面抗原(HBsAg)、抗-HBs和乙肝病毒核心抗体水平,并对抗-HBs阴性儿童进行加强免疫。结果3~12岁儿童抗-HBs平均阳性率为49.3%,几何平均浓度(GMC)为70.22毫国际单位/毫升(mIU/ml)。重组乙肝疫苗(酵母)免疫后3~6岁儿童抗-HBs阳性率为37.6%,随年龄增长而下降,GMC为55.29mIU/ml,各年龄组差异有非常显著的统计学意义。6~12岁儿童使用血源HepB,抗-HBs阳性率为51.0%,GMC为68.27mIU/ml,各年龄组差异无显著的统计学意义。抗-HBs阴性儿童加强免疫后抗体阳转率为93.9%,GMC为91.83mIU/ml。结论儿童HepB免疫后12年保护性抗体应答良好,HBsAg阳性率未随免疫时间延长而增加,目前尚不需进行加强免疫。抗-HBs阴性儿童加强免疫后有很好的回忆反应。     

Efficacy of oral poliovirus vaccine in rural communities of North Arcot District, India

The protective efficacy of three doses of oral poliovirus vaccine (OPV) was measured in children under five in the rural blocks of North Arcot District. In 1988, a sample survey of 7% of the total population of the district (population five million) was conducted to determine the immunization coverage with OPV and the incidence of paralytic poliomyelitis in under-fives in the previous 12 months, (n = 42,045). For every case of poliomyelitis, all children matched for exact age in months resident within the same block were taken as controls. Some 67 children had poliomyelitis (prevalence of lameness 1.59/1000, estimated annual incidence 2.57/1000 under-fives). Among cases and controls 24 and 42%, respectively, had received three doses of OPV, while 44 and 33% had received none. In a case-control analysis, the vaccine efficacy (VE) was 62% for all under-fives; for the 12-23 months age group it was 71.4%. For a vaccine with the potential of near 100% VE, this is disappointingly low. Obviously, not only the immunization coverage level, but also the VE should be enhanced if poliomyelitis is to be controlled in India. This may be achieved by a five-dose OPV schedule, annual OPV immunization campaigns in addition to the routine three-dose schedule or by using inactivated poliovirus vaccine of enhanced potency.     

克拉玛依市乙肝疫苗纳入儿童免疫规划后接种率调查与评价

目的评价克拉玛依市乙型肝炎（乙肝）疫苗纳入儿童免疫规划后的工作质量和效果。方法采用按容量比例概率抽样方法随机调查305名儿童乙肝疫苗（HB—VAX）接种情况；开展3岁以下儿童乙肝病毒感染标志的血清学监测；调查在医院出生的2500名新生儿首针HB—VAX接种情况。结果新生儿首针HB—VAX接种率为97．36％，及时接种率为95．12％；儿童首针及时接种率为75．74％，全程及时接种率81．97％，全程接种率88．52％，HB—VAX全程接种率和首针及时接种率均呈逐年上升趋势；HB—V．AX免疫后抗-HBs阳性率为93．45％。结论HB—VAX纳入儿童免疫规划工作后，有效提高了儿童HB—VAX接种率、首针及时接种率和全程及时接种率。但还应重视在家里出生的新生儿和流动儿童HB—VAX接种率的提高。     

Factors Influencing Childhood Immunization in Uganda

This paper investigates the factors associated with childhood immunization in Uganda. We used nationally-representative data from Uganda Demographic and Health Survey (UDHS) of 2006. Both bivariate and multivariate approaches were employed in the analysis. The bivariate approach involved generating average percentages of children who were immunized, with analysis of pertinent background characteristics. The multivariate approach involved employing maximum likelihood probit technique and generating marginal effects to ascertain the probability of being immunized, given the same background characteristics. It revealed that slightly over 50% of children in Uganda were fully immunized. Additionally, 89%, 24%, 52%, and 64% received BCG, DPT, polio and measles vaccines respectively. Factors which have a significant association with childhood immunization are: maternal education (especially at post-secondary level), exposure to media, maternal healthcare utilization, maternal age, occupation type, immunization plan, and regional and local peculiarities. Children whose mothers had post-secondary education were twice as likely to be fully immunized compared to their counterparts whose mothers had only primary education (p<0.01). Thus, gender parity in education enhancement efforts is crucial. There is also a need to increase media penetration, maternal healthcare utilization, and to ensure parity across localities and regions.Key words: BCG vaccine, DPT vaccine, Polio vaccine, Full immunization, Measles vaccine, Uganda     

山东省儿童乙肝疫苗接种率及其影响因素调查

[目的]了解山东省儿童乙肝疫苗接种率及其影响因素.[方法]1999年9月,采用世界卫生组织推荐的分层多阶段按容量比例概率随机抽样方法(PPS),在山东省城乡105个县(市、区)抽取840名1997年1月1日至12月31日出生的儿童,对其进行乙肝疫苗接种率及其影响因素的调查.[结果]840名儿童中,707名在1岁内完成3针乙肝疫苗的全程接种,接种率为84.17%.经单因素卡方分析发现,平原、经济收入低的农村地区,父母为农民、母亲文化程度为初中以下、儿童自费医疗保健、未参加计划免疫保偿、家长缺乏乙肝预防知识、在家出生、看护人认为乙肝疫苗价格高、乙肝疫苗一次性收费、第1针乙肝疫苗不在医院接种等因素,均影响乙肝疫苗接种率的提高.多因素Logistic回归分析发现,女童、自费医疗保健儿童、乙肝疫苗接种卡证登记不全、看护人缺乏乙肝疫苗接种知识、家长对儿童接种乙肝疫苗自觉性低、接种乙肝疫苗一次性收费及没有在医院接种第1针乙肝疫苗等因素,影响儿童乙肝疫苗接种率的提高.[结论]影响儿童乙肝疫苗接种率的主要因素是对乙肝预防知识了解不够.因此,加大乙肝疫苗接种的宣传力度,使群众了解预防乙肝的重要性,是提高乙肝疫苗接种率的关键.