2016年郑州市免疫规划服务体系建设现状分析

目的了解郑州市当前免疫规划服务工作现状以及预防接种工作中存在的主要问题,为建设完善的免疫规划服务体系提出合理的建议。方法采用描述性分析方法,用Excel2003对数据进行统计分析。结果郑州市有207家预防接种门诊,其中省级示范预防接种门诊占接种门诊的42.51%,从事免疫规划管理人员和业务人员共1 391人。儿童预防接种信息化管理已覆盖全市所辖县(市、区)及乡镇,麻疹等疫苗针对传染病得到有效控制。结论郑州市完成了免疫规划服务体系的基础建设,但仍需按照新修订的《疫苗流通和预防接种管理条例》和《预防接种工作规范(2016年版)》的要求,加大免疫规划保障的财政投入,增加冷链系统设备和免疫规划工作人员数量,适时增加社区卫生服务中心设置,加大对流动儿童的管理力度,从而来提高免疫规划服务水平。     

2016年某市免疫规划及预防接种门诊室现况调查

目的 调查2016年普宁市免疫规划及预防接种门诊室现况, 为加快该市免疫规划建设提供参考。
方法 2016年对随机选取的该市4个区预防接种门诊室情况进行全面调查, 收集预防接种门诊室人员基本情况、门诊室面积以及人员配备情况、门诊室接种天数、总接种量以及日均接种量, 对结果进行统计分析。
结果 该市4个区预防接种门诊室共有234名免疫规划人员, 职称基本以初级为主。4个区预防接种门诊室完全达标率为50.0%~71.4%。4个社区预防接种门诊室接种时间、日均接种例数差异无统计学意义(P>0.05)。
结论 该市4个区预防接种门诊室达标情况、人员配备情况不理想。应进一步增加预防接种门诊室建设经费投入, 提倡数字化、信息化建设, 提高免疫规划及预防接种质量。
     

寿宁县规范化预防接种门诊建设的做法与体会

[目的]为提高我县儿童计划免疫接种率,提高预防接种质量,确保接种安全有效,实现免疫规划工作由数量型向质量型的转变,管理工作制度化、规范化、标准化和程序化。[方法]按《宁德市规范化预防接种门诊建设验收标准》要求,结合我县实际,对13个预防接种门诊进行标准化建设。[结果]13个预防接种门诊服务设施完善,管理制度和操作技术规范,全部通过市卫生局考核验收。[结论]儿童计划免疫预防接种规范化建设,可统一预防接种工作秩序,创建优美舒适、技术精良和安全可靠的环境。     

全球成年人疫苗免疫策略和研究进展

预防接种工作是儿童及成年人预防相关传染病经济、有效的措施。目前,全球成年人传染病的疾病负担仍然很重,随着疫苗的不断研发和更新,预防接种在成年人相关疾病中显示出巨大的潜力,可以进一步降低成年人传染病的发病率和死亡率,提高生活质量。本文通过对成年人免疫现状、代表性国家的免疫策略、不同成年人疫苗接种的免疫策略以及成年人免疫的优势和挑战等多方面进行综述,旨在为进一步探讨成年人免疫策略、完善成年人疫苗接种提供方向。应重视不同成年人群的免疫策略,采取有效措施,提高疫苗接种率,更好地保障人群生命与健康。     

预防接种信息化及短信预约使用效果分析

目的分析预防接种信息化及短信预约使用常态化后,顺昌县免疫规划疫苗接种率的变化情况,探讨预防接种信息化及短信预约使用对接种率的影响。方法按容量比例概率抽样法(PPS),分别于2011年和2014年2次入户开展疫苗接种及时率调查,进行基础免疫和加强免疫接种率比较分析。结果预防接种信息化及短信预约使用常态化后,8种基础免疫疫苗及时接种率均有提高;6月龄后疫苗及时接种率均有提高;6种加强针接种率均提高;上传接种信息和发送短信频数逐年增加。结论开展儿童预防接种信息化建设,运用网络技术科学管理是提高免疫规划工作质量和整体效益、实现现代化管理的必要手段。     

基层预防接种门诊改造经验探讨

[目的]探讨基层预防接种门诊改造。[方法]实行基层预防接种门诊改造前后进行对比。[结果]实行基层预防接种门诊改造可改美善预防接种门诊的环境,扩大了宣传面,儿童家长的参与意识得到增强,儿童预防接种及时率、有效率得到提高,接种反应发生率控制在较低的水平。[结论]预防接种门诊改造是今后推行计划免疫集中接种工作的必然趋势。     

湖南省基层计划免疫工作现状调查分析

目的 了解基层计划免疫工作现状，调查分析工作中存在的主要问题，为改善免疫服务行为、提高预防接种质量提供决策依据。方法 采用按容量比例概率法(PPS法)抽取30个乡镇，对适龄儿童计划免疫疫苗接种质量及基层计划免疫管理、接种单位服务质量进行调查、分析。结果 BCG合格接种率为96．2％，OPV合格接种率为94．1％，DPT合格接种率为92．2％，MV合格接种率为91．7％，“四苗”全程合格接种率为87.1％，乙肝疫苗合格接种率为78.6％；适龄儿童建卡率为94．1％；建证率为76．7％；乡级按要求上报常规免疫报表的占56.6％；乡村医师预防接种能够做到一人一针一管的占77．5％。结论 要通过加大计划免疫经费投入，开展预防接种单位与人员的规范化管理，进行预防接种人员技术培训，在预防接种工作中推广应用自毁型注射器，加强计划免疫督促检查与考核等综合措施来进一步提高全省计划免疫工作质量。     

宁化县预防接种规范化门诊建设做法和体会

[目的]为提高我县儿童计划免疫接种率,提高预防接种质量,确保接种安全,实现儿童计划免疫管理制度化、操作程序化、资料档案化、建设标准化.[方法]按《福建省规范化预防接种门诊评审标准》（试行）要求,结合我县实际,通过对我县16个预防接种门诊进行标准化建设,加强督导,作出评估.[结果]我县16个预防接种门诊服务设施得到完善,管理制度和操作技术更加规范,已完成10个接种单位规范化门诊建设.[结论]儿童计划免疫规范化门诊建设统一了预防接种工作秩序,创造了一个优美舒适的服务环境,赢得了群众的信任.     

连云港市2008年免疫规划工作综合审评情况分析

[目的]了解连云港市2008年免疫规划工作现状,发现存在的问题,促进免疫规划工作可持续发展.[方法]对所辖8 个县区免疫规划工作的有关扩大儿童免疫规划培训及实施、计划免疫现场督导、儿童预防接种信息管理系统使用、接种率等进行调查,采用描述流行病学方法进行分析. [结果]经费投入不足,只有灌南增拨到位15万元;儿童预防接种信息化建设发展不平衡,新浦、灌云、灌南等县区硬件设施仍未配备到位,一些硬件配备到位的接种门诊还未正式使用软件,多为门诊接种后补录数据;预防接种服务管理工作薄弱,计免门诊现场督导不合格的预防接种单位占25%,以上各种因素是影响连云港市免疫规划工作正常发展的症结所在. [结论]加大免疫规划相关法规的宣传以及免疫规划配套政策的制定和执行力度,并采取有效的措施将免疫规划工作的各项任务层层落实,是提高免疫规划工作水平的关键.     

贵州省少数民族地区加强常规免疫服务效果评价

目的 评价贵州省少数民族地区加强常规免疫服务策略的实施效果.方法 采用队列研究,设计统一调查表,对剑河、台江、罗甸、长顺4个试点县,在实施加强常规免疫服务策略前后,通过询问儿童监护人并核对预防接种证和预防接种卡的方法调查儿童免疫规划疫苗基础免疫覆盖率,通过问卷调查儿章监护人预防接种知识、态度、行为(KAP).结果 2008年效果评估中,儿童建预防接种卡、证率,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)5种疫苗的基础免疫覆盖率,HepB首针(HepB1)及时接种率和卡疤率均比2006年基线调查结果有不同程度提高;儿童住院分娩比例、儿童监护人预防接种KAP知晓率较2006年也呈升高趋势.结论 对基层防保人员进行反复培训,对基层工作开展经常性检查指导,加强与相关部门合作,开展有针对性的宣传活动,是少数民族地区提高常规免疫服务质量的有效策略.     

Lebenslanges Impfen

The importance of vaccinations during childhood as a basic element of health care is universally accepted. In contrast a discrepancy can be found in Europe between vaccination recommendations for older people and the actual vaccination rates despite strong evidence for the effectiveness of immunization against the flu, pneumococcal diseases, and other vaccine-preventable infectious diseases. Older Europeans are not sufficiently inoculated against these diseases and thus are not adequately protected. A crucial goal for European health care policy is thus to develop strategies to overcome barriers to vaccination.This brief report summarizes the methods applied worldwide to promote vaccination and lists measures that decision makers should take to improve vaccination rates and thus support healthy aging. The four strategic goals are: (1) promotion of lifelong vaccination programs to lower the burden of disease due to vaccine-preventable infectious diseases and foster healthy aging; (2) improve vaccination rates among medical personnel and strengthen their decisive role as vaccination providers; (3) broaden the range of vaccinations offered to patients; and (4) improve information given to patients and their knowledge.     

Strategies to improve vaccination uptake in Australia,a systematic review of types and effectiveness

Objective: To identify and critique interventions to improve vaccination uptake in Australia. Methods: Peer‐reviewed and grey literature from 1997 to May 2011 was searched to identify evaluations of one or more interventions to improve vaccination uptake among any target group in Australia. Studies were categorised by intervention type and target group. Recommended tools for assessing quality in public health interventions were used in the methodological critique of included studies. Results: Forty‐nine studies met the inclusion criteria, two‐thirds of which were published in peer‐reviewed journals. Evidence for strategies that increase community demand for vaccination was most common. Multi‐component strategies, patient and provider reminders, plans for catch‐up vaccination and accelerated schedules were identified as most effective. There was a lack of evidence for strategies to improve coverage in Aboriginal and Torres Strait Islander peoples, behaviourally at‐risk groups and pregnant women. Major limitations of identified studies were the lack of baseline coverage for comparison, limited use of controlled designs and measurement biases. Conclusion: The evidence, while limited, suggests that the most effective strategies are those which increase community demand for and enhance access to vaccines. Strategies to increase vaccination uptake are infrequently and often inadequately evaluated, despite the need for evidence to support their use. Implications: The results of this review, used in conjunction with international evidence, can guide those desiring to improve the performance of vaccination programs and suggest priorities for future evaluation of strategies to improve vaccination uptake.     

深圳市宝安区西乡社区儿童水痘疫苗接种率及影响因素分析

[目的]了解社区儿童水痘疫苗接种情况及其影响因素,探讨社区儿童水痘疫苗接种效果,提高疫苗接种率。[方法]2009年9-10月,对深圳市宝安区西乡预防保健所辖区街道1-10岁儿童进行调查。[结果]调查490名儿童,水痘疫苗接种率为47.55%。接种水痘疫苗后1个月至10年间,接种组水痘及轻型皮疹、重型皮疹、发热发生率分别为13.30%、10.30%、3.00%、11.59%,未接种组分别为37.96%、26.45%、10.51%、30.74%,接种组均低于未接种组（P〈0.01）。多因素非条件Logistic回归分析结果显示,本地户籍、家庭月人均收入≥3 000元、医院分娩的儿童水痘疫苗接种率较高（OR=2.34,1.68,3.42,P〈0.01）。[结论]社区儿童的水痘疫苗接种率较低,应加大水痘疫苗知识的宣传,提高各人群对水痘疫苗的认识,提高接种率,有效预防水痘疾病的发生。     

SIRVA (Shoulder Injury Related to Vaccine Administration) following mRNA COVID-19 Vaccination: Case discussion and literature review

Shoulder injury related to vaccine administration (SIRVA) is an increasingly recognised complication after vaccination and presents with significant shoulder pain and stiffness. SIRVA is thought to occur as a result of improper administration of vaccine into the subdeltoid bursa or shoulder joint. This results in an inflammatory cascade that damages the structures in the shoulder region. The incidence of SIRVA is relatively higher for influenza vaccination due its widespread administration. We present a reported case of SIRVA following a mRNA COVID-19 vaccination and review the current literature. As we embark on a worldwide scale of COVID-19 vaccination, it is of utmost important that we use proper vaccination techniques and screen patients at risk of SIRVA. This would improve the efficacy of the vaccine and improve the outcomes of the vaccination programme.     

Vaccination by muscle electroporation: the injury helps

Electroporation has been widely adopted in gene therapy and vaccination processes. Improving the vaccination efficiency has been constant question for both basic research and clinical studies. Recent evidences suggest that the EP-induced muscle injury contribute to the high vaccination efficiency by muscle electroporation. Here, we propose increasing the current intensity as a quick and simple approach to improve vaccination efficiency.     

达标理论在流感疫苗接种中的护理干预研究

目的探讨达标理论在流感疫苗接种中的护理干预措施,提高流感疫苗接种率。方法选择6~59个月龄珠海市儿童1 000名,随机分为对照组和干预组,应用达标理论方法对儿童接种流感疫苗进行护理干预,分析流感疫苗接种率变化。结果干预前后流感疫苗接种率分别为6.1%、18.4%,干预后比干预前接种率显著提高(2=70.1,p<0.01)。干预组和对照组流感疫苗接种率分别为24.8%、12.0%,干预组明显高于对照组(2=24.0,p<0.01)。干预组干预前后流感疫苗接种率分别为6.3%、24.8%,干预后明显高于干预前(2=64.1,p<0.01)。结论在流感疫苗预防接种中,达标理论的护理干预模式是一种行之有效的干预方法,能有效提高儿童流感疫苗接种率。     

Delivering Influenza Vaccine to Pregnant Women

Pregnant women have an increased risk of influenza infectionand complications. The Advisory Committee on Immunization Practicescurrently recommends vaccination for women who are pregnantduring influenza season. The authors review the literature concerninginfluenza vaccine safety, effectiveness, and coverage ratesduring pregnancy, as well as opportunities to improve vaccinationrates during pregnancy. No study has demonstrated an increasedrisk of maternal complications or adverse fetal outcomes associatedwith inactivated influenza vaccine. Few studies have examinedthe effectiveness of vaccination during pregnancy, and the resultsfrom these studies are inconsistent, with some showing a protectiveeffect and others showing no effect. Despite the proven safetyof vaccination and the possible benefits to women and theirinfants, reported vaccination rates during pregnancy are generallyless than 10%. Mothers frequently cite concerns about vaccinesafety as a barrier to vaccination. Lack of adequate informationabout the risks and benefits of vaccination is reported by bothpatients and obstetric care providers. Organizational factorssuch as lack of vaccine storage facilities may also limit vaccinationduring pregnancy. Effective interventions should target factorspertaining to patients or providers, or they should addressorganizational or logistic barriers. The Advisory Committeeon Immunization Practices currently recommends standing ordersprograms or reminders for patients and providers as strategiesto improve vaccination rates. influenza, human • pregnancy • vaccination     

The impact of vaccination and patient characteristics on influenza vaccination uptake of elderly people: A discrete choice experiment

ObjectivesTo improve information for patients and to facilitate a vaccination coverage that is in line with the EU and World Health Organization goals, we aimed to quantify how vaccination and patient characteristics impact on influenza vaccination uptake of elderly people.MethodsAn online discrete choice experiment (DCE) was conducted among 1261 representatives of the Dutch general population aged 60 years or older. In the DCE, we used influenza vaccination scenarios based on five vaccination characteristics: effectiveness, risk of severe side effects, risk of mild side effects, protection duration, and absorption time. A heteroscedastic multinomial logit model was used, taking scale and preference heterogeneity (based on 19 patient characteristics) into account.ResultsVaccination and patient characteristics both contributed to explain influenza vaccination uptake. Assuming a base case respondent and a realistic vaccination scenario, the predicted uptake was 58%. One-way changes in vaccination characteristics and patient characteristics changed this uptake from 46% up to 61% and from 37% up to 95%, respectively. The strongest impact on vaccination uptake was whether the patient had been vaccinated last year, whether s/he had experienced vaccination side effects, and the patient’s general attitude towards vaccination.ConclusionsAlthough vaccination characteristics proved to influence influenza vaccination uptake, certain patient characteristics had an even higher impact on influenza vaccination uptake. Policy makers and general practitioners can use these insights to improve their communication plans and information regarding influenza vaccination for individuals aged 60 years or older. For instance, physicians should focus more on patients who had experienced side effects due to vaccination in the past, and policy makers should tailor the standard information folder to patients who had been vaccinated last year and to patient who had not.     

Health-care workers vaccination coverage: such a long way to run

The poor vaccination coverage among health-care workers in a hospital, resulted from a self-administered questionnaire, showed the necessity to improve educational efforts and to promote vaccination campaign.     

育龄女性人乳头瘤病毒疫苗预防接种现状及影响因素分析

目的:了解安徽地区育龄女性人乳头瘤病毒(HPV)疫苗预防接种现状及其影响因素。方法:采用方便抽样法,调查2019年4-5月于中国科学技术大学附属第一医院(安徽省立医院)健康体检的417名女性。采用自编结构式问卷,调查育龄女性的一般资料、HPV接种情况,以及对HPV疫苗的认知及接种意愿情况。结果:7.19%(30/417)育龄女性接种过HPV疫苗,57.07%(238/417)育龄女性表示愿意接种。家庭年收入、文化程度、职业、对HPV疫苗了解及认同程度、接种意愿均与育龄女性HPV疫苗的接种有关。结论:有必要针对安徽地区育龄女性开展HPV疫苗预防接种知识的健康教育,提高其对HPV疫苗的了解和预防接种的意识。