入托入学儿童预防接种证查验工作的家长认知和影响因素调查北大核心

目的评估家长对入托入学儿童预防接种证查验工作的认知和影响因素。方法采用分层整群抽样方法在湖北省4个县18所幼儿园和小学选择新入学儿童的家长开展问卷调查,分析家长对接种证查验工作的态度、知晓率及其影响因素。结果在1900名儿童家长中,认为疫苗安全、疫苗有效、接种证查验必要、接种犹豫的家长比例分别为81.9%、77.4%、96.8%、14.4%。家长对接种证查验、疫苗补种工作的知晓率分别为99.2%、97.2%。Logistic回归分析显示,地区、与儿童关系、疫苗安全性认知、疫苗有效性认知显著影响家长知晓率;学校类型、疫苗安全性认知显著影响家长对接种证查验必要性的态度。结论儿童家长对入托入学儿童预防接种证查验工作的认知度较高;需针对性地加强接种证查验工作和预防接种知识宣传。     

入托入学儿童预防接种证查验工作的家长认知和影响因素调查

目的评估家长对入托入学儿童预防接种证查验工作的认知和影响因素。方法采用分层整群抽样方法在湖北省4个县18所幼儿园和小学选择新入学儿童的家长开展问卷调查,分析家长对接种证查验工作的态度、知晓率及其影响因素。结果在1 900名儿童家长中,认为疫苗安全、疫苗有效、接种证查验必要、接种犹豫的家长比例分别为81.9%、77.4%、96.8%、14.4%。家长对接种证查验、疫苗补种工作的知晓率分别为99.2%、97.2%。Logistic回归分析显示,地区、与儿童关系、疫苗安全性认知、疫苗有效性认知显著影响家长知晓率;学校类型、疫苗安全性认知显著影响家长对接种证查验必要性的态度。结论儿童家长对入托入学儿童预防接种证查验工作的认知度较高;需针对性地加强接种证查验工作和预防接种知识宣传。     

家长预防接种收益和风险感知对其为儿童接种非免疫规划疫苗意愿的影响

目的了解家长为儿童接种非免疫规划(Expanded Program on Immunization, EPI)疫苗的意愿,分析接种疫苗收益和风险感知对接种意愿的影响。方法 2019年12月至2020年1月选择中国6个省份12个区县34个预防接种门诊0-3岁儿童家长,开展接种疫苗收益和风险感知和非EPI疫苗接种意愿问卷调查。采用Logistic回归模型分析儿童家长接种疫苗收益和风险感知对接种意愿的影响。结果本研究纳入儿童家长3 030名,其中感知到接种疫苗收益、风险的家长分别占88.38%、60.51%,71.16%的家长愿意为儿童接种非EPI疫苗。Logistic回归分析显示,与未感知接种疫苗收益和风险的儿童家长相比,同时感知收益和风险、仅感知收益、仅感知风险的儿童家长的接种意愿高[OR(95%CI):7.03(5.05-9.77)、5.49(3.91-7.71)、2.02(1.30-3.16)]。结论家长对儿童接种非EPI疫苗普遍持接受态度,接种疫苗收益和风险感知影响接种意愿;应加强儿童家长的非EPI疫苗预防接种知识宣传。     

天津市儿童家长预防接种态度及第二类疫苗管理新机制认知调查

目的了解天津市儿童家长对预防接种工作的态度和第二类疫苗管理新机制的认知。方法在全市随机抽取36家常规预防接种门诊,于2017年4-5月在每家接种门诊接种现场采用便利抽样选取25名3岁儿童的家长,开展家长态度和认知调查。结果在900名调查对象中,99.11%表示信任预防接种;83.67%和74.78%分别能够分辨"疾病可以治疗,疫苗作用不大"和"接种疫苗过多会影响发育"的错误认知;38.44%知道第二类疫苗管理新机制;希望获取疫苗安全性和有效性信息分别占68.33%、55.67%;希望通过接种医生、告知手册、手机APP获取疫苗知识分别占69.89%、64.00%、31.33%。结论天津市儿童家长对预防接种信任度高,而对第二类疫苗管理新机制认知少。应加强儿童家长预防接种知识和第二类疫苗管理新机制的宣传教育。     

北京市西城(南)区儿童家长对预防接种规范化门诊服务满意度调查

目的了解儿童家长对预防接种规范化门诊服务的满意度,发现预防接种规范化门诊有待改善的环节,为进一步规范预防接种规范化门诊建设,提高预防接种服务质量提供参考。方法以当前中国社区卫生/全科医学服务病人满意度测量工具为模板,设计儿童家长调查问卷,用于预防接种服务的满意度评价。采用平均分配样本的方法,调查接种门诊日所有儿童家长。结果 90%以上儿童家长认可门诊提供的免疫预防服务,85%以上儿童家长对门诊卫生环境、了解儿童健康状况、解释知情同意书、接种后告知注意事项和留观30 min表示满意,75%以上儿童家长对门诊日时间、儿童未种及时通知等服务表示满意。关于在接种过程中核对儿童姓名、核对所种疫苗名称、医生耐心听取咨询和回答以及接种后医生询问儿童健康状况方面满意度不足,仅为60%,尤其是对儿童未留观30 min进行劝阻、儿童娱乐设施方面回答满意的家长分别只有47.3%和37.1%。结论儿童家长对西城南(区)规范化门诊总体服务满意度较好,尤其是在接种前和接种后的告知方面。但仍存在需要改善卫生服务质量和水平的环节,尤其是在儿童娱乐设施、回答家长咨询等方面有待进一步改善。     

甲肝灭活疫苗接种后发生血管性水肿1例报告

随着国家免疫规划工作的发展,儿童接种的疫苗种类及数量不断增加,家长或监护人对接种疫苗的安全性认识日益增强,因此规范预防接种操作,提高接种的安全性显得尤为重要。现就一起预防接种门诊儿童接种甲肝灭活疫苗后发生的血管性水肿     

山东非法经营疫苗系列案对深圳市儿童家长预防接种态度和行为的影响

目的了解山东非法经营疫苗系列案对深圳市儿童家长预防接种态度和接种行为的影响,分析儿童家长接种犹豫的影响因素。方法 2016年4月在深圳市罗湖区和龙岗区75家预防接种门诊,采用单纯随机抽样方法抽取1 284名≤2岁儿童的家长进行预防接种态度和接种行为调查,采用Logistic回归模型分析接种犹豫的影响因素。结果案件报道后32.4%的家长出现接种犹豫。Logistic回归分析显示,女童(OR=1.32,95%CI:1.01-1.72)、没有使用预防接种手机应用程序(OR=4.39,95%CI:3.21-6.01)、认为案件对孩子有影响(OR=3.43,95%CI:2.28-5.16)、认为预防接种门诊使用的疫苗不安全(OR=8.26,95%CI:1.79-4.73)的家长更易产生接种犹豫。全市2016年乙型肝炎疫苗第3剂、无细胞百白破联合疫苗第1剂和第2剂接种率比2015年分别下降了5.23、5.67、5.78个百分点;2016年轮状病毒疫苗、b型流感嗜血杆菌疫苗、水痘减毒活疫苗接种剂次数比2015年分别下降了20.49%、40.60%、28.26%。结论儿童家长对山东非法经营疫苗系列案的认知差,产生接种犹豫,儿童疫苗接种率下降;需采取有效措施预防和减少案件的影响。     

某区5岁及以下儿童家长手足口病认知和EV71疫苗接种意愿调查

目的 了解某区5岁及以下儿童家长对手足口病的认知情况和EV71疫苗接种意愿,为制定EV71疫苗免疫策略和健康促进提供科学依据。方法 采用整群随机抽样从北京市某区44家社区卫生服务中心抽取6家,对6家社区卫生服务中心接种门诊接种日当天带领儿童来进行预防接种的5岁及以下儿童家长进行面访并填写调查问卷。结果 该区5岁及以下儿童家长对手足口病防治知识知晓率为71%(95%CI=66%~76%),对预防措施的认知好于对传播途径的认知。儿童母亲(OR=2.77,95%CI=1.67~4.57)、本科/大专以上学历的儿童家长(OR=2.10,95% CI =1.24~3.56)、高年龄儿童的家长(OR=1.58,95%CI=1.10~2.26)知晓率更高。75%的被调查儿童家长表示会为孩子接种EV71疫苗,其中58%的家长更希望能够以“一类疫苗”和28%认为“一类疫苗或二类疫苗都行”的形式提供接种服务;知道我国正在研制EV71疫苗的家长接种意愿高于不知道者(OR=2.57,95%CI=1.17~5.65);25%的被调查儿童家长不会给孩子接种EV71疫苗,“担心疫苗不安全”(67%)和“担心疫苗效果不好”(34%)是最主要原因。结论 对低年龄儿童的家长、低学历家长更应加强手足口病知识宣传,以提高手足口病知识知晓程度。建议优先考虑将EV71疫苗作为一类疫苗进行接种,并通过多种途径向公众报告疫苗研究进展和EV71疫苗宣传,尤其提供预防接种服务的医务人员应积极向儿童家长宣传接种EV71疫苗,以提高儿童家长接种意愿。     

张家港市儿童家长对预防接种服务满意度的调查

目的 了解张家港市儿童家长对预防接种门诊服务的满意度,发现存在的问题,为提高预防接种服务质量提供依据。方法 对张家港市20家预防接种门诊的629名儿童家长进行满意度问卷调查,对数据进行单因素方差分析和t检验统计分析。结果 儿童家长对预防接种服务总体满意率96.82%,满意度平均得分4.59分;满意度与职业有关联,差异有统计学意义（P<0.05）,与年龄、户籍、性别、学历和收入无关,差异无统计学意义（P>0.05）。在预防接种门诊基本情况方面,儿童家长对接种服务流程满意率最高（95.55%）,对等候时间满意率最低（81.09%）;接种疫苗前儿童家长对下次预约方式满意率最高（97.46%）,对二类疫苗品种告知满意率最低（80.92%）;接种疫苗后儿童家长对留观30分钟满意率最低（88.24%）。结论 儿童家长对预防接种服务总体满意率较高,但仍有进一步完善和提升的空间,尤其是在等候时间和二类疫苗品种告知等方面有待改善;还应提供更多人性化服务,提高儿童家长对预防接种服务的满意度。     

农村流行性腮腺炎患儿家长预防知识的调查

目的:了解农村群众流腮预防接种认知、意愿及主要影响因素,指导流腮预防控制工作。方法:随机抽取15个乡镇,对报告的流腮患儿家长进行入户问卷调查。结果:农村群众流腮预防认识水平较低,68.61%的家长不知道流腮如何传播,72.65%家长不知道流腮如何预防。单价疫苗的接种意愿高于联合疫苗的接种意愿,接种流腮疫苗愿意支付费用平均为15.06元。不知道要接种疫苗;本地没有流行,无需接种疫苗;不知道接种疫苗的时间、地点等预防认知问题,是影响流腮预防控制的最主要因素。结论:提高农村群众预防认知水平及农村地区预防接种服务可及性,扩大国家免疫规划,是经济落后地区预防控制疫苗针对传染病的根本措施。     

开封市某医院医务人员对流感疫苗认知和接种意愿调查

目的了解医务人员对流感疫苗的认知和接种意愿情况,探讨开展以医院为基础的提高医务人员流感疫苗接种率的方法。方法对255名医务人员采取自行设计的对流感疫苗的认知和接种意愿问卷进行调查。结果 38.04%的人员认为接种流感疫苗对预防流感有效,33.73%的人员认为接种流感疫苗是安全的;调查人群中有42.75%愿意接种流感疫苗,但仅有27.45%能够接受每年进行接种;不愿意接种流感疫苗的原因主要为对疫苗的安全性、来源不放心,疫苗的保护作用有限,保护时间短等。结论医务人员对流感疫苗相关知识的认知和接种意愿偏低,可利用多种形式开展宣传教育活动提高医务人员对流感疫苗的认知和接种率。     

Systematic review of human papillomavirus vaccine coadministration

Human papillomavirus (HPV) vaccination is recommended in early adolescence, at an age when other vaccines are also recommended. Administration of multiple vaccines during one visit is an opportunity to improve uptake of adolescent vaccines. We conducted a systematic review of safety and immunogenicity of HPV vaccines coadministered with other vaccines. Our review included 9 studies, 4 of quadrivalent HPV vaccine and 5 of bivalent HPV vaccine; coadministered vaccines included: meningococcal conjugate, hepatitis A, hepatitis B, combined hepatitis A and B, tetanus, diphtheria, acellular pertussis, and inactivated poliovirus vaccines. Studies varied in methods of data collection and measurement of immunogenicity and safety. Noninferiority of immune response and an acceptable safety profile were demonstrated when HPV vaccine was coadministered with other vaccines.     

New acellular pertussis-containing paediatric combined vaccines

Combined pediatric vaccines have the advantages of conferring protection against multiple common infectious diseases with a reduced number of injections. Their use should lead to better compliance to recommended vaccination schedules. Diphtheria (D), tetanus (T) and whole-cell pertussis vaccine (P) have been successfully combined, with or without inactivated poliovirus vaccine (IPV) in the same syringe for many years. Recently developed acellular pertussis (aP) Haemophilus influenzae type B (Hib), inactivated poliomyelitis virus and hepatitis B vaccines are ideal candidates for inclusion in current combined vaccines. Nevertheless, the development of new combinations has to face preclinical and clinical issues: the appropriate formulation of the new antigen(s) and other vaccine components needs to be determined to ensure compatibility and guard against potential additive or unexpected adverse reactions; potential immunological interference between antigens and the negative impact of other vaccine components on immunogenicity may occur, and these have to be examined also. Whole-cell pertussis vaccines are highly protective against whooping cough, but the severe adverse reactions that these vaccines sometimes produce have led to hesitation over their use, including the decision of some countries to stop pertussis immunization. To increase the acceptability of pertussis vaccination, Pasteur Mérieux Connaught has developed a combined D, T and a two-component acellular pertussis vaccine (DTaP), composed of purified pertussis toxoid (PT) and filamentous haemagglutinin (FHA), which has been shown to be effective in an efficacy trial conducted in Senegal. Acellular DTaP vaccines are immunogenic and have a better safety profile than DTP vaccines, when given either for the primary series, for the booster vaccination or for both. In order to meet worldwide demands, the combined DTaP-IPV or DTP-IPV has been developed for countries where IPV is recommended. Following the encouragement of the WHO, an H. influenzae type B tetanus-conjugated (Act-HIB) vaccine, has been combined in a full liquid formulation with the whole-cell DTP. This vaccine showed a good safety and immunogenicity profile in infants and in toddlers. A combined DTaP-IPV-PRP-T vaccine (where the Act-HIB vaccine is reconstituted by the full-liquid DTaP-IPV) also has been successfully developed both for the primary series and for booster vaccination; although, a reduced immunogenicity against PRP observed after the primary series, this did not affect vaccine priming. Hepatitis B immunization campaigns targeting high-risk groups have failed to control the disease in areas of low endemicity. In 1992, the WHO recommended that hepatitis B vaccination should be integrated into the EPI in all countries by 1997-1999. For that purpose, hepatitis B vaccine is currently evaluated in pediatric combined vaccines. Developing new combination vaccines is a difficult but essential process for maintaining high immunization rates worldwide against infectious diseases, provided that the costs are acceptable. New combined vaccines including pneumococcal and meningococcal component are under wide-scale development.     

Evaluation of safety and immunogenicity of feline vaccines with reduced volume

A non adjuvanted vaccine against feline herpesvirus, feline calicivirus, feline panleucopenia and feline leukemia has been formulated in reduced volume (0.5 ml) with the same antigen content as the conventional 1 ml presentation. This paper reports studies evaluating the safety and the immunogenicity of this reduced volume vaccine in comparison with the conventional volume vaccine. The safety of both vaccines was evaluated in a small sized laboratory trial. It was further tested in a randomized controlled field trial on a total of 398 cats. Immediate and delayed local and systemic adverse events were monitored after vaccination. The immunogenicity of each vaccine was also checked by serological antibody responses against the vaccines antigens during the laboratory trial.These studies showed that the 0.5 ml vaccine was well tolerated in cats, inducing less local events, while keeping the same immunogenicity as the corresponding 1 ml vaccine. Reducing the volume of the vaccine is a way to improve the convenience of administration and to help following vaccination guidelines with the aim of reducing the incidence of adverse events following vaccination.     

中国一般人群及医务工作者的新冠肺炎疫苗接种意愿及影响因素研究

目的了解中国一般人群和医务工作者在新冠肺炎疫苗上市前的接种意愿及其影响因素。方法2020年6月18—30日,在中国东、中、西部三个城市,随机选择当地居民和医务工作者,通过电话调查和网络问卷的方式研究新冠肺炎疫苗接种意愿,并采用多因素logistic回归分析其影响因素。结果共有1874名一般人群和627名医务工作者参加本研究。一般人群和医务工作者的新冠肺炎疫苗接种意愿分别为82.9%和95.9%,监护者和看护人对小孩和老人的疫苗接种意愿分别为83.0%和77.8%。疫苗的有效性和接种意愿呈正相关。多因素logistic回归结果显示,相较于兰州,居住在上海(OR=0.314,95%CI:0.209~0.464)或武汉(OR=0.547,95%CI:0.354~0.836)的一般人群新冠肺炎疫苗接种意愿更低,而有流感疫苗接种史(OR=2.784,95%CI:1.254~6.279)的医务工作者更愿意接种新冠肺炎疫苗;对于新冠肺炎的风险认知更高的一般人群及医务工作者新冠肺炎疫苗接种意愿更高(OR_(一般人群)=2.046,95%CI:1.685~2.495;OR_(医务工作者)=1.843,95%CI:1.081~3.082)。不愿意接种的主要原因为担心疫苗的安全性和有效性。结论中国公众和医务工作者对新冠肺炎疫苗接种的需求和认知度较高,建议开展大规模疫苗接种时注重介绍疫苗安全性和有效性以提高新冠肺炎疫苗的接种率,促进尽早形成人群免疫屏障.     

Vaccine administration in children with chronic kidney disease

Pediatric patients with severe chronic kidney disease (CKD) on conservative treatment, on dialysis, and those with renal transplantation are at a higher risk for infectious diseases as the result of impaired immune responses against infectious agents. Infections in these patients can have drastic consequences for disease morbidity and mortality. Immunization is a crucial preventive strategy for disease management in this pediatric population. However, vaccination coverage among children with CKD remains low due to safety concerns and doubts about vaccine immunogenicity and efficacy. In this study, we reviewed why children with CKD are at higher risk of infections, the importance of vaccinations among these children, barriers to vaccinations, and recommend the best vaccination schedules. Overall, vaccines have acceptable immunogenicity, efficacy, and safety profiles in children with CKD. However, in some cases, the protective antibody levels induced by vaccines and the benefits and risks of booster vaccine doses must be individually managed. Furthermore, close contacts and household members of these children should complete age-appropriate vaccination schedules to increase the child's indirect protection.     

禽流感病毒研究进展及抗H7N9型病毒疫苗与抗体研究

禽流感病毒（avian influenza virus,AIV）是一种可引起急性呼吸道传染病的人畜共患病毒。自2013年我国出现了全球首例人感染H7N9型AIV病例以来,人们对该病毒产生了担忧与恐慌。AIV在全球广泛传播,人感染不同型别AIV事件也持续发生,造成了巨大的经济损失。目前尚无针对该病的特异性治疗措施与药物,疫苗成为最有可能预防控制病毒传播的手段。现有针对H7N9型AIV的兽用与人用疫苗种类繁多,其中,4类人用H7N9型AIV疫苗已经率先进入了临床试验阶段,主要包括了病毒样颗粒疫苗、减毒活疫苗、灭活疫苗及DNA疫苗,并显示出了良好的安全性和免疫原性。因为暂无上市的人用AIV疫苗,所以其真实效力不得而知。此外,现有的流感疫苗在人群中虽然具有良好的安全性和免疫原性,但对H7N9型AIV并无交叉抗体反应。本文回顾AIV的病原学、流行病学、职业暴露人群调查与防控策略、H7N9型AIV疫苗及H7N9型AIV全人源单克隆抗体研究进展,讨论尚存的问题和挑战以及未来的发展方向,为加深对疾病的了解以及控制AIV在全球的蔓延提供防控策略与方针。     

Childhood vaccination: achievements and challenges

As the goal of eradicating smallpox was being met, the World Health Organization created its Expanded Programme on Immunisation (EPI) in 1974 and reached its initial goal of achieving full vaccination of 80% of the world's children by 1990. This effort was aided by the creation of "cold chain" delivery systems and resulted in the annual saving of 3.5 million children in less-developed countries. Current EPI vaccination goals include 1) eradication of poliomyelitis by the year 2000, 2) elimination of neonatal tetanus by the year 1995, 3) control of measles and hepatitis B, and 4) immunization of 90% of the world's children 1 year or younger by the year 2000. Goals of the Children's Vaccine Initiative (formed in 1991) include 1) provision of an adequate supply of affordable, safe, and effective vaccines; 2) production of improved and new vaccines; and 3) simplification of the logistics of vaccine delivery. Future challenges are to sustain high vaccination coverage, reach the unreached, achieve proper storage of vaccines and reduce waste, integrate new vaccines into national programs, and achieve vaccine self-sufficiency. The fact that these challenges will be difficult to achieve is illustrated by the situation in Africa where the high immunization levels achieved in 1990 have dropped dramatically. Those who must act to implement immunization programs are health personnel, families, governments, and development partners. In order to achieve equity in health, every child must be reached, governments must be made accountable for programs, health workers must convince families of the importance of vaccination, delivery systems must be in place to take advantage of the new vaccines being delivered, and a multisectoral approach must be taken to assure sustainability.     

‘My primary purpose is to protect the unborn child’: Understanding pregnant women’s perceptions of maternal vaccination and vaccine trials in Europe

Despite the important benefits of maternal vaccination for pregnant women and newborns, vaccination uptake is low in many European countries. Differences in vaccination policies and recommendations, as well as concerns about vaccine safety can partly explain inadequate coverage rates and women’s hesitancy to get vaccinated during pregnancy. This study aims to explore pregnant women’s experiences, decision-making processes and perceptions towards maternal vaccination and maternal vaccine trials in France, Germany, Italy, Spain and the United Kingdom. Qualitative interviews and focus groups were conducted with 258 pregnant women identified through local research panels and snowballing. Topic guides translated in local languages were designed to explore women’s awareness and perceptions of maternal vaccination, and willingness to participate in vaccine trials during pregnancy. A thematic analysis was conducted. Pregnant women were found to have low awareness about maternal vaccination, with many reporting not having received a recommendation to vaccinate from their doctors. Strong trust in health professionals indicate that strengthened recommendations could improve vaccination uptake. Vaccination decision-making in pregnancy was described in the context of a highly emotional period, generating anxiety and fears around the safety of vaccines. Pregnancy was also discussed as a period during which women develop nurturing and protective identities. However, depending on the information they received as well as influences from experts, families and peers, women either perceived vaccination as a threat to their babies’ safety or as a means to protect them. Attitudes towards maternal vaccine trials were less ambiguous, with most pregnant women strongly rejecting the notion of taking part in trials. While strategies to improve pregnant women’s awareness and perceptions of maternal vaccination are needed, it is equally important to understand why healthcare professionals may not be recommending vaccination. More coordinated strategies across Europe could help strengthen communication and trust in maternal vaccination.     

华北地区大学生对HPV及其疫苗的认知现况调查

目的 了解华北地区高校学生对人乳头瘤病毒（human papillomavirus,HPV）及其疫苗的认知、态度和疫苗接受意愿,为高校HPV的健康教育和疫苗的推广提供参考。方法 采用自制问卷方便抽样的方法,针对我国华北地区5个市的大学生开展大规模横断面流行病学研究,并分析大学生HPV疫苗接受度的影响因素。 结果 2 783（52.8%）名大学生听说过HPV,其中女生人数明显多于男生（2 148 vs 635,P＜0.05）;2 933（55.6%）名大学生听说过HPV疫苗,疫苗认知率女生高于男生（59.6%vs 44.5%,P＜0.05）;4 155（78.8%）名大学生愿意接种HPV疫苗,其中3198（79.9%）名大学生认为HPV疫苗费用过高,应由政府和个人共同承担;大学生的性别、专业和对HPV疫苗的认知影响疫苗的接种。结论 我国大学生对HPV及其疫苗的认知仍然十分欠缺,高校HPV相关健康教育对本地区疫苗推广和宫颈癌的预防十分必要。