连云港市2012—2021年出生队列儿童EV 71型疫苗接种情况分析

目的 分析连云港市2012—2021年出生队列儿童EV 71型疫苗接种现状,为制定疫苗接种策略和科学防控手足口病提供依据。方法 利用江苏省预防接种综合服务管理信息系统建立自2017年EV 71型疫苗在连云港市开始接种以来适龄儿童的出生队列,分析出生队列儿童EV 71型疫苗接种情况。结果 连云港市2012—2021年出生队列儿童500 016名。截至2021年12月31日,连云港市2012—2021年出生队列儿童接种首剂EV 71型疫苗71 715人,接种率为14.34%;完成全程接种60 915人,全程接种率为12.18%。2012—2017年出生队列儿童EV 71型疫苗接种率和全程接种率在2018年度最高,2018—2020年出生队列儿童EV 71型疫苗接种率和全程接种率在出生后第2年最高。接种首剂EV 71型疫苗年龄中位数为14月龄（IQR为15月龄）。流动儿童、市区儿童、女童的EV 71型疫苗接种率及全程接种率均较高（均P<0.01）。结论 连云港市2012—2021年出生队列儿童EV 71型疫苗接种率有所上升,但总体水平仍然较低。免疫起始月龄较晚,居住属性、居住地区、性别...     

江苏省2013-2020年出生队列儿童肠道病毒71型疫苗接种率

目的分析江苏省适龄儿童肠道病毒71型(EV71)疫苗接种率。方法通过江苏省预防接种综合服务管理信息系统建立自2016年EV71疫苗上市以来适龄儿童出生队列,计算EV71疫苗2剂次全程接种率。结果江苏省2013-2020年出生队列儿童共764.69万名,截至2020年EV71疫苗总全程接种率为13.67%;各出生队列儿童全程接种率在1.35%(2013年出生队列)-25.91%(2018年出生队列)之间;常住、流动儿童全程接种率分别为14.06%、12.84%;苏南、苏中和苏北地区儿童全程接种率分别为14.81%、15.18%和11.96%。结论江苏省2013-2020年出生队列儿童EV71疫苗接种率呈上升趋势,但总体水平仍然较低;需对儿童家长开展针对性健康教育工作,并加强儿童EV71疫苗接种。     

山东省基于出生队列的1～7岁儿童常规免疫接种率分析

目的 分析山东省不同出生队列儿童常规免疫接种率。方法 采用描述流行病学方法对山东省预防接种信息系统（Immunization Information System,IIS）收集的1～7岁儿童接种个案分出生队列、分地区、分居住类型进行疫苗接种率分析。结果 山东省预防接种信息系统共收集1～7岁儿童预防接种个案8 512 824例；1～7岁本地和流动儿童常规免疫疫苗全程接种率分别为94.69%和92.26%；各出生队列儿童疫苗全程接种率分别为92.01%、94.59%、95.72%、95.15%、94%、96.51%和91.55%。中、西部地区接种率低于东部地区；流动儿童接种率低于本地儿童；西部地区流失儿童比例高于东、西部地区。结论 山东省1～7岁儿童常规免疫疫苗接种率总体较高，中西部和流动儿童是预防接种管理重点，西部地区需控制流失儿童比例。     

柯桥区1～7岁儿童第二类疫苗接种情况分析

目的了解绍兴市柯桥区1～7岁儿童部分第二类疫苗接种情况,为提高第二类疫苗接种率和防制相关疾病提供依据。方法通过浙江省免疫规划信息管理系统收集柯桥区1～7岁(2011—2017年出生)儿童预防接种资料,对水痘减毒活疫苗(水痘疫苗)、b型流感嗜血杆菌疫苗(Hib疫苗)、吸附无细胞百白破灭活脊髓灰质炎和b型流感嗜血杆菌联合疫苗(五联疫苗)、肠道病毒71型灭活疫苗(EV71疫苗)、13价肺炎球菌多糖结合疫苗(13价肺炎疫苗)、流感病毒裂解疫苗(流感疫苗)和口服轮状减毒活疫苗(轮状疫苗) 7种第二类疫苗的接种情况进行分析。结果柯桥区1～7岁出生儿童79 731人,水痘疫苗、Hib疫苗、五联疫苗、EV71疫苗、13价肺炎疫苗、流感疫苗和轮状疫苗接种率分别为93.27%、46.10%、8.21%、8.85%、0.26%、13.17%和10.83%,除流感疫苗和轮状疫苗外,接种率基本呈逐年上升趋势。Hib疫苗、流感疫苗和轮状疫苗的全程接种率较低,分别为15.48%、0.04%和0.08%。本地儿童五联疫苗、EV71疫苗和13价肺炎疫苗的接种率均高于流动儿童,接种率差距分别为129.81%、21.98%和325.00%;Hib疫苗和流感疫苗接种率均低于流动儿童,接种率差距分别为10.93%和7.51%。不同镇/街道儿童第二类疫苗接种率比较,除水痘疫苗差距较小以外,其他疫苗接种率差距为1.40～12.15倍。结论柯桥区1～7岁儿童第二类疫苗接种率总体逐年提高,除水痘疫苗接种率较高外,其他6种第二类疫苗的接种率均较低,EV71疫苗、五联疫苗和流感疫苗在不同镇/街道接种率相差7倍以上。     

2017-2021年中国肠道病毒71型灭活疫苗接种现状分析

目的了解2017-2021年中国肠道病毒71型(EV71)灭活疫苗接种现状, 为制定手足口病防控和免疫策略提供参考。方法利用中国免疫规划信息管理系统收集的EV71灭活疫苗报告接种剂次数和出生人口数据估算2012年以来各出生队列截至2021年底的全国、分省和分地市EV71灭活疫苗累计接种率, 并分析与接种率水平相关的潜在影响因素。结果截至2021年, 全国2012年以来出生队列EV71灭活疫苗估算累计接种率为24.96%, 各省份估算接种率为3.09%～56.59%, 各地市估算接种率为0～88.17%。不同地区疫苗接种率与该地区既往手足口病报告发病水平和人均可支配收入的相关性均有统计学意义。结论 2017年以来EV71灭活疫苗在全国范围内应用广泛, 但地区间疫苗接种覆盖情况差异较大, 经济相对发达地区接种率较高, 既往疾病流行强度可能对疫苗的接受度和接种服务模式产生一定影响。EV71灭活疫苗接种对手足口病流行的影响还需进一步研究。     

2010 - 2018年衢州市出生儿童含b型流感嗜血杆菌成分疫苗接种情况分析

目的 分析衢州市2010 - 2018年出生儿童含b型流感嗜血杆菌（Hib）成分疫苗接种情况，为制定Hib相关免疫决策提供依据。方法 从浙江省免疫规划信息管理平台选取2010 - 2018年出生儿童为研究对象，分析含Hib成分疫苗的接种信息，进行描述性分析。结果 2010 - 2018年出生儿童共193 560名，含Hib成分疫苗≥1剂次、≥3剂次接种率分别为67.29%、29.32%；本地儿童≥1剂次总接种率（68.40%）高于流动儿童（65.34%），接种率差异有统计学意义（χ2 = 187.72，P＜0.01），≥3剂次总接种率（29.36%）与流动儿童接种率（29.24%）差异无统计学意义（χ2 = 0.34，P = 0.559）；城区MenAC - Hib、DTaP - Hib、DTaP - IPV/Hib接种率（3.56%、6.74%、10.96%）均高于农村地区（2.87%、1.11%、2.83%）,各接种率差异均有统计学意义（均P＜0.01）；首剂次接种月龄＜3月龄、3～6月龄、12～23月龄的接种比例分别为14.65%、31.05%、31.88%；2018年出生的儿童中，不同类型的疫苗、不同接种的剂次与首剂次接种月龄间差异有统计学意义（χ2 = 7 524.21，P＜0.01；χ2 = 10 731.87，P＜0.01）首剂次接种时间＜3月龄、3～6月龄、7～11月龄、12～23月龄、24～71月龄五个时间段中，选择联合疫苗的比例分别为76.92%、59.19%、59.61%、3.28%、0.00%，累计接种≥3剂次接种率分别为90.45%、70.35%、10.41%、1.18%、0.00%，说明首剂次接种月龄越早的儿童，其选择联合疫苗的比例越高，累计接种≥3剂次接种率也越高。结论 衢州市儿童Hib接种率处于较低水平，建议将其纳入免疫规划；农村地区预防接种门诊在做好Hib疫苗首剂次接种的同时，加强全程接种的催种工作和对儿童家长的疫苗知识宣贯工作，进而提高Hib的全程接种率。     

2012年寿光市2～5岁儿童水痘疫苗接种率监测评价

[目的]评价寿光市儿童水痘疫苗接种率,探讨免疫防控策略。[方法]2012年3月,对寿光市通过山东省免疫规划接种率监测信息系统报告的2007～2010年出生(2～5岁)的儿童水痘疫苗接种率监测信息进行分析。[结果]寿光市2007～2010年出生儿童合计44 115名,水痘疫苗平均接种率为57.07%,其中2剂次接种率仅为0.65%。2007～2010年出生儿童水痘疫苗接种率分别为57.18%、61.07%、56.37%、53.79%。不同乡镇平均接种率为18.32%～84.57%。已接种水痘疫苗的25 134名儿童中,73.82%在12～17月龄完成首针接种,14.27%在18～23月龄接种。2007～2010年出生者,首针在12～17月龄接种者所占比例逐年提高,分别为64.30%、65.92%、69.74%、94.50%。[结论]寿光市儿童水痘疫苗接种率较低。应加强宣传,提高2剂次水痘疫苗接种率。     

重庆市沙坪坝区学龄前儿童二类疫苗接种情况及影响因素调查

目的 了解重庆市沙坪坝区0-6岁学龄前儿童二类疫苗接种情况及影响因素。方法 采用分层抽样抽取沙坪坝区26个街镇的1820名2008年-2014年出生的儿童,从儿童预防接种卡收集疫苗接种情况。采用分层抽样从全区25个接种门诊预防接种卡上抽取250张卡片上的家长进行问卷调查,了解家庭基本情况。用EpiData3.1软件建立数据库,采用SPSS21.0进行单因素及多因素Logistic回归分析。结果 沙坪坝区学龄前儿童二类疫苗接种率为92.97%。水痘疫苗全程接种率最高（76.28%）,轮状病毒疫苗全程接种率最低（0.13%）。其他无一类苗替代的接种率较低的二类疫苗还有四联疫苗（0.48%）、7价肺炎疫苗（0.62%）及五联疫苗（3.46%）。本区儿童与流动儿童接种率差异有统计学意义（t=8.317,P<0.001）。影响因素分析显示,不同出生地点影响二类疫苗接种率（OR=2.986,OR95%CI：1.008-8.746,P= 0.048）。结论 重庆市沙坪坝区学龄前儿童二类疫苗不同品种之间的接种率差异较大,应宣传选择医院接生,并加强流动儿童的疫苗接种管理。     

北京市丰台区蒲黄榆地区0～3岁儿童第二类疫苗接种情况分析

目的对北京市丰台区蒲黄榆地区0~3岁儿童第二类疫苗接种情况进行分析,为提高第二类疫苗接种率,控制疫苗相关传染病提供基础数据。方法选取北京市儿童预防接种管理系统(客户端)在册的丰台区蒲黄榆社区卫生服务中心管辖的蒲黄榆地区2011年1月1日-2013年12月31日出生的儿童作为研究对象,对常规计划免疫门诊使用的6种第二类疫苗使用情况进行分析。结果蒲黄榆地区2011年1月1日-2013年12月31日出生的客户端在册儿童数合计1 584人(男849人,女735人),6种第二类疫苗接种率在11.81%~95.37%之间,多剂次免疫程序的第二类疫苗全程接种率较低。本市户籍儿童1 048人,6种第二类疫苗接种率为11.93%~97.10%;流动儿童536人,6种第二类疫苗接种率为4.48%~93.26%,本市户籍儿童与流动儿童不同疫苗接种率差异有统计学意义(χ~2=3 694.89,P﹤0.01),且同种疫苗本市户籍儿童与流动儿童接种率差异有统计学意义(χ2Hib=23.947,P﹤0.01;χ2轮状=18.121,P﹤0.01;χ223价肺炎=15.290,P﹤0.01;χ2水痘=8.033,P﹤0.01;χ_(7价肺炎)~2=22.944,P﹤0.0;χ_(五联)~2=41.783,P﹤0.01)。结论目前,除了《北京市水痘疫苗使用技术指南(试行)》要求学龄前儿童接种的水痘疫苗,北京市丰台区蒲黄榆地区其余5种第二类疫苗接种率仍处于较低水平。     

连云港市EV 71疫苗接种前后手足口病流行特征分析

目的 了解连云港市EV 71型灭活疫苗接种前后手足口病的流行特征，为手足口病的科学防控提供依据。方法 对2010—2021年连云港市报告的手足口病病例、病原学监测结果及2017—2021年EV 71疫苗接种情况进行统计，利用SPSS 25.0软件进行统计学差异检验和趋势分析，率的比较采用χ2检验，检验水准为α=0.05。结果 2010—2021年连云港累计报告手足口病60 042例，年发病率在43.59/10万～206.65/10万之间；2017—2021年连云港市目标人群EV 71疫苗估算接种率和全程接种率逐年提升；疫苗接种前手足口病发病呈现隔年高发的趋势，接种后发病率持续下降；发病季节呈现双峰模式；病例集中在0～5岁（95.31%）的散居儿童和幼托儿童，报告发病率男性高于女性，市区高于市县；疫苗接种前病原以EV 71型肠道病毒为主，疫苗接种后，手足口病发病率、重症率、病死率、EV 71型肠道病毒构成比均显著下降。结论 EV 71疫苗接种前后，连云港市手足口病的流行特征发生了明显的改变。在今后的防控工作中，建议进一步提高EV 71疫苗接种率，尤其是0岁组儿童和农村地区儿童的接种率，同...     

苏州地区b型流感嗜血杆菌结合疫苗对减少儿童住院肺炎有效性的观察性研究

  目的  评价接种不同剂次b型流感嗜血杆菌(Haemophilus influenzae type b, Hib)结合疫苗对儿童住院肺炎的保护效果(vaccine effectiveness, VE)。  方法  采用回顾性队列研究设计,以2018年出生并在苏州大学附属儿童医院住院的苏州地区常住儿童为研究对象,分别通过苏州大学附属儿童医院卫生信息系统和苏州市疾病预防控制中心疫苗登记数据库收集研究对象在2019年6月30日之前因肺炎住院的相关医疗信息以及Hib疫苗接种信息,比较不同剂次Hib疫苗接种组和未接种组的住院肺炎发生率,计算Hib疫苗保护效果。  结果  2018年1月1日-2019年6月30日苏州地区儿童Hib疫苗的首剂接种率为18.8%(10 080/53 753);住院肺炎发生率随接种剂次的增加而降低(χ2=-4.31, P < 0.001),其中1剂次Hib疫苗未显示保护效果,2剂次Hib疫苗已显示出保护趋势,但差异无统计学意义,接种3剂次及以上Hib疫苗的儿童住院肺炎发生率低于未接种组(RR=0.72, 95% CI: 0.59~0.89, P＜0.001),且可预防的住院肺炎发生率为1 514.8/105人年,保护效果为28%(95% CI: 11%~41%)。  结论  苏州地区3剂次及以上Hib疫苗接种可降低儿童因肺炎住院的发生率,建议推广儿童Hib疫苗接种工作,提高Hib疫苗覆盖率。     

Inequalities in childhood vaccination timing and completion in London

The UK primary vaccination course includes vaccination against diphtheria, tetanus, pertussis, polio and Haemophilus influenzae type b (DTaP/IPV/Hib) and is scheduled at ages four, 8 and 12 weeks, followed by a ‘preschool booster’ at age three years four months. Vaccine coverage is generally measured at age one, two and five years. In addition to high coverage, vaccination should be timely to maximise population protection.Vaccination histories for 315,381 children born March 2001 to April 2010 were extracted from Child Health Information Systems in nine London health service areas and grouped into first and fifth birthday cohorts. We assessed timeliness of receipt of DTaP/IPV/Hib and drop-out rates by ethnicity, deprivation and area.Most children received their first, second and third doses on time at two, three, and four months. Among children completing by one year and after adjusting for deprivation and health area, compared with White-British children, Somali and Bangladeshi children were less likely to have received three doses of DTaP/IPV/Hib by six months of age (−11% and −5% respectively). Differences in timeliness by deprivation and health area existed, but were smaller. Compared with White-British children, children of Polish, Somali and Caribbean ethnicities were less likely to return for preschool booster, with a drop-out rate at least 7% higher in these groups. Within the fifth birthday cohort, only 2.3% of children who were completely unvaccinated (575/25,095) at age one year were fully vaccinated by age five. Higher proportions of partially vaccinated (one or two doses) children at age one year went on to be fully vaccinated by age five ((836/3213) 26.0% and (3565/6076) 58.7% respectively).These inequalities suggest that tailored approaches may be required to target specific groups with regards to improving vaccine uptake.     

Polio vaccination coverage and seroprevalence of poliovirus antibodies after the introduction of inactivated poliovirus vaccines for routine immunization in Japan

In Japan, the oral poliovirus vaccine (OPV) was changed to 2 types of inactivated poliovirus vaccine (IPV), the standalone conventional IPV (cIPV) and the Sabin-derived IPV combined with diphtheria-tetanus-acellular pertussis vaccine (DTaP-sIPV), for routine immunization in 2012. We evaluated polio vaccination coverage and the seroprevalence of poliovirus antibodies using data from the National Epidemiological Surveillance of Vaccine-Preventable Diseases (NESVPD) from 2011 to 2015. Several years before the introduction of IPV in 2012, OPV administration for children was refused by some parents because of concerns about the risk of vaccine-associated paralytic poliomyelitis. Consequently, in children aged <1?years who were surveyed in 2011–2012, polio vaccination coverage (45.0–48.8%) and seropositivity rates for poliovirus (type 1: 51.7–65.9%, type 2: 48.3–53.7%, and type 3: 15.0–29.3%) were decreased compared to those surveyed in 2009. However, after IPV introduction, the vaccination coverage (95.5–100%) and seropositivity rates (type 1: 93.2–96.6%, type 2: 93.1–100%, and type 3: 88.6–93.9%) increased among children aged <1?years in 2013–2015. In particular, seropositivity rates and geometric mean titers (GMTs) for poliovirus type 3 in <5-year-old children who received 4 doses of IPV (98.5% and 247.4, respectively) were significantly higher than in those who received 2 doses of OPV (72.5% and 22.9, respectively). Furthermore, in <5-year-old children who received 4 doses of either DTaP-sIPV or cIPV, the seropositivity rates and the GMTs for all 3 types of poliovirus were similarly high (96.5–100% and 170.3–368.8, respectively). Our findings from the NESVPD demonstrate that both the vaccination coverage and seropositivity rates for polio remained high in children after IPV introduction.     

Economic evaluation of delivering Haemophilus influenzae type b vaccine in routine immunization services in Kenya

OBJECTIVE: Haemophilus influenzae type b (Hib) vaccine was introduced into routine immunization services in Kenya in 2001. We aimed to estimate the cost-effectiveness of Hib vaccine delivery. METHODS: A model was developed to follow the Kenyan 2004 birth cohort until death, with and without Hib vaccine. Incidence of invasive Hib disease was estimated at Kilifi District Hospital and in the surrounding demographic surveillance system in coastal Kenya. National Hib disease incidence was estimated by adjusting incidence observed by passive hospital surveillance using assumptions about access to care. Case fatality rates were also assumed dependent on access to care. A price of US$ 3.65 per dose of pentavalent diphtheria-tetanus-pertussis-hep B-Hib vaccine was used. Multivariate Monte Carlo simulations were performed in order to assess the impact on the cost-effectiveness ratios of uncertainty in parameter values. FINDINGS: The introduction of Hib vaccine reduced the estimated incidence of Hib meningitis per 100,000 children aged < 5 years from 71 to 8; of Hib non-meningitic invasive disease from 61 to 7; and of non-bacteraemic Hib pneumonia from 296 to 34. The costs per discounted disability adjusted life year (DALY) and per discounted death averted were US$ 38 (95% confidence interval, CI: 26-63) and US$ 1197 (95% CI: 814-2021) respectively. Most of the uncertainty in the results was due to uncertain access to care parameters. The break-even pentavalent vaccine price--where incremental Hib vaccination costs equal treatment costs averted from Hib disease--was US$ 1.82 per dose. CONCLUSION: Hib vaccine is a highly cost-effective intervention in Kenya. It would be cost-saving if the vaccine price was below half of its present level.     

Immunisation coverage of Queensland indigenous two-year-old children by cluster sampling and by register

OBJECTIVES: To obtain, through a survey, estimates of immunisation coverage in a birth cohort of Indigenous children, and to compare survey estimates with those obtained from the Australian Childhood Immunisation Register (ACIR) for the same birth cohort of Indigenous children. METHODS: Cluster sampling of a birth cohort of two-year-old Indigenous children across Queensland, stratified according to accessibility/remoteness from services, was undertaken in 2003. An innovative method of identifying participants was used. Survey results of 10 vaccine doses were compared with ACIR data. RESULTS: The survey obtained a 4% sample of the birth cohort (137 children). Universally recommended vaccines showed high levels of coverage at 12 and 24 months, and survey estimates were slightly higher than ACIR estimates. Diphtheria-tetanus-acellular pertussis vaccine dose 3 (DTPa3) coverage was 93.8% (95% CI 88.0-99.6) by 12 months on survey and 87.5% on ACIR. Coverage was not timely and a lag phase of 4-6 months occurred for each vaccine dose. Haemophilus influenzae type b vaccine dose 2 (Hib2), scheduled for the age of four months, reached 90% coverage by nine months of age in the survey children. CONCLUSION: Both methods reported here provided similar results. IMPLICATIONS: These data indicate that ACIR Indigenous reporting rates have increased and coverage estimates are comparable to those provided by a survey. Immunisation coverage appears to be high, and the main remaining challenge in further reducing vaccine-preventable disease in Indigenous children is to improve immunisation timeliness.     

Impact of the sequential poliovirus immunization schedule: a demonstration project

OBJECTIVE: Researchers for this project evaluated compliance with the sequential poliovirus immunization schedule that uses inactivated poliovirus vaccine (IPV) for the first 2 doses of the polio immunization series, and assessed immunization coverage rates before and after implementation of this schedule at 6 public health clinics serving 1 county in Georgia. DESIGN: Immunization histories for 3 birth cohorts of infants were compared: (1) the baseline cohort, born January 1 through June 30, 1995; (2) the evaluation cohort, born January 1 through June 30, 1997, after implementation of the schedule change; and (3) the dose-3 cohort, born August 1 through November 30, 1996 (i.e., old enough to be eligible for a third dose of poliovirus vaccine following implementation of the sequential schedule). RESULTS: Following implementation of the new poliovirus immunization recommendations, 94% (534 of 567) of infants who received their first dose of poliovirus vaccine by age 3 months received IPV. Among these infants, 99.6% (532 of 534) were also up to date (UTD) for first doses of diphtheria and tetanus toxoids and acellular pertussis vaccine (DTP1/DTaP1), 99.6% (532 of 534) were UTD for first doses of hemophilus influenza type b (Hib 1), and 98.6% (527 of 534) had received at least one dose of Hepatitis B. Among infants visiting the clinics for their first or second dose of poliovirus vaccine, DTaP/DTP, and/or Hib, 76% received 3 or 4 simultaneous injections. In the dose-3 cohort, 78% (145 of 185) of infants who received a third dose of poliovirus vaccine had received 2 doses of IPV and 1 dose of oral poliovirus vaccine. CONCLUSIONS: Compliance with the recommended use of IPV for the first 2 poliovirus immunization doses as part of the sequential schedule was very high in this low-income and ethnically diverse population. Furthermore, the need for additional injections did not impede the delivery of recommended childhood immunizations.     

Feasibility of influenza immunization for inner-city children aged 6 to 23 months

BACKGROUND: Annual influenza-related hospitalization rates of children aged < 2 years in the United States are second only to those of the elderly. Yet no recommendations existed for vaccinating healthy children aged 6 to 23 months until 2002, when the Advisory Committee on Immunization Practices encouraged influenza vaccination for them. This study tested the feasibility of vaccinating 6- to 23-month-old children against influenza and assessed the effect on timely receipt of other vaccines. METHODS: A pre-post trial was used in urban health centers serving low-income children. Sites selected interventions from strategies proven to increase vaccination rates. Targeted patients were aged 6 to 23 months by November 30, 2002 (N = 1534). RESULTS: Influenza vaccination rates for the 2002-2003 intervention season improved significantly from 6.5% to 38.5% for the first dose (p < 0.001). Second-dose rates were significantly improved over preintervention (1.9% preintervention, 13.2% intervention), but lower than first-dose rates. Mean ages at vaccination for other recommended childhood vaccines did not differ or were significantly younger (measles, mumps, and rubella vaccine [MMR] and varicella) for children who received influenza vaccine versus those who did not. Moreover, a higher percentage of influenza-vaccinated than unvaccinated children received MMR, diphtheria, tetanus, pertussis vaccine 3 (DTaP3), inactivated poliovirus vaccine 2 (IPV2), and Haemophilus influenzae b (Hib2) vaccines within a 2-month grace period of the recommended age (p < 0.039), with no differences between groups for Hib1, DTaP1, IPV1, and varicella. CONCLUSIONS: With directed effort, it is possible to increase influenza vaccination at health centers serving low-income children. The addition of a two-dose vaccine was not associated with delayed receipt of other vaccines among these children.     

Incidence rates of health outcomes of interest among Chinese children exposed to selected vaccines in Yinzhou Electronic Health Records: A population-based retrospective cohort study

IntroductionOral poliovirus vaccine (OPV) and diphtheria-tetanus-acellular pertussis vaccine (DTaP) are widely used in China while Haemophilus influenzae type b vaccines (Hib) and a DTaP, inactivated poliovirus (IPV) and Hib polysaccharide conjugated to tetanus protein (PRP ~ T) combined vaccine (DTaP–IPV//PRP ~ T) have lower coverage. There are limited safety data on these vaccines in Chinese pediatric populations. Methods: To estimate incidence rates (IRs) of health outcomes of interest (HOIs) among children exposed to OPV, DTaP, Hib, and DTaP–IPV//PRP ~ T, we conducted a retrospective cohort study using a population-based electronic health record (EHR) database in Yinzhou district, Ningbo City. Children 0–2 years of age receiving at least one dose of these vaccines between January 1, 2012 and March 31, 2017 were included in the study. Yinzhou EHR database consisted of immunization records and healthcare data of children from hospitals and community health centers in the district. Eight HOIs (i.e., anaphylaxis, febrile seizures, all seizures, asthma, apnea, Kawasaki disease [KD], urticaria/angioedema, Guillain–Barré syndrome [GBS]) were identified using ICD-10 codes. Results: A total of 220,422 eligible children was identified. No cases of apnea, KD, and GBS were observed within 7 days post-vaccination. During 0–7 days post-vaccination for OPV, DTaP, Hib, and DTaP–IPV//PRP ~ T, the IRs of anaphylaxis, febrile seizures, all seizures, urticaria/angioedema and asthma ranged from 0.0 to 50.0, 0.0 to 99.9, 29.1 to 249.8, 297.8 to 949.1, and 992.7 to 2298.2 per 100,000 person-years, respectively, and 0.0 to 0.9, 0.0 to 1.9, 0.6 to 4.6, 5.6 to 17.5, and 18.7 to 42.3 per 100,000 doses, respectively. Conclusion: IRs of some HOIs in our study were comparable with those in the literature while IRs of other HOIs were not due to differences in study design, post-vaccination risk periods assessed, and vaccine types. Future studies should consider medical chart review for validating HOIs obtained in the EHR.