南昌市常住儿童与流动儿童10种免疫规划疫苗接种率的比较

目的了解南昌市10种免疫规划疫苗的接种状况,比较常住儿童与流动儿童的接种率水平。方法采用分层随机抽样方法。结果常住儿童预防接种建证率、建卡率、卡证符合率及卡介苗、乙型肝炎疫苗、脊髓灰质炎减毒活疫苗、百白破联合疫苗、麻疹减毒活疫苗（BCG、HepB、OPV、DPT、MV）基础免疫（初种）（包括麻风疫苗）和加强免疫（复种）合格接种率均〉95%,脑膜炎球菌多糖疫苗、流行性乙型脑炎（乙脑）疫苗（MPV、JEV）基础免疫合格接种率分别达80.8%、92.9%,加强免疫合格接种率分别为80.4%、86.7%。与常住儿童相比,流动儿童的建证率、建卡率、卡证符合率分别低38、16、40个百分点,基础免疫针次合格接种率,各项指标常住儿童与流动儿童之间差异有统计学意义（P〈0.01）。另外,所有疫苗针次中以超期和未种多。结论南昌市常住儿童基础免疫各疫苗针次接种率维持在较高水平,3岁以后的加强免疫接种有待加强。流动儿童的接种率水平显著低于常住儿童。针对流动儿童接种率低的情况,需加强流动儿童的免疫规划管理工作,有针对性地采取措施,减少免疫空白,提高接种质量。     

西安市未央区流动儿童免疫规划7种疫苗接种率调查

【目的】 了解西安市未央区流动人口聚集地区儿童免疫规划 7 种疫苗[卡介苗(BCG)、脊髓灰质炎疫苗(OPV)、百白破疫苗(DPT)、含麻疹成分疫苗(MCV)、乙肝疫苗(HepB)、乙脑疫苗(JEV)、流脑疫苗(MPV)]预防接种现状。 【方法】 采用单纯随机抽样法随机抽取居住 ≥3 个月的1~2岁流动儿童和常住儿童各758 名,进行免疫规划7种疫苗的接种率调查。 【结果】 调查儿童建证率 100.0% ,建卡率99.9 %。7 种疫苗BCG、 OPV、 DTP、 MCV、 HepB 、JEV、 MPV的基础免疫接种率分别为 99.5 %、 99.4 %、97.8 %、 92.5 %、 98.4 % 、90.9%、93.1%,7苗合格免疫覆盖率为90.9%。但流动儿童的 7 种疫苗合格免疫覆盖率(86.8%)显著低于常住儿童(95.3%),差异有高度统计学意义 (P<0.01);DTP加强免疫和MCV复种接种率分别为94.0%和94.4%。与常住儿童相比 ,流动儿童的7种疫苗基础免疫接种率除MCV、JEV基础免疫接种率为 89.7 %、86.8%外,其它疫苗的基础免疫接种率均高于90 %;除BCG和HepB首针及时接种率外其它各项指标流动儿童与常住儿童之间差异均有高度统计学意义(P<0.01) 。另外,7种疫苗针次中以超期、未种接种较多。 【结论】 在流动人口聚集地区 ,做好常住儿童免疫接种同时 ,还要加强流动儿童的预防接种工作。     

北京市2004～2011年常住儿童免疫规划疫苗接种率调查

目的 了解北京市2004～2011年常住儿童免疫规划疫苗接种情况变化趋势,以指导今后常规免疫工作.方法 按容量比例概率抽样法,每年在全市范围内,以区县为单位,随机抽取至少30个村居,每个村居随机抽查1～3岁7名常住儿童,调查其免疫规划疫苗基础免疫、百白破(DPT)和麻疹(MV)疫苗的加强免疫接种情况.结果 北京市常住儿童免疫预防接种率逐年提高,2011年,预防接种建卡率、建证率;卡证符合率、卡介苗(BCG)、脊髓灰质炎(脊灰,OPV)基础全程、DPT基础全程、MV基础、乙型肝炎(乙肝,HepB)基础全程、风疹(Rubella)基础、流行性腮腺炎(流腮,Mumps)基础、流行性脑脊髓膜炎(流脑,MPV)基础、流行性乙型脑炎(乙脑,JEV)基础和甲型肝炎(甲肝,HepA)基础免疫、DPT、MV加强免疫合格接种率均达97％以上;四苗(BCG、OPV、DPT、MV)基础免疫全程及时接种率达90.46％、HepB首针及时接种率达97.33％.结论 北京市常住儿童中已建立起较为牢固的免疫规划疫苗相关疾病的免疫屏障,但仍需继续加强流动儿童的免疫预防服务工作.     

2013 年南昌市常住儿童免疫规划疫苗接种率调查

摘要:目的　了解2013年南昌市常住儿童国家免疫规划（NIP）疫苗接种情况,指导今后常规免疫工作。方法　使用批质量保证抽样法,以乡镇为单位,抽查NIP疫苗基础免疫、百白破（DPT）和麻疹（MV）疫苗的加强免疫接种情况。结果　调查儿童4 872人,建卡率99.3%,建证率99.9%,卡证符合率99.0%;卡介苗（BCG）、脊髓灰质炎（OPV）基础全程、DPT 基础全程、MV 基础、乙型肝炎（HepB）基础全程、流行性脑脊髓膜炎（MPV）基础、流行性乙型脑炎（JEV）基础免疫接种率达到90%以上;不同年龄组不同户籍属性之间大部分NIP疫苗基础免疫合格接种率差异无统计学意义（ P＞0.05）,城区儿童HepB首针及时率、DPT、MV、JEV、HepA接种率高于农村地区。结论　我市NIP疫苗常规免疫接种率处于较高水平,但存在地域差异,接种率较低的乡主要分布在农村地区,尤其是加强免疫较薄弱,应加强农村地区的免疫规划工作。     

南通经济技术开发区儿童免疫接种率调查

目的 了解南通开发区免疫规划相关疫苗的接种状况 方法 采用按容量比例概率抽样(PPS)法,调查南通开发区5个乡镇30个村的278名本地儿童和169名流动儿童.结果 本地儿童预防接种建卡率、建证率均＞99％,卡介苗(BCG)、乙型肝炎疫苗(HepB)、口服脊髓灰质炎减毒活疫苗(OPV)、百白破联合疫苗(DPT)和麻疹减毒活疫苗(MV)合格接种率与A型脑膜炎球菌多糖疫苗(LNA)、流行性乙型脑炎疫苗(YN)、流行性腮腺炎疫苗、甲肝疫苗的接种率均＞98％,除HepB首针及时率＞90％以外,OPV和MV的及时接种率均＜90％;与本地儿童相比,流动儿童的建证率、基础五苗合格接种率和其他疫苗的接种率水平均较低,差别有统计学意义.结论　南通开发区本地儿童基础疫苗各针次的接种率维持在较高水平,但加强疫苗接种率较低,流动儿童的接种率明显低于本地儿童.须摸清影响儿童接种率的影响因素,采取针对性的措施,提高接种率.     

泰兴市2009—2011年出生儿童接种率调查

目的了解泰兴市适龄儿童免疫规划相关疫苗接种状况。方法采用批质量保证抽样方法(LQAS),抽取452名常住儿童和220名流动儿童,入户调查儿童免疫规划疫苗接种情况。结果 672名儿童,建证率为99.55%,建卡率为99.11%。BCG、HepB、OPV、DPT、MV等五苗合格接种率分别为96.88%、97.32%、96.88%、97.02%、97.32%,基础五苗全程接种率为95.24%,JE1、Men A1、MMR、HepA1疫苗合格接种率分别为96.58%、96.73%、96.88%、96.73%,各疫苗接种率流动儿童均低于常住儿童,差异均有统计学意义(P0.05)。结论泰兴市适龄儿童免疫规划疫苗接种率维持在较高水平,但流动儿童接种率低于常住儿童。应采取有效措施,加强对流动儿童的管理。     

2011年北京市常住儿童常规免疫接种率调查结果分析

目的了解北京市常住儿童免疫规划疫苗接种情况。方法按容量比例概率抽样法,在每个区县范围内随机抽取30～42个村居,每个村居随机抽查1～3岁7名常住儿童,共计调查3 900名儿童的免疫规划疫苗基础免疫、百白破(DPTa)和麻疹(MV)疫苗的加强免疫接种情况。调查接种率按可信区间比较法进行统计学检验。结果北京市常住儿童预防接种建卡率达100.00%、建证率99.97%、卡证符合率99.74%。卡介苗(BCG)、脊髓灰质炎(脊灰,OPV)基础全程、百白破基础全程、麻疹基础、乙型肝炎(乙肝,HepB)基础全程、风疹(Rubella)基础、流行性腮腺炎(流腮,Mumps)基础、流行性脑脊髓膜炎(流脑,MPV)基础、流行性乙型脑炎(乙脑,JEV)基础和甲型肝炎(甲肝,HepA)基础免疫的合格接种率分别为100.00%、99.87%、98.87%、99.62%、99.95%、99.71%、99.53%、99.43%、99.82%和97.94%。五苗(BCG、OPV、DPTa、MV、HepB)基础免疫全程合格接种率99.33%。DPTa、MV加强免疫合格接种率分别为99.18%、98.59%;BCG、OPV基础全程、DPTa基础全程和MV基础免疫及时接种率依次是96.59%、97.28%、96.08%和96.72%。四苗(BCG、OPV、DPTa、MV)基础免疫全程及时接种率90.46%。HepB第1针免疫及时接种率97.33%。门头沟和延庆MV加强免疫、丰台和海淀HepA基础免疫合格接种率低于全市平均水平。东城(北)、西城(南)、丰台、石景山、密云均至少有一项基础免疫及时率低于全市平均水平。不合格接种主要是HepA基础的超期接种、提前接种和未种及MPV基础疫苗的提前接种和超期接种;明确的未种原因中,以家中无人带孩子接种为主。结论北京市常住儿童免疫规划疫苗报告接种率真实可靠,各免疫规划疫苗接种率均维持在较高水平,但仍需加强薄弱地区的合格接种率和提高家长对6月龄以上免疫规划疫苗接种的重视。     

2012年大连市1～5岁儿童免疫规划疫苗接种率调查

目的掌握大连市儿童免疫规划疫苗预防接种现状。方法采用容量比例概率抽样法（PPS）对大连市2008年1月1日至2010年12月31日出生的898名儿童,进行免疫规划疫苗的接种率调查。结果调查898名儿童,建卡率为99．78％,建证率为99．33％,卡介苗（BCG）、口服脊灰疫苗（OPV）、百白破疫苗（DPT）、麻疹疫苗（MV）、乙肝疫苗（HepB）五种疫苗基础免疫接种率均超过99％,HepB首针及时接种率为97．44％,“五苗”全程接种率为99．55％。实施扩大国家免疫规划后甲肝疫苗（HepA）、A群流脑疫苗（MenA）第一剂、第二剂及乙脑疫苗第一剂（JEV）接种率也均超过99％,且流动儿童、本地儿童各疫苗接种率差异均无统计学意义（P〉0．05）。基础免疫疫苗不合格接种共有436针次,其中超期接种338针次,占77．52％。结论将联合疫苗纳入计划免疫将减少超期接种的发生,定期查验接种证,做好查漏补种工作是提高疫苗接种率的重要措施。     

大连市适龄儿童国家免疫规划疫苗接种情况调查

目的了解辽宁省大连市儿童基础免疫接种现状,为制定免疫预防策略提供科学依据。方法采用2阶段按容量比例概率抽样(PPS)方法,在全市11个区市县抽查210名2006—2007年出生儿童,进行卡介苗(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)接种情况免疫调查。结果大连市适龄儿童建卡率为99.05%,建证率为97.14%,各种疫苗合格接种率分别为BCG 98.57%、OPV 98.57%、DPT 98.10%、MV 95.24%、HepB 94.76%,HepB首针及时接种率为94.29%,五苗全程合格接种率为97.62%,卡痕率为96.67%。结论大连市适龄儿童BCG、OPV、DPT、MV、HBV接种率均超过或接近95%,保持在较高水平。     

扬州市2013年适龄儿童免疫接种情况调查

目的了解扬州市适龄儿童国家免疫规划疫苗接种率水平。方法采用现场走访调查与系统抽样调查相结合的方法,对儿童建卡率、建证率、卡证相符率及疫苗接种率和接种及时率进行调查。结果建卡率、建证率和卡证相符率分别为99.14%、100.00%、98.28%,常住儿童建卡率(100.00%)、流动儿童(93.75%)差异有统计学意义(P0.05)。五苗基础免疫合格接种率分别为100.00%、99.73%、99.25%、98.64%、98.50%,"五苗覆盖率"为96.94%,常住儿童(97.81%)与流动儿童(94.76%)差异有统计学意义(P0.05)。MMR、HAV、MenA、JEV1基础免疫接种率分别为98.40%、93.88%、98.16%、93.69%;OPV、DPT、DT、JEV2、MenAC1、MenAC2加强免疫接种率分别为81.82%、99.39%、88.57%、96.94%、94.48%和72.96%,3岁以上OPV、DT、MenAC疫苗基础免疫与加强免疫接种率差异均有统计学意义(P值均0.05);HBV1、OPV基础免疫、MV、MMR接种及时率分别为96.80%、80.68%、90.20%和81.54%。结论扬州市适龄儿童免疫接种率保持在较高水平,但基础免疫接种及时率和加强免疫接种率有待提高,对流动儿童的管理仍需加强。     

Timeliness of routine immunization in a population-based Italian cohort of very preterm infants: Results of the ACTION follow-up project

Background

Although very preterm infants are recommended to receive immunizations, according to their chronological age, immunization start in these infants is often delayed.Aim To measure coverage and timeliness of routine immunizations in Italian very preterm infants and to assess determinants of delay.

Methods

We followed up infants 22–31 completed weeks of gestational age discharged from intensive care. We measured the proportion of children with one dose of diphtheria–tetanus–pertussis–poliohepatitis, B-Hib vaccine (DTP–Pol–HBV-Hib), measles–mumps–rubella vaccine (MMR), conjugate pneumococcal vaccine (Pnc), conjugate meningococcal C vaccine (MenC), and varicella vaccine (Var) by 24 months. We used the Kaplan Meier method and Cox proportional hazard models to estimate the age, at immunization start and determinants of timeliness for each vaccine.

Results

Data on 1102 (92.1%) children out of 1196 included in the cohort were analyzed. Immunization start by 24 months of age occurred in 95.9% of children for DTP–Pol–HBV-Hib; 84.0% for MMR; 49.7% for Pnc; 38.5% for MenC; and 4.1% for Var. Eighty-seven percent of participants received the first dose of DTP–Pol–HBV-Hib by 6 months of age, and 66.7% had their first MMR administered by 18 months. Hospitalization was associated with delay for all vaccines with the exception of MenC and Var. Maternal employment was associated with earlier immunization for MMR, Pnc, and MenC. DTP–Pol–HBV-Hib timeliness improved with increasing birthweight and paternal employment and decreased with a larger number of siblings in the household. MMR was delayed in children with cerebral palsy, and in those with a larger number of children in the household. Immunization for Pnc was delayed in children with larger number of siblings.

Conclusions

Immunization start for all vaccines was considerably delayed in many very preterm infants. Public health strategies taking into account determinants of delay should be implemented to improve coverage and timeliness of vaccination in this group of infants.     

Immunization information system status in China, 2017

Immunization Information Systems (IIS) are computerized population-based systems with individual-level vaccination-related information used to help ensure protection from vaccine preventable diseases. The Chinese Center for Diseases Control and Prevention (China CDC) conducted a survey of the 32 mainland China provincial CDCs to determine IIS coverage and implementation of key functions: individual vaccination records, vaccine management, cold-chain management, and school entry vaccination status verification. Twenty-seven IISs collectively managed 252 million immunization records, 43.8% for children under 6 years; 20 could exchange records with other IISs. The within-province duplicate-record rate varied from 0.3% to 4.0%, but compared with National Statistical Bureau’s census estimates, 138.0% of births from 2012 to 2017 were represented in the IISs, implying significant across-province record duplication. China CDC should consider developing a national-level IIS center for data exchange and analysis.     

2007年栖霞市部分小学入学新生预防接种情况调查

[目的]了解栖霞市入学新生预防接种证查验状况,为今后制订相关政策提供依据。[方法]采用随机抽样抽取5所小学,查验入校新生预防接种证、免疫规划疫苗接种率以及教师预防接种证查验知晓率调查。[结果]调查5所小学新生2 024人,有预防接种证1 658人,占81.92%。流动人口有预防接种证者占74.24%。城市、农村小学新生疫苗接种率均高于流动人口新生。调查小学老师82名,预防接种证查验知识知晓率为70.73%,且城镇老师知晓率高于农村。[结论]加强卫生和教育部门协作,提高入学新生预防接种证查验和疫苗查漏补种率。重点关注流动儿童的接种工作。     

2004年浙江省洞头县流动儿童免疫接种情况分析

[目的]了解洞头县流动儿童免疫接种现状。[方法]于2004年11月调查全县374名流动儿童。按照卫生部《计划免疫技术管理规程》的规定进行合格接种判定。[结果]显示流动儿童“五苗”全程免疫覆盖率为58．85％，低于常住儿童的97.57％（P〈0.01）。[结论]流动儿童大多集中在县城及靠近县城的乡镇，提示城市计划免疫工作应重视流动儿童，加大宣传力度，尤其是对流动人群聚集地的计划免疫管理。     

Assessing immunization rates in an ambulatory care setting

Members of the Collaborative Immunization Initiatives determined the immunization coverage rates for two groups of children in our clinic: those 7 to 12 months old and those 18 to 23 months old. The Clinic Assessment Software Application from the Centers for Disease Control and Prevention was used. The immunization rates determined by this method appeared to significantly underestimate the vaccination coverage rates in our clinic. A review of available charts included in the original sample was done excluding patients no longer attending our clinic. We found a higher rate of coverage in the same sample and a low rate of missed opportunities for administering immunizations. The major reason for this discrepancy is overly stringent Clinic Assessment Software Application inclusion criteria. Additional factors include failure to take into account the wide range of acceptable ages for administering immunizations and different dosages for different brands of vaccines. Different methods of calculation may cause as much as a 20% difference in immunization rates for the same or similar population groups. Such large differences may lead to vastly different responses and interventions. We believe that a central registry is the most accurate method of determining immunization rates. Until this is widely available and applied, a more accurate measure of a facility’s immunization effectiveness is the number of missed opportunities for administering immunizations.     

Immunization costs,from evidence to policy: Findings from a nationally representative costing study and policy translation effort in Tanzania

IntroductionInformation on the costs of routine immunization programs is needed for budgeting, planning, and domestic resource mobilization. This information is particularly important for countries such as Tanzania that are preparing to transition out of support from Gavi, the Vaccine Alliance. This study aimed to estimate the total and unit costs for of child immunization in Tanzania from July 2016 to June 2017 and make this evidence available to key stakeholders.MethodsWe used an ingredients-based approach to collect routine immunization cost data from the facility, district, regional, and national levels. We collected data on the cost of vaccines as well as non-vaccine delivery costs. We estimated total and unit costs from a provider perspective for each level and overall, and examined how costs varied by delivery strategy, geographic area, and facility-level service delivery volume. An evidence-to-policy plan identified key opportunities and stakeholders to target to facilitate the use of results.ResultsThe total annual economic cost of the immunization program, inclusive of vaccines, was estimated to be US$138 million (95% CI: 133, 144), or $4.32 ($3.72, $4.98) per dose. The delivery costs made up $45 million (38, 52), or $1.38 (1.06, 1.70) per dose. The costs of facility-based delivery were similar in urban and rural areas, but the costs of outreach delivery were higher in rural areas than in urban areas. The facility-level delivery cost per dose decreased with the facility service delivery volume.DiscussionWe estimated the costs of the routine immunization program in Tanzania, where no immunization costing study had been conducted for five years. These estimates can inform the program’s budgeting and planning as Tanzania prepares to transition out of Gavi support. Next steps for evidence-to-policy translation have been identified, including technical support requirements for policy advocacy and planning.     

2012年大连市适龄儿童国家免疫规划疫苗接种情况调查

目的 了解大连市适龄儿童国家免疫规划（National Immunization Program,NIP）疫苗接种现状,为制定免疫预防策略提供科学依据。方法 2012年9月,采用两阶段按容量比例概率抽样（PPS）方法,在全市15个县（市、区）抽查898名2008年1月1日至2010年12月31日出生儿童,进行NIP疫苗免疫接种情况调查。结果 大连市适龄儿童建卡率为100%、建证率和卡证符合率均为100%,各种疫苗基础免疫合格接种率分别为BCG 99.67%、OPV98.22%、DPT96.99%、MV 95.43%、HepB 98.22%、MenA 94.43%、JE 99.89%、HepA 94.77%,HepA首针及时接种率为97.44%。加强免疫接种率分别为DPT 95.77%、MV 96.21%、MenA＋C 92.48%、JE 81.49%。结论 大连市适龄儿童国家免疫规划疫苗接种率均超过或接近95%,保持在较高水平。但个别地区预防接种管理有待加强。     

几种麻疹疫苗强化免疫接种率评价方法的比较

[目的]比较几种麻疹疫苗强化免疫接种率的评价方法。[方法]分析比较调查接种率和报告接种率;利用统计局提供人口学资料、计划免疫年报+儿童预防接种信息化系统适龄儿童数、计划免疫年报+儿童预防接种信息化系统乙肝疫苗第二针实种数为应种数计算估算接种比1、2和接种比3,通过差值法和χ2检验对估算接种比进行评价。[结果]8月龄~14岁儿童报告接种837 926人,报告接种率为98.6%,调查目标儿童2 919人,调查接种率为96.1%,差异无统计学意义。估算接种比1、2、3分别为102.5%、101.2%、101.8%。差值法结果显示:估算接种比1、2、3分别有1个、6个、4个县区为可信。除连云区外,其他7个县区估算接种比2与调查接种率结果差异无统计学意义。[结论]我市强化免疫接种率达到95%的目标要求,整体工作质量较好;利用计划免疫年报+儿童预防接种信息系统适龄儿童数计算估算接种比可信度较好。     

Approved but non-funded vaccines: Accessing individual protection

Funded immunization programs are best able to achieve high participation rates, optimal protection of the target population, and indirect protection of others. However, in many countries public funding of approved vaccines can be substantially delayed, limited to a portion of the at-risk population or denied altogether. In these situations, unfunded vaccines are often inaccessible to individuals at risk, allowing potentially avoidable morbidity and mortality to continue to occur. We contend that private access to approved but unfunded vaccines should be reconsidered and encouraged, with recognition that individuals have a prerogative to take advantage of a vaccine of potential benefit to them whether it is publicly funded or not. Moreover, numbers of “approved but unfunded” vaccines are likely to grow because governments will not be able to fund all future vaccines of potential benefit to some citizens. New strategies are needed to better use unfunded vaccines even though the net benefits will fall short of those of funded programs.