替代第二类疫苗对儿童完成国家免疫规划疫苗系列接种影响

目的 了解替代第二类疫苗（SV）对儿童完成国家免疫规划疫苗系列（NIPVS）接种的影响，为儿童免疫规划工作提供参考依据。方法 于2013年10月采用按容量比例概率抽样方法从福建省1 004个合并后的乡镇中抽取34个乡镇（街道），按批质量保证抽样方法抽取其中1 428名2~4岁儿童进行疫苗接种情况调查，评估SV的覆盖范围及其对儿童完成NIPVS的影响。结果 调查的34个乡镇（街道）中有24个（70.6%）开展了SV服务，调查的1 428名儿童中有1 350名儿童完成了NIPVS接种，NIPVS完成接种率为94.5%；未供应SV地区儿童、SV供应地区未接种SV儿童和供应SV地区接种SV儿童NIPVS完成接种率分别为96.4%、92.1%和97.9%，差异有统计学意义（χ²=17.00，P<0.01）；多因素非条件logistic回归分析结果显示，年龄3~4岁、父亲文化程度高中/中专和居住在丘陵地区均有利于儿童完成NIPVS接种；少数民族和SV供应地区未接种SV均不利于儿童完成NIPVS接种。结论 供应SV对儿童完成NIPVS接种具有双刃剑作用，对于SV供应地区儿童更应促进其SV的接种。

Impact of surrogate vaccines service on completion of National Immunization Program vaccine series

Objective To study the impact of surrogate vaccines (SV) on the completion of National Immunization Program vaccine series (NIPVS).Methods A total of 1 428 children aged 2-4 years were selected with lot quality assurance sampling (LQAS) from 34 of 1 004 townships or communities with a population size of ≥ 10 000 residents.Information on immunization of the children was collected to evaluate the coverage of SV and its impact on NIPVS completion.Results Of the 34 townships or communities sampled,24 (70.6%) had provided SV service and of all the children surveyed 1 350 (94.5%) had finished the NIPVS.The NIPVS completion rate was significantly lower among the children in the regions providing SV service but not undertaking the SV (92.1%) than both the rate among those in the regions not providing SV service (96.4%) and among those in the regions providing SV service while not undertaking the SV (97.9%) (χ²=17.00,P<0.01).Unconditional logistic regression analysis indicated that children aged 3-4 years,living in hilly areas,and with fathers having the education of senior high school or technical school were more likely to complete the NIPVS;while those being ethnic minority and those living in regions providing SV service but not undertaking the SV service were less likely to finish the NIPVS.Conclusion Offering SV service exerts either promoting or hindering effect on the completion of NIPVS among children and the children in regions providing SV service should be advised to undertake the SV.