社区医生对接种肺炎球菌疫苗的知信行及影响因素研究

  目的  了解2022年浙江省 ≥ 50岁居民流感和肺炎球菌疫苗接种情况及其影响因素，为有效提高该地区中老年人群流感和肺炎球菌疫苗的接种率提供参考依据。  方法  于2022年6月采用多阶段随机抽样方法在浙江省7个区/县35个社区/村抽取2200名 ≥ 50岁居民对其流感和肺炎球菌疫苗接种情况进行问卷调查，并采用多因素非条件logistic回归模型分析影响浙江省 ≥ 50岁居民流感和肺炎球菌疫苗接种情况的主要因素。  结果  浙江省最终纳入分析的2100名 ≥ 50岁居民中，接种流感疫苗和肺炎球菌疫苗者分别为776人和116人，流感疫苗和肺炎球菌疫苗接种率分别为36.95%和5.52%。多因素非条件logistic回归分析结果显示，高中及以上文化程度、知晓流感及其疫苗知识、享受流感疫苗免费接种政策和有医生推荐接种的居民更意愿接种流感疫苗；享受肺炎球菌疫苗免费接种政策和有医生推荐接种的居民更意愿接种肺炎球菌疫苗。浙江省 ≥ 50岁居民接种流感疫苗的主要原因为社区通知接种[590人次（76.03%）]、家人建议接种[400人次（51.55%）]和自己想要预防疾病[350人次（45.49%）]，未接种的主要原因为对疫苗不了解[816人次（61.63%）]、担心有副作用[321人次（24.24%）]和感觉没有必要[296人次（22.36%）]；接种肺炎球菌疫苗的主要原因为社区通知接种[85人次（73.28%）]、家人建议接种[67人次（57.76%）]和自己想要预防疾病[51人次（43.97%）]，未接种的主要原因为对疫苗不了解[1270人次（64.01%）]、感觉没有必要[450人次（22.68%）]和担心有副作用[442人（22.28%）]。  结论   2022年浙江省 ≥ 50岁居民流感和肺炎球菌疫苗接种率均较低，是否享受疫苗免费接种政策和是否有医生推荐接种疫苗是该地区 ≥ 50岁居民流感和肺炎球菌疫苗接种情况的共同影响因素。

Impacts of free vaccination policy and associated factors on influenza vaccination behavior of the elderly in China: a quasi-experimental study

  Objective  To examine the coverage and influencing factors of influenza and pneumococcal vaccines among urban and rural residents aged ≥ 50 years in Zhejiang province for promoting the vaccination of the two vaccines in the population.   Methods  A face-to-face interview with a self-designed questionnaire was conducted during June of 2022 among 2 200 residents aged 50 years above recruited in 35 communities/villages of 7 districts/counties, Zhejiang province. The coverage of influenza and pneumococcal vaccination were statistically described and unconditional multivariate logistic regression model was used to analyze main influencing factors of influenza and pneumococcal vaccination.   Results  Of the 2100 residents ultimately included in the analysis, 776 (36.95%) and 116 (5.52%) reported having influenza vaccination in past one year and pneumococcal vaccination in past five years, respectively. The results of unconditional multivariate logistic regression analysis showed that the residents having the education of high school and above, with influenza vaccine-related awareness, being able to have free of charge vaccination, and ever receiving doctor’s relevant recommendation were more likely to have influenza vaccination and that the residents being able to have pneumococcal vaccination free of charge and ever receiving doctor’s relevant recommendation were more likely to have pneumococcal vaccination. The vaccinees of influenza and pneumococcal vaccine reported following similar vaccination motivations: receiving vaccination notification from community health centers (reported by 590 [76.03%] and 85 [73.28%] of the vaccinees), being promoted by suggestions of family members (400 [51.55%] and 67 [57.76%]), and self-intention to prevent the diseases (350 [45.49%] and 51 [43.97%]); while, the non-vaccinees of influenza and pneumococcal vaccine also reported similar reasons for not having the vaccinations, including without knowledge about influenza or pneumococcal vaccine (reported by 816 [61.63%] and 1 334 [63.52%] of the non-vaccinees), being worried about side effects of the vaccine (321 [24.24%] and 442 [22.28%]), and not perceiving vaccination necessity (296 [22.36%] and 472 [22.48%]).   Conclusion  The vaccination rate of influenza and pneumococcal vaccine are relatively low and mainly influenced by the accessibility of vaccinations free of charge and recommendation on the vaccinations from medical professionals among residents aged ≥ 50 in Zhejiang province.