腾冲县扩大国家免疫规划疫苗接种率调查分析

目的了解腾冲县扩大国家免疫规划（National Immunization Program,NIP）疫苗的接种现状,分析存在问题,促进免疫规划工作的可持续发展。方法采用容量比例概率抽样方法抽取30个村,每个村随机调查1~2岁儿童14人,共调查420名儿童NIP疫苗的基础免疫（初种）及加强免疫（复种）情况。结果建预防接种卡率100%,建预防接种证率100%,预防接种卡、证符合率68.57%。调查儿童卡介苗、口服脊髓灰质炎减毒活疫苗、白喉-破伤风-百日咳联合疫苗（Diphtheria,Tetanus and Pertussis Combined Vaccine;DTP）、首剂含麻疹成分疫苗（First Dose Measles-containing Vaccine,MCV1）、乙型肝炎疫苗（以上五种NIP疫苗简称＂五苗＂）基础免疫（初种）全程接种率为98.57%,合格接种率为82.38%;加强免疫（复种）第4剂（Fourth Dose）DTP（DTP4）、第2剂（Second Dose）MCV（MCV2）免疫接种率分别为91.09%、92.25%,合格接种率分别为86.82%、89.92%。NIP新增疫苗A群脑膜炎球菌多糖疫苗（Group A Meningococcal Polysaccharide Vaccine,MPV-A）、首剂流行性乙型脑炎减毒活疫苗（First Dose Japanese Encephalitis Attenuated Live Vaccine,JEV-L1）、甲型肝炎减毒活疫苗基础免疫（初种）接种率分别为92.38%、97.38%、92.98%,合格接种率为84.52%、83.10%、80.95%;第二剂（Second Dose）JEV-L（JEV-L2）接种率为92.25%,合格接种率为79.53%。不合格接种的前三位原因是漏种/未完成全程接种、提前接种、超期接种;主要不合格接种疫苗为JEV-L、MPV-A、MCV、DTP。结论腾冲县NIP非新增疫苗基础免疫（初种）接种率﹥99%,加强免疫（复种）及NIP新增疫苗接种率﹥90%,但合格接种率相对较低,要在保持和提高接种率的同时,提高合格、有效接种是核心。

Survey and Analysis of Vaccine Coverage of the National Immunization Programs in Tengchong County

Objective To determine vaccination coverage in the Notional Immunization Program （NIP） of Tengchong County;to identify problems associated with vaccination coverage;and to promote sustainable immunization program planning. Method Using a probabillity proportional to size sampling method, we selected 30 villages, and in each village we interviewed parents of 14 randomly selected children aged 1 to 2 years. A total of 420 children were surveyed for NIP vaccination status. Result Parents of all surveyed children had immunization records. Clinic records matched parent＇ s records for 68.57% of the children. Coverage for BCG, live attenuated oral polio vaccine, diphtheria-tetanus-pertussis vaccine （ DTP）, the first dose of measles-containing vaccine （ MCV1 ） , and Hepatitis B vaccine, which, together, are considered the 5-vaccine series, was 98.57% , with a qualified （on-time） vaccination rate of 82.38%. Coverage levels with the fourth dose of DTP （ DTP4 ） and the second dose of MCV （ MCV2 ） were 91.09% and 92.25% ,respectively,with qualified vaccination rates of 86.82% and 89.92%, respectively. Coverage levels of newly introduced NIP vaccines-group A meningococcal polysaccharide vaccine （MPV-A）, the first dose of live attenuated Japanese encephalitis vaccine （JEV-L1） , live attenuated hepatitis A vaccinewere 92. 38% ,97.38 and 92. 98%, respectively, with qualified vaccination rates of 84. 52%, 83.10%, and 80.95%. Coverage of the second dose of JEV-L （JEV-L2） was 92. 25% , with a qualified vaccination rate of 79. 53%. The 3 mostcommon reasons for under-vaccination were （1） missing 1 or more doses in a series. （2） doses administered too early, and （3） doses given too late. The most commonly missed vaccinations were JEV- L,MPV-A,MCV,and DTP. Conclusion Coverage for routine NIP vaccines was greater than 99% ,and coverage for new NIP vaccines was over 90%. However, qualified vaccination rates were relatively low. It is important to maintain and improve vaccination services