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大规模疫苗接种活动中的疫苗接种率和收入不平等。

Vaccination uptake and income inequalities within a mass vaccination campaign.

机构信息

Department of Health Systems Management, The Max Stern Yezreel Valley College, Emek Yezreel, Israel.

Department of Health Systems Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

出版信息

Isr J Health Policy Res. 2019 Jul 15;8(1):63. doi: 10.1186/s13584-019-0324-6.

Abstract

BACKGROUND

In July 2013, Israel was swept with fear of a polio outbreak. In response to the importation of wild polio virus, the Ministry decided to take preventive action by administering oral poliovirus vaccine (OPV) to all children born after 1 January 2004 who had received at least one dose of inactivated poliovirus vaccine (IPV) in the past. This study analyzes the vaccination uptake rates resulting from the mass polio vaccination campaign on the basis of health inequality parameters of socioeconomic status (SES), principles of solidarity, and the Gini inequality index. The research explores understanding the value of the Gini inequality index within the context of SES and solidarity.

METHODS

The study is based on data gathered from the Israeli Ministry of Health's administrative records from mother-and-child clinics across Israel. The research population is comprised of resident infants and children whom the Ministry of Health defined as eligible for the OPV between August and December 2013 (the "campaign period"). The analysis was carried out at the municipality level as well as the statistical area level.

RESULTS

The higher the SES level of the municipality where the mother-and-child clinic is located, the lower the OPV vaccination uptake is. The greater the income inequality is in the municipality where the mother-and-child clinic is situated, the lower the vaccination uptake.

CONCLUSIONS

Public health professionals promoting vaccine programs need to make specially-designed efforts both in localities with high average income and in localities with a high level of income diversity/inequality. Such practice will better utilize funds, resources, and manpower dedicated to increasing vaccination uptake across varying populations and communities.

摘要

背景

2013 年 7 月,以色列陷入了小儿麻痹症爆发的恐慌之中。为应对野生脊髓灰质炎病毒的输入,卫生部决定采取预防措施,为所有 2004 年 1 月 1 日后出生、过去至少接种过一剂灭活脊髓灰质炎疫苗(IPV)的儿童接种口服脊髓灰质炎疫苗(OPV)。本研究基于社会经济地位(SES)、团结原则和基尼不平等指数等不平等参数,分析大规模脊髓灰质炎疫苗接种运动的疫苗接种率。本研究旨在探讨 SES 和团结背景下基尼不平等指数的价值。

方法

本研究基于以色列卫生部从全国各地母婴诊所收集的行政记录数据。研究人群包括卫生部界定的 2013 年 8 月至 12 月期间有资格接种 OPV 的常住婴儿和儿童(“接种期”)。分析在市一级和统计区一级进行。

结果

母-婴诊所所在地的 SES 水平越高,OPV 接种率越低。母-婴诊所所在地的收入不平等程度越高,接种率越低。

结论

推广疫苗接种项目的公共卫生专业人员需要在高平均收入地区和收入多样性/不平等程度高的地区做出特别努力。这种做法将更好地利用资金、资源和人力,提高不同人群和社区的疫苗接种率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ddc/6628472/90d9bcf2bb88/13584_2019_324_Fig1_HTML.jpg

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