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[2019年至2023年出生于上海的儿童中与含百日咳疫苗及时接种相关的因素]

[Factors associated with timely vaccination of pertussis-containing vaccines in children born from 2019 to 2023, Shanghai].

作者信息

Gao M X, Wang N, Tian J, Ma Z H, Wu Y, Wang X Y, Zhang S Y, Yang M Y, Wang W B, Huang Z Y

机构信息

Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai 200032, China.

Immunization Planning Institute, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2024 Sep 10;45(9):1216-1223. doi: 10.3760/cma.j.cn112338-20240506-00238.

Abstract

To analyze factors associated with timely vaccination of pertussis-containing vaccines in children born in Shanghai from 2019 to 2023. Children born in Shanghai between 2019 and 2023 were selected using a stratified random sampling method, and their vaccination data were obtained from the Shanghai Vaccine Management and Vaccination Service Information System. The vaccination rates, timely vaccination rates, and the proportions of diphtheria-tetanus-acellular pertussis-haemophilus influenzae type b combination vaccine (DTaP-Hib) and diphtheria-tetanus-acellular pertussis-inactivated poliovirus-haemophilus influenzae type b combination vaccine (DTaP-IPV-Hib) for the substitution of diphtheria- tetanus-acellular pertussis vaccine (DTaP) were calculated. Also, the factors associated with timely vaccination rate was analyzed with multivariate logistic regression analysis. The average vaccination coverage rate of pertussis-containing vaccines in children born in Shanghai from 2019 to 2023 ranged from 94.71% to 99.53%. There were significant differences in the vaccination coverage of the 1-4 doses of pertussis-containing vaccines among children born in different years (all <0.05), but no gender and area specific significant differences were observed (all >0.05). Non-national immunization program (non-NIP) vaccines were used to substitute DTaP vaccines in some children, with the proportion of DTaP-IPV-Hib vaccine accounting for 50.11%-52.69% and the proportion of DTaP-Hib vaccine accounting for 27.22%-28.43%. The proportions of DTaP-Hib and DTaP-IPV-Hib for the substitution of DTaP had increasing trends over the years. The overall timely vaccination rate of pertussis-containing vaccine vaccination was 84.09%. Analysis on the factors affecting the timely vaccination rate showed that the rate gradually decreased with the increase of the doses. Children who received the self-paid quadrivalent or pentavalent vaccines were less likely to have vaccination delays. Birth year had a significant impact on the timely vaccination rate, while the area had less impact. Additionally, the timely vaccination rate was also influenced by the degree of non-pharmaceutical intervention measures. The substitution of pertussis- containing vaccines with non-NIP vaccines was common in Shanghai. The coverage and timeliness of pertussis-containing vaccine vaccination were relatively high. The timely vaccination rate was significantly associated with gender, dose, vaccine type, and the degree of non-pharmaceutical interventions. There was a certain proportions of delayed and missed vaccinations, and it is necessary to pay attention to children who are not vaccinated timely and conduct high-quality catch-up vaccination to ensure timely and complete vaccination of pertussis-containing vaccines.

摘要

分析2019年至2023年在上海出生儿童中与含百日咳疫苗及时接种相关的因素。采用分层随机抽样方法选取2019年至2023年在上海出生的儿童,其接种数据来自上海疫苗管理和接种服务信息系统。计算接种率、及时接种率以及白喉-破伤风-无细胞百日咳- b型流感嗜血杆菌联合疫苗(DTaP-Hib)和白喉-破伤风-无细胞百日咳-灭活脊髓灰质炎病毒- b型流感嗜血杆菌联合疫苗(DTaP-IPV-Hib)替代白喉-破伤风-无细胞百日咳疫苗(DTaP)的比例。同时,采用多因素logistic回归分析方法分析与及时接种率相关的因素。2019年至2023年在上海出生儿童中含百日咳疫苗的平均接种覆盖率在94.71%至99.53%之间。不同年份出生儿童中1-4剂含百日咳疫苗的接种覆盖率存在显著差异(均<0.05),但未观察到性别和地区特异性显著差异(均>0.05)。部分儿童使用非国家免疫规划(非NIP)疫苗替代DTaP疫苗,其中DTaP-IPV-Hib疫苗的比例为50.11%-52.69%,DTaP-Hib疫苗的比例为27.22%-28.43%。多年来,DTaP-Hib和DTaP-IPV-Hib替代DTaP的比例呈上升趋势。含百日咳疫苗接种的总体及时接种率为84.09%。对影响及时接种率的因素分析显示,随着剂次增加接种率逐渐降低。接种自费四价或五价疫苗的儿童接种延迟的可能性较小。出生年份对及时接种率有显著影响,而地区影响较小。此外,及时接种率还受到非药物干预措施程度的影响。在上海,用非NIP疫苗替代含百日咳疫苗的情况较为普遍。含百日咳疫苗接种的覆盖率和及时性相对较高。及时接种率与性别、剂次、疫苗类型以及非药物干预程度显著相关。存在一定比例的接种延迟和漏种情况,有必要关注未及时接种的儿童并开展高质量的补种工作,以确保含百日咳疫苗的及时、全程接种。

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