1999年全国儿童计划免疫与乙型肝炎疫苗接种率及影响因素调查分析  

National EPI Vaccination and Hepatitis B Vaccine Coverage Rate and the Related Factors: Results from the 1999 Nationwide Survey

作　　者：朱徐[1] 中国预防 

机构地区：[1]卫生部疾病控制司,北京 [2]医学科学院,北京

出　　处：《中国计划免疫》2000年第4期193-197,共5页Chinese Journal of Vaccines and Immunization

摘　　要：为了解我国儿童计划免疫和乙型肝炎 (乙肝 )疫苗接种的现状 ,在全国 3 1个省 (自治区、直辖市 ,下同 )采用组群抽样法进行了调查。结果显示 ,全国四种疫苗的接种率是 :卡介苗 97 2 % ,口服脊髓灰质炎疫苗 ( 3剂全程 ) 92 0 % ,百白破混合制剂 ( 3针全程 ) 92 7% ,麻疹疫苗 93 0 % ;四种疫苗全程免疫覆盖率平均为 85 3 % ;计划免疫保偿率为 46 0 %。乙肝疫苗 3针全程接种率全国平均为 70 7% ,12月龄内 3针全程接种率平均为 63 5 % ;全国接种点提供乙肝疫苗免疫服务的占 85 4%。向儿童家长的调查表明 ,影响四种疫苗接种的原因是 :( 1)不知道要接种 ;( 2 )时间不合适 ;( 3 )本地无户口 ;( 4 )计划外生育。影响乙肝疫苗接种的原因是 :( 1)本地不提供服务 ;( 2 )不知道要接种 ;( 3 )收费太贵。本次调查也证实 ,我国计划免疫工作薄弱之处主要是少数民族地区、贫困地区、经济发展滞后的边远地区和山区 ;人群主要是流动儿童和计划外生育的儿童。今后在发展当地经济的同时 ,应加强对这些地区和这些特殊人群的宣传教育 ,探讨为当地居民乐于接受的方法和形式来提高居民对计划免疫的认识和要求 ,既有利于减轻计划免疫服务方的工作负担 ,又有利于提高计划免疫服务的质量。To evaluate routine EPI and hepatitis B vaccine coverage rate, a nationwide survey was conducted in 1999 in 31 provinces of China. The survey used cluster sampling method to select children aged 18～34 months(n= 25,878 ); in addition, village immunization providers(n= 3,656 )were recruited. Overall, vaccine coverage rate for BCG was 97.2%, OPV(3 doses)92.0%, DPT(3 doses)92.7%, and MV 93.0%. The up-to-date vaccine coverage rate of hepatitis B (3 doses)was 70 7%, 63.5% of children had received 3 doses under 12 months of age. Eighty-five percent of immunization sites provided hepatitis B vaccine. Factors identified to be associated with children not being vaccinated included: 1)parents not knowing vaccination was indicated; 2)indication about the length of time that vaccines were available at immunization sites was not adequate; 3)children were not registered as local residents; and 4)children out of family planning. Factors identified to be associated with not receiving hepatitis B vaccine included: 1)hepatitis B vaccine not provided at the immunization site; 2) parents were not aware that hepatitis B vaccine was recommended; 3) the vaccine charge is too expensive. This study indicates that EPI services need to be improved in poor areas, minority populations, and mountainous areas in China. In addition, accessing floating populations and children out of family planning remains a difficult challenge for the EPI program in China. Possible ways to improve EPI services among undeserved populations include making great efforts on health education, taking studies on immunization strategies and ways that can be easily accepted by the local populations, these not only can reduce the burden on EPI program and also can improve the quality of vaccination services.

关 键 词：乙型肝炎 疫苗接种率 计划免疫 儿童 

分 类 号：R725.126.2[医药卫生—儿科]