2013年全国省级抽查以乡为单位适龄儿童国家免疫规划疫苗接种率分析  

Immunization Coverage of the National Immunization Program Vaccines at the Township Level,based on a Survey Conducted by Provincial CDCs in China,2013

作　　者：郑景山[1] 曹雷[1] 郭世成[2] 张晓曙[3] 卢莉[4] 王雷[5] 胡昱[6] 曹玲生[1] 袁平[1] 崔健[1] 王华庆[1] 李黎[1] 

机构地区：[1]中国疾病预防控制中心免疫规划中心,北京100050 [2]江西省疾病预防控制中心,南昌330029 [3]甘肃省疾病预防控制中心,兰州730000 [4]北京市疾病预防控制中心,北京100013 [5]湖北省疾病预防控制中心,武汉430079 [6]浙江省疾病预防控制中心,杭州310051

出　　处：《中国疫苗和免疫》2014年第6期492-498,546,共8页Chinese Journal of Vaccines and Immunization

基　　金：国家卫生和计划生育委员会;世界卫生组织接种率调查专项资金

摘　　要：目的分析2013年全国省[自治区、直辖市、新疆生产建设兵团（新疆兵团）,下同]级抽查以乡（镇、街道、苏木、新疆兵团团场,下同）为单位适龄儿童国家免疫规划疫苗（National Immunization Program Vaccines,NIPV）接种率调查结果。方法各省按照国家统一要求,分别简单/系统随机抽取29-35个乡,在乡内以批质量保证抽样（Lot Quality Assurance Sampling,LQAS）方法随机抽取≥42名2-3岁儿童开展NIPV接种情况入户调查。全国及各省以乡为单位NIPV分疫苗/剂次接种率以LQAS方法定性评价。调查乡8种NIPV接种率均≥90%时,可认为该乡适龄儿童NIPV接种率≥90%。结果省级抽查了全国32个省、963个县（区、市、旗、新疆兵团师）、1073个乡的45 095名2-3岁儿童。全国适龄儿童建预防接种卡率、预防接种证持有率和预防接种卡（证）相符率≥90%的乡比例分别为89.3%、96.6%和38.6%。全国第4剂百日咳-白喉-破伤风联合疫苗、第2剂含麻疹成分疫苗、第2剂A群脑膜炎球菌多糖疫苗（Group A Meningococcal Polysaccharide Vaccine,MPV-A）和1剂甲型肝炎减毒活疫苗接种率≥90%的乡比例〈90%（82.5%-87.2%）,第1剂MPV-A接种率≥90%的乡比例为92.7%,评估的NIPV其余各剂次接种率≥90%的乡比例均〉95%（95.8%-97.9%）。全国平均75.4%的乡8种NIPV接种率≥90%。缺乏信息和客观原因是儿童漏种的主要原因。结论全国NIPV接种率总体保持较高水平,但距国务院发布的《卫生事业发展＂十二五＂规划》中以乡为单位接种率≥90%的目标仍有差距,多个省不同程度地存在薄弱地区,不同省、不同疫苗和不同剂次间差异较大。应进一步提高预防接种服务可及性,加强信息交流,完善预防接种服务,提升服务质量,全面提高和保持以乡为单位NIPV接种率水平。Objective To determine immunization coverage of National Immunization Program vaccines （NIPV） at the township level, based on a survey conducted by provincial CDCs in China in 2013. Meth- ods Using the national immunization survey guidelines, 29 -35 townships from each province were se- lected by simple or systematic random sampling. Using lot quality assurance sampling （LQAS） methodol- ogy, ≥42 children, aged 2 -3 years, were investigated through household interviews to determine NIPV immunization status. Township-level NIPV immunization coverage was qualitatively evaluated by LQAS methods： townships were categorized as having ≥90% coverage only if all coverage levels of all town-ships for all 8 NIPVs were≥90%. Results Parents or caregivers of 45,095 children, aged 2 -3 years, from 1,073 townships of 973 counties of 31 provinces （including Xinjiang production and construction corps） were interviewed at their home. Among all townships, 89.3% of children had vaccination cards; 96. 6% had vaccination clinic records; and for 38.6% of townships, atleast 90% of cards matched the records. Fewer than 90% of townships had i〉90% immunization cover- age （ range 82.5% - 87.2% ） for the fourth dose of diphtheria, tetanus and pertussis combined vaccine, the second dose of measles-containing vaccine, group A meningocoecal polysaccharide vaccine （MPV- A）, and hepatitis A attenuated live vaccine （HepA）. Coverage for the first dose of MPV-A was 92.7 %, and coverage was 〉95% （95.8% -97. 9% ） for the other NIPVs. Of the 1,073 townships surveyed, 75.4% had I〉90% immunization coverage for each of the S NIPVs. Lacking information about vaccination, and objective reasons were the main factors associated with missing opportunities for immunization. Conclusions NIPV immunization coverage remains high throughout China, however, there are disparities between survey coverage results and the national immunization goals of the twelfth five-year plan. Some areas had poor immunization coverage, and ther

关 键 词：省级抽样调查 国家免疫规划疫苗 以乡为单位 接种率 

分 类 号：R186[医药卫生—流行病学]