上海市2019-2023年出生儿童含百日咳成分疫苗接种及时率及其影响因素研究  

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

作　　者：高梦贤 王楠 田婕 马中慧[3] 吴晔 王鑫钰 张素熠 杨敏艺 王伟炳 黄卓英[3] Gao Mengxian;Wang Nan;Tian Jie;Ma Zhonghui;Wu Ye;Wang Xinyu;Zhang Suyi;Yang Minyi;Wang Weibing;Huang Zhuoying(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)

机构地区：[1]复旦大学公共卫生学院流行病教研室,上海200032 [2]复旦大学上海市重大传染病和生物安全研究院,上海200032 [3]上海市疾病预防控制中心免疫规划所,上海200336

出　　处：《中华流行病学杂志》2024年第9期1216-1223,共8页Chinese Journal of Epidemiology

基　　金：比尔及梅琳达·盖茨基金会(INV-034554);2023年上海市东方英才计划青年项目。

摘　　要：目的了解2019-2023年上海市出生儿童含百日咳成分疫苗接种情况并分析其影响因素。方法对2019-2023年上海市出生的儿童进行分层随机抽样,计算不同年份及不同地区儿童的含百日咳成分疫苗接种率与接种及时率,无细胞百白破b型流感嗜血杆菌联合疫苗(四联疫苗)、吸附无细胞百白破灭活脊髓灰质炎和b型流感嗜血杆菌(结合)联合疫苗(五联疫苗)对免疫规划疫苗的替代比例,采用χ^(2)检验比较组间差异,采用多因素logistic回归分析可能影响接种及时率的相关因素。结果2019-2023年上海市出生儿童含百日咳成分疫苗平均接种率在94.71%~99.53%,不同年份出生儿童含百日咳成分疫苗第1~4剂次接种率差异有统计学意义(均P<0.05),在性别和地区之间差异无统计学意义(均P>0.05)。部分儿童使用自费的联合疫苗替代了免疫规划吸附无细胞百白破联合疫苗的接种,其中大部分选择了五联疫苗替代(替代比例为50.11%~52.69%),也有部分选择四联疫苗替代(替代比例为27.22%~28.43%);市区接种的儿童五联疫苗替代比例更高;替代比例逐年增加。含百日咳成分疫苗总体接种及时率为84.09%,对接种及时率影响因素分析结果显示,随着剂次数的增加,接种及时率逐渐降低;自费接种四联、五联疫苗儿童接种延迟的可能性低;出生年份对接种及时率有显著影响;地区对接种及时率影响不大。此外,接种及时率还受到非药物干预措施实施严格程度的影响。结论上海市含百日咳成分疫苗非免疫规划疫苗替代常见,含百日咳成分疫苗接种率和接种及时率较高,疫苗接种及时率与性别、接种剂次、疫苗种类和非药物干预措施实施的严格程度显著相关。存在一定比例的延迟接种和漏种,仍应关注未及时接种和漏种儿童,开展高质量的查漏补种,确保及时、全程接种含百日咳成分疫苗。Objective To analyze factors associated with timely vaccination of pertussis-containing vaccines in children born in Shanghai from 2019 to 2023.Methods 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 diphtheriatetanus-acellular pertussis vaccine(DTaP)were calculated.Also,the factors associated with timely vaccination rate was analyzed with multivariate logistic regression analysis.Results 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 1st-4th doses of pertussis-containing vaccines among children born in different years(all P<0.05),but no gender and area specific significant differences were observed(all P>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 r

关 键 词：疫苗 接种率 及时率 影响因素 百日咳 

分 类 号：R186[医药卫生—流行病学]