Risk factors for delay in age-appropriate vaccination
Risk factors for delay in age-appropriate vaccination
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DOI：
10.1177/003335490411900207
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发表时间：
2004-03-01
影响因子：
3.3
通讯作者：
Freed, GL
中科院分区：
文献类型：
--
作者：
Dombkowski, KJ;Lantz, PM;Freed, GL
目标。利用具有全国代表性的儿童人群，估计适龄儿童延迟接种疫苗的危险因素，并将疫苗接种延迟的危险因素与基于最新疫苗接种状况模型的危险因素进行比较。作者使用国家健康访谈调查（NHIS）免疫补充的5年汇总数据（1992-1996年）的全国代表性儿童样本，比较了与年龄相适应的疫苗接种延迟的预测因子与未更新的儿童的预测因子。使用与年龄相适应的疫苗接种标准计算DTP4、脊髓灰质炎、MMR1剂量和4:11系列的延迟时间；还确定了最新状态（即是否接受了剂量）。对疫苗接种延迟和最新疫苗接种状况模型使用多变量logistic回归估计调整后的优势比。缺少双亲家庭、家庭规模大、父母受教育程度、医疗补助登记、缺少常规提供者、没有保险覆盖和没有电话的家庭与儿童经历疫苗接种延迟的几率增加显著相关（小于或等于0.05）。在疫苗接种延迟模型中观察到的许多危险因素在基于最新状况的风险模型中并不重要。因此，与年龄相适应的疫苗接种延迟风险模型可能有助于识别疫苗接种不足风险增加的儿童。通过与年龄相适应的疫苗接种延迟风险模型，可以更清楚地确定疫苗接种不足风险增加的人群。
Objective. To estimate the risk factors of children experiencing delay in age-appropriate vaccination using a nationally representative population of children, and to compare risk factors for vaccination delay with those based on up-to-date vaccination status models.Methods. The authors compared predictors of delay in age-appropriate vaccination with those for children who were not up-to-date, using a nationally representative sample of children from five years of pooled data (1992-1996) from the National Health Interview Survey (NHIS) Immunization Supplement. Duration of delay was calculated for the DTP4, Polio3, MMR1 doses and 4:11 series using age-appropriate vaccination standards; up-to-date status (i.e., whether or not a dose was received) was also determined. Adjusted odds ratios were estimated using multivariate logistic regression for models of vaccination delay and up-to-date vaccination status.Results. Absence of a two-parent household, large family size, parental education, Medicaid enrollment, absence of a usual provider, no insurance coverage, and households without a telephone were significantly related to increased odds of a child experiencing vaccination delay (pless than or equal to0.05).Conclusions. Many of the risk factors observed in models of vaccination delay were not found to be significant in risk models based upon up-to-date status. Consequently, risk models of delays in age-appropriate vaccination may foster identification of children at increased risk for inadequate vaccination. Populations at increased risk of inadequate vaccination can be more clearly identified through risk models of delays in age-appropriate vaccination.