Compliance with vaccination recommendations for US children
Compliance with vaccination recommendations for US children
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DOI：
10.1016/j.amepre.2008.01.033
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发表时间：
2008-06-01
影响因子：
5.5
通讯作者：
Stokley, Shannon K.
中科院分区：
文献类型：
--
作者：
Luman, Elizabeth T.;Shaw, Kate M.;Stokley, Shannon K.
背景资料：由免疫实践咨询委员会（ACIP）制定的美国儿童常规疫苗接种的官方建议规定了接种疫苗，应给予的剂量，接种年龄范围，剂量被认为有效的最低年龄，一系列剂量之间的最小间隔，以及几种额外的疫苗特定调整和例外情况。联邦报告的疫苗接种覆盖率估计值仅测量了对所需剂量的依从性;其他建议未进行常规评估。方法：分析2005年全国免疫调查中17，563名19-35个月的美国儿童的疫苗接种史。主要结果测量：每个疫苗接种建议的依从性和增量影响。结果：标准疫苗接种系列的估计覆盖率为72%，占所有建议，比仅基于计数剂量的覆盖率低9个百分点。总体而言，19%的儿童错过了一次或多次剂量，8%的儿童接受了无效剂量，9%的儿童受到其他建议的影响。由于错过剂量与其他建议的不遵守的比例不同的状态和antigen.Conclusions：大约28%的儿童不遵守官方疫苗接种建议。错过剂量约占不遵守的三分之二，其余的是由于错误的时间剂量和其他要求。衡量所有ACIP建议的遵守情况提供了一个有价值的工具，可以评估和提高医疗服务的质量，并确保儿童和社区得到最佳保护，免受疫苗可预防疾病的侵害。
Background: Official recommendations for the routine vaccination of U.S. children, made by the Advisory Committee on Immunization Practices (ACIP), specify the vaccines for administration, the number of doses that should be given, the age ranges for administration, the minimum ages at which doses are considered valid, the minimum intervals between doses within a series, and several additional vaccine-specific adjustments and exceptions. Federally reported estimates of vaccination coverage measure only compliance with the required number of doses; other recommendations are not routinely evaluated.Methods: Analysis of vaccination histories for 17,563 U.S. children aged 19-35 months from the 2005 National Immunization Survey.Main Outcome Measures: Compliance with, and incremental impact of, each vaccination recommendation.Results: Estimated coverage was 72% for the standard vaccination series accounting for all recommendations, 9 percentage points lower than coverage based solely on counting doses. Overall, 19% of children were missing one or more doses, while 8% had received an invalid dose, and 9% were affected by other recommendations. The proportion of noncompliance due to missed doses versus other recommendations varied by state and by antigen.Conclusions: Approximately 28% of children were not in compliance with the official vaccination recommendations. Missed doses accounted for approximately two thirds of noncompliance, with the remainder due to mis-timed doses and other requirements. Measuring compliance with all ACIP recommendations provides a valuable tool to assess and improve the quality of healthcare delivery and ensure that children and communities are optimally protected from vaccine-preventable diseases.