Factors associated with uptake of measles, mumps, and rubella vaccine (MMR) and use of single antigen vaccines in a contemporary UK cohort: prospective cohort study
Factors associated with uptake of measles, mumps, and rubella vaccine (MMR) and use of single antigen vaccines in a contemporary UK cohort: prospective cohort study
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DOI：
10.1136/bmj.39489.590671.25
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发表时间：
2008-04-05
影响因子：
105.7
通讯作者：
Bedford, Helen
中科院分区：
文献类型：
--
作者：
Pearce, Anna;Law, Catherine;Bedford, Helen
目的评估麻疹、腮腺炎和风疹联合疫苗（MMR）和单一抗原疫苗的接种率，并探讨与接种率相关的因素和不使用MMR的原因。设计全国代表性队列研究。2000- 2.参与者14 578名儿童，他们的免疫接种数据可用。主要结果测量3年时的免疫接种状态定义为“用MMR免疫”、“用至少一种单一抗原疫苗免疫”和“未免疫"。“结果88.6%（13013）的人接种过MMR疫苗，5.2%（634）的人接种过至少一种单一抗原疫苗。如果儿童与其他儿童生活在一个家庭中，（风险比为1.74，95%置信区间为1.35至2.25，对于与三个或三个以上的人生活在一起的人）或一个音调父母（1.31，1.07至1.60）或如果他们的母亲在20岁以下（1.41，1.08至1.85）或在同群子女出生时超过34岁（达到2.34，1.20至3.23，>= 40），教育程度更高（1.41，1.05至1.89，对于学位），没有工作（1.43，1.12至1.82），或自营职业（1.71，1.18至2.47）。单一疫苗的使用随着家庭收入（收入≥ 52 000英镑（69 750欧元，102 190美元）的家庭达到2.98，2.05至4.32）、母亲年龄（≥ 40岁的家庭达到3.04，2.05至4.50）和教育程度（达到3.15，1.78至5.58，获得学位）的增加而增加。如果儿童与其他儿童一起生活，他们接受单一疫苗的可能性较小（达到0.14，0.07到0.29，对于三个或更多），母亲是印度人（0.50，0.25至0.99），巴基斯坦或孟加拉国（0.13，0.04至0.39），或黑人（0.31，0.14至0.64），或年龄在25岁以下（达到0.14，0.05至0.36，14-19）。近四分之三（74.4%，1110）的父母谁没有免疫接种MMR作出了“有意识的决定”，不immunise.Conclusions虽然MMR摄取在这个队列是高的，相当大比例的儿童仍然容易受到可避免的感染，主要是因为父母有意识地决定不免疫。吸收方面的社会差异可用于为促进吸收的有针对性的干预措施提供信息。
Objectives To estimate uptake of the combined measles, mumps, and rubella vaccine (MMR) and single antigen vaccines and explore factors associated with uptake and reasons for not using MMR.Design Nationally representative cohort study.Setting Children born in the UK, 2000-2.Participants 14 578 children for whom data on immunisation were available.Main outcome measures Immunisation status at 3 years defined as "immunised with MMR," "immunised with at least one single antigen vaccine," and "unimmunised."Results 88.6% (13 013) were immunised with MMR and 5.2% (634) had received at least one single antigen vaccine. Children were more likely to be unimmunised if they lived in a household with other children (risk ratio 1.74, 95% confidence interval 1.35 to 2.25, for those living with three or more) or a tone parent (1.31, 1.07 to 1.60) or if their mother was under 20 (1.41, 1.08 to 1.85) or over 34 at cohort child's birth (reaching 2.34, 1.20 to 3.23, for >= 40), more highly educated (1.41, 1.05 to 1.89, for a degree), not employed (1.43, 1.12 to 1.82), or self employed (1.71, 1.18 to 2.47). Use of single vaccines increased with household income (reaching 2.98, 2.05 to 4.32, for incomes of >=52 pound 000 ((euro)69 750, $102 190)), maternal age (reaching 3.04, 2.05 to 4.50, for >= 40), and education (reaching 3.15, 1.78 to 5.58, for a degree). Children were less likely to have received single vaccines if they lived with other children (reaching 0.14, 0.07 to 0.29, for three or more), had mothers who were Indian (0.50, 0.25 to 0.99), Pakistani or Bangladeshi (0.13, 0.04 to 0.39), or black (0.31, 0.14 to 0.64), or aged under 25 (reaching 0.14, 0.05 to 0.36, for 14-19). Nearly three quarters (74.4%, 1110) of parents who did not immunise with MMR made a "conscious decision" not to immunise.Conclusions Although MMR uptake in this cohort is high, a substantial proportion of children remain susceptible to avoidable infection, largely because parents consciously decide not to immunise. Social differentials in uptake could be used to inform targeted interventions to promote uptake.