Frequency of Alternative Immunization Schedule Use in a Metropolitan Area
Frequency of Alternative Immunization Schedule Use in a Metropolitan Area
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DOI：
10.1542/peds.2011-3154
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发表时间：
2012-07-01
期刊：
影响因子：
8
通讯作者：
Young, Collette
中科院分区：
文献类型：
--
作者：
Robison, Steve G.;Groom, Holly;Young, Collette
目的：最近的研究描述了父母对疫苗的犹豫增加，以及父母采用疫苗时间表的增加，延迟或限制了推荐疫苗的接收。本研究量化潜在的流行和趋势，在替代时间表遵守测量一致射击限制在俄勒冈州的大都市区。方法：采用俄勒冈ALERT免疫信息系统进行回顾性队列分析，追踪2003年至2009年在波特兰市区出生的儿童。使用联结点回归分析在该时间段内一致限制注射的流行趋势。还检查了2007-2009年b型流感嗜血杆菌疫苗短缺和联合疫苗供应增加对注射限制率的影响。结果：97 711名儿童中，4502名（4.6%）符合一致射击限制者的定义。从2006年到2009年，持续限制射击者在人口中的比例从2.5%上升到9.5%。与没有限制或发作性限制的儿童相比，9个月大的持续注射限制者注射次数较少（6.4 vs 10.4），但接种疫苗时就诊次数较多（4.2 vs 3.3）。然而，只有一小部分限制者严格遵守公布的替代时间表。结论：出生至9个月之间每次就诊持续接受2次或更少疫苗注射的儿童百分比在2年内增加了3倍，这表明该地理区域对非免疫实践咨询委员会疫苗接种计划的接受程度有所提高。儿科2012;130: 32-38
OBJECTIVES: Recent studies have described an increase in parental hesitancy regarding vaccines as well as increases in parental adoption of vaccine schedules that delay or limit receipt of recommended vaccines. This study quantifies potential prevalence and trends in alternative schedule compliance by measuring consistent shot-limiting in a metropolitan area of Oregon.METHODS: Retrospective cohort analysis using the Oregon ALERT Immunization Information System to track children born between 2003 and 2009 in the Portland metropolitan area. Joinpoint regression was used to analyze prevalence trends in consistent shot-limiting during that time period. The 2007-2009 Haemophilus influenzae type b vaccine shortage and increased availability of combination vaccines were also examined for their effects on shot-limiting rates.RESULTS: A total of 4502 of 97 711 (4.6%) children met the definition of consistent shot-limiters. The proportion of consistent shot-limiters in the population increased from 2.5% to 9.5% between 2006 and 2009. Compared with those with no or episodic limiting, consistent shot-limiters by 9 months of age had fewer injections (6.4 vs 10.4) but more visits when immunizations were administered (4.2 vs 3.3). However, only a small minority of shot-limiters closely adhered to published alternative schedules.CONCLUSIONS: The percentage of children consistently receiving 2 or fewer vaccine injections per visit between birth and age 9 months increased threefold within a 2-year period, suggesting an increase in acceptance of non-Advisory Committee on Immunization Practices vaccine schedules in this geographic area. Pediatrics 2012; 130: 32-38