Children who have received no vaccines: Who are they and where do they live?
Children who have received no vaccines: Who are they and where do they live?
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DOI：
10.1542/peds.114.1.187
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发表时间：
2004-07-01
期刊：
影响因子：
8
通讯作者：
Barker, LE
中科院分区：
文献类型：
--
作者：
Smith, PJ;Chu, SY;Barker, LE
上下文每年有210万19至35个月的儿童接种不足。其中包括没有接种疫苗的儿童。未接种疫苗的儿童感染和传播疫苗可预防疾病的风险增加。评估未接种疫苗的儿童的特征是否与未接种疫苗的儿童的特征不同，监测未接种疫苗的儿童数量的趋势，并确定未接种疫苗儿童数量高的州和县。在1995年至2001年期间，每年收集19至35个月儿童的全国代表性概率样本。从儿童的医疗提供者那里确定疫苗接种史。接种不足的儿童接受了大于或等于1剂的白喉-百日咳、脊髓灰质炎、麻疹、B型流感嗜血杆菌、B型肝炎或水痘疫苗，但没有完全接种。未接种疫苗的儿童是指据报告没有医疗服务提供者和未接种疫苗的儿童，或其医疗服务提供者报告未接种疫苗的儿童。1995 ~ 2001年共调查151720名儿童，其中795名未接种疫苗。接种不足的儿童往往是黑人，母亲年轻未婚，没有大学学位，生活在接近贫困线的家庭，生活在中心城市。未接种疫苗的儿童往往是白色，母亲已婚并有大学学位，生活在年收入超过75 000美元的家庭，父母对疫苗的安全性表示担忧，并表示医生对其子女的疫苗接种决定几乎没有影响力。未接种疫苗的儿童更可能是男性而不是女性。每年大约有17000名儿童没有接种疫苗。未接种疫苗的儿童人数最多的是居住在加州、伊利诺伊、纽约、华盛顿、宾夕法尼亚、得克萨斯、俄克拉荷马州、科罗拉多、犹他州和密歇根州的县。允许哲学豁免的法律规定，为儿童接种疫苗，因为他们进入学校的国家有显着更高的估计率未接种疫苗的儿童。未接种疫苗的儿童具有与接种不足儿童明显不同的特征。未接种疫苗的儿童在地理上聚集在一起，增加了将疫苗可预防的疾病传播给未接种疫苗和接种不足的儿童的风险。
Context. Each year 2.1 million children 19 to 35 months of age are undervaccinated. Among these are children who have received no vaccinations. Unvaccinated children are at increased risk of acquiring and transmitting vaccine-preventable diseases.Objectives. To assess whether the characteristics of children with no vaccinations differ from those of undervaccinated children, to monitor trends in the numbers of unvaccinated children, and to identify states with high rates and counties with large numbers of unvaccinated children.Design. A nationally representative probability sample of children 19 to 35 months of age was collected annually between 1995 and 2001. Vaccination histories were ascertained from children's medical providers. Undervaccinated children had received greater than or equal to1 dose of diphtheriatetanus-pertussis, polio, measles, Haemophilus influenzae type b, hepatitis B, or varicella vaccine but were not fully vaccinated. Unvaccinated children were children who were reported as having no medical providers and having received no vaccinations or children whose medical providers reported administering no vaccinations.Participants. A total of 151 720 children sampled between 1995 and 2001, 795 of whom were unvaccinated.Results. Undervaccinated children tended to be black, to have a younger mother who was not married and did not have a college degree, to live in a household near the poverty level, and to live in a central city. Unvaccinated children tended to be white, to have a mother who was married and had a college degree, to live in a household with an annual income exceeding $75 000, and to have parents who expressed concerns regarding the safety of vaccines and indicated that medical doctors have little influence over vaccination decisions for their children. Unvaccinated children were more likely to be male than female. Annually, similar to17 000 children were unvaccinated. The largest numbers of unvaccinated children lived in counties in California, Illinois, New York, Washington, Pennsylvania, Texas, Oklahoma, Colorado, Utah, and Michigan. States that allowed philosophical exemptions to laws mandating vaccinations for children as they entered school had significantly higher estimated rates of unvaccinated children.Conclusions. Unvaccinated children have characteristics that are distinctly different from those of undervaccinated children. Unvaccinated children are clustered geographically, increasing the risk of transmitting vaccine-preventable diseases to both unvaccinated and undervaccinated children.