Risk factors associated with failure to receive vaccinations.
Risk factors associated with failure to receive vaccinations.
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与未能接种疫苗相关的风险因素。
DOI：
10.1542/peds.64.3.304
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发表时间：
1979
期刊：
影响因子：
8
通讯作者：
John R. Keller
中科院分区：
文献类型：
--
作者：
J. Marks;T. Halpin;John J. Irvin;Deane Johnson;John R. Keller
一项全州范围的调查记录了1,003名2岁儿童的疫苗接种状况，其主要目的是确定与未能接种推荐疫苗有关的因素。基本系列免疫包括三剂白喉-破伤风-百日咳(DTP)、三支口服脊髓灰质炎疫苗(OPV)、一支麻疹疫苗和一支风疹疫苗，72.5%的儿童完成了这一系列免疫。当完成的系列被重新定义为包括第四种DTP和腮腺炎疫苗时，完成率下降到40.8%。然而，59.1%没有完成这一最佳系列的儿童只需去一次他们的医疗保健提供者那里就可以了解最新情况。与完成基本系列独立相关的人口统计学变量有：父亲教育程度增加(P<0.001)、母亲教育程度增加(P<0.02)、家庭规模较小(P<0.01)以及人口普查地区或农村城镇所决定的较高的社会经济地位(P<0.02)。当社会经济地位得到控制时，种族并不是疫苗接种率的相关因素。从私人医生那里接种疫苗的患者比那些到卫生部门诊所接种疫苗的患者的疫苗接种率更高。即使在社会经济地位由居住地控制的情况下，这种差异仍然存在(P<0.02)。对父母教育程度和家庭规模的同时比较表明，父母一方受教育不足12年或至少有三个兄弟姐妹的孩子完成免疫接种失败的风险是父母都是大学毕业生的孩子的四倍。以父亲和母亲的文化程度和家庭规模为筛查变量，前瞻性地识别未完成免疫接种的高危儿童，并将其作为干预计划的目标，以提高依从性。
A major purpose of a state-wide survey to document the vaccination status of 1,003 2-year-old children was to identify factors associated with failure to receive the recommended vaccinations. With a basic series of immunization defined as three doses of diphtheria-tetanus-pertussis (DTP), three oral polio vaccine (OPV), one measles, and one rubella, 72.5% of the children had completed the series. When the completed series was redefined to include a fourth DTP and mumps vaccine the rate of completion dropped to 40.8%. However, 59.1% of the children who had not completed this optimal series could be brought up-to-date with a single visit to their provider of medical care. Demographic variables independently associated with completion of the basic series were increased paternal education (P less than .001), increased maternal education (P less than .02), smaller family size (P less than .01) and higher socioeconomic status, as determined by census tract or rural town of residence (P less than .02). Race was not found to be a factor associated with vaccination rates when socioeconomic status was controlled. Patients who received their vaccinations from private physicians had a better vaccination rate than those who attended health department clinics. This difference persisted even when socioeconomic status was controlled by residence (P less than .02). The simultaneous comparison of parental education and family size demonstrated that a child having one parent with less than 12 years education or having at least three siblings has a fourfold greater risk of failure to complete his immunization than children whose parents are both college graduates. By using paternal and maternal education level and family size as screening variables, children at high risk for failure to complete their immunizations could be identified prospectively and made the target of intervention programs to improve compliance.