Factors influencing the routine immunization status of children aged 2-3 years in China.
Factors influencing the routine immunization status of children aged 2-3 years in China.
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DOI：
10.1371/journal.pone.0206566
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Xiao QY
中科院分区：
文献类型：
--
作者：
Cao L;Zheng JS;Cao LS;Cui J;Duan MJ;Xiao QY
了解影响我国2-3岁儿童常规免疫接种状况的相关因素，为进一步了解我国计划免疫工作提供依据，为制定有针对性的策略，指导卫生资源配置提供依据。我们分析了2013年全国免疫接种覆盖率调查中45095名2-3岁儿童的数据，以确定影响儿童全面免疫接种状况的社会人口学和提供者相关因素。进行单因素和多因素logistic回归分析。2-3岁儿童的免疫率从95.9%（白喉和破伤风类毒素加百日咳疫苗，第4剂）到99.5%（乙型脑炎疫苗，第1剂）不等，全程免疫率为93.1%。在社会人口学因素方面，男性儿童[校正OR（AOR）：1.115; 95%置信区间（CI）：1.016-1.222]，少数民族儿童（AOR：1.632; 95%CI：1.457-1.828），父亲文化程度低于高中的子女（AOR：1.577; 95%CI：1.195-2.081），家中出生者（AOR：4.655，95%CI：3.771-5.746），外县移民（AOR：2.006; 95%CI：1.581-2.546），以及城乡结合部（AOR：1.807; 95%CI：1.475-2.214）或山区（AOR：1.615; 95%CI：1.437-1.814）未完全免疫的几率显着增加。在提供者相关因素方面，在家接种疫苗（AOR：2.311; 95% CI：1.316-4.059），家庭提醒（AOR：2.292; 95% CI：1.884-2.789），以及前往疫苗接种提供者的旅行时间>40分钟（AOR：1.622; 95%CI：1.309-2.010）与免疫率呈负相关。此外，与3岁儿童相比，2岁儿童（AOR：1.201; 95%CI：1.094-1.318）完全免疫的可能性较小。除母亲受教育程度和从家到接种提供者的距离外，所有因素均显着影响免疫接种率。适当的提醒和免疫服务的可及性在改善免疫状况方面发挥了关键作用。对本研究中确定的高危人群给予更多关注可能会减少中国儿童常规免疫接种的差异。
To examine the factors associated with the routine immunization status of children aged 2–3 years in China for gaining a better understanding of the Expanded Program on Immunization and to provide evidence for formulating specific strategies to guide the allocation of health resources. We analyzed data from 45095 children aged 2–3 years in the 2013 National Immunization Coverage Survey to identify the sociodemographic and provider-associated factors affecting the full immunization status of children. Univariate and multiple logistic regression analyses were performed. The immunization rate for children aged 2–3 years ranged from 95.9% (diphtheria and tetanus toxoid with pertussis vaccine, 4th dose) to 99.5% (Japanese encephalitis vaccine, 1st dose) and was 93.1% for full immunization. In terms of sociodemographic factors, male children [adjusted OR (AOR): 1.115; 95% confidence interval(CI):1.016–1.222], minority children (AOR: 1.632; 95% CI: 1.457–1.828), children of fathers with less than high school education (AOR: 1.577; 95% CI: 1.195–2.081), those born at home (AOR: 4.655; 95% CI: 3.771–5.746), those who immigrated from an adjacent county (AOR: 2.006; 95% CI: 1.581–2.546), and those living in urban-rural fringe areas (AOR: 1.807; 95% CI: 1.475–2.214) or mountainous areas (AOR: 1.615; 95% CI: 1.437–1.814) had significantly increased odds of not being fully immunized. In terms of provider-associated factors, administration of vaccines at home (AOR: 2.311; 95% CI: 1.316–4.059), household reminders (AOR: 2.292; 95% CI: 1.884–2.789), and travel time to vaccination providers of >40 minutes (AOR: 1.622; 95% CI: 1.309–2.010) were negatively associated with immunization rates. In addition, compared to 3-year-old years, 2-year-old children (AOR: 1.201; 95% CI: 1.094–1.318) were less likely to be fully immunized. All included factors except maternal education level and distance from home to vaccination providers significantly affected immunization rates. Appropriate reminders and accessibility of immunization services played key roles in improving the immunization status. More attention to high-risk groups identified in this study may reduce the disparities in routine childhood immunization in China.
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