Impact of measles supplementary immunization activities on reaching children missed by routine programs
Impact of measles supplementary immunization activities on reaching children missed by routine programs
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DOI：
10.1016/j.vaccine.2017.10.080
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发表时间：
2018-01-02
期刊：
影响因子：
5.5
通讯作者：
Verguet, Stephane
中科院分区：
文献类型：
--
作者：
Portnoy, Allison;Jit, Mark;Verguet, Stephane
背景：麻疹补充免疫活动（SIAs）是针对不同年龄的儿童，不论其既往麻疹疫苗接种史如何，以推荐的第二剂机会补充常规疫苗接种计划的疫苗接种活动。在许多低收入和中等收入国家，每2-4年进行一次，为期几周。虽然补充免疫活动的疫苗接种率很高，但尚不清楚它们是否覆盖了未接种常规麻疹疫苗的儿童。确定补充免疫活动的覆盖对象对于了解其有效性以及衡量在麻疹控制方面取得的进展至关重要。方法：我们使用人口与健康调查的数据，对2000年至2014年低收入和中等收入国家的补充免疫缺陷患者进行了调查。根据儿童的常规麻疹疫苗接种情况，我们检查了儿童是否参加了最近的麻疹SIA。结果：14个国家补充免疫机构覆盖的零剂量儿童（以前没有常规接种麻疹疫苗，定义为在补充免疫之前没有接种日期）的平均比例为66%，从圣多美和普林西比的28%到尼日利亚的91%不等。然而，当还包括所有常规麻疹疫苗接种数据的儿童时，这一比例降至12%，当计入各国母亲报告接种疫苗的儿童数据和疫苗接种卡上的疫苗接种标记时，这一比例降至58%。总体而言，补充免疫措施惠及的零剂量儿童比例随着家庭财富的增加而下降。结论：一些国家的零剂量儿童使用sla的比例似乎高于其他国家，所达到的比例根据麻疹疫苗接种的定义（例如，疫苗接种卡上的疫苗接种日期、疫苗接种卡上的疫苗接种标记和/或自我报告的数据）而有所不同。这表明，一些国家可以改进针对错过其他麻疹疫苗接种机会的儿童的补充免疫接种。在所有国家，补充免疫活动在帮助贫困家庭儿童方面发挥了重要作用。(C) 2017年作者。Elsevier Ltd.出版。
Background: Measles supplementary immunization activities (SIAs) are vaccination campaigns that supplement routine vaccination programs with a recommended second dose opportunity to children of different ages regardless of their previous history of measles vaccination. They are conducted every 2-4 years and over a few weeks in many low- and middle-income countries. While SIAs have high vaccination coverage, it is unclear whether they reach the children who miss their routine measles vaccine dose. Determining who is reached by SIAs is vital to understanding their effectiveness, as well as measure progress towards measles control.Methods: We examined SIAs in low- and middle-income countries from 2000 to 2014 using data from the Demographic and Health Surveys. Conditional on a child's routine measles vaccination status, we examined whether children participated in the most recent measles SIA.Results: The average proportion of zero-dose children (no previous routine measles vaccination defined as no vaccination date before the SIA) reached by SIAs across 14 countries was 66%, ranging from 28% in Sao Tome and Principe to 91% in Nigeria. However, when also including all children with routine measles vaccination data, this proportion decreased to 12% and to 58% when imputing data for children with vaccination reported by the mother and vaccination marks on the vaccination card across countries. Overall, the proportions of zero-dose children reached by SIAs declined with increasing household wealth.Conclusions: Some countries appeared to reach a higher proportion of zero-dose children using SlAs than others, with proportions reached varying according to the definition of measles vaccination (e.g., vaccination dates on the vaccination card, vaccination marks on the vaccination card, and/or self-reported data). This suggests that some countries could improve their targeting of SIAs to children who miss other measles vaccine opportunities. Across all countries, SIAs played an important role in reaching children from poor households. (C) 2017 The Authors. Published by Elsevier Ltd.