Fully immunized child: coverage, timing and sequencing of routine immunization in an urban poor settlement in Nairobi, Kenya.
Fully immunized child: coverage, timing and sequencing of routine immunization in an urban poor settlement in Nairobi, Kenya.
复制标题
完全免疫的儿童：在肯尼亚内罗毕的城市贫困定居点中，常规免疫的覆盖范围，时间和测序。
DOI：
10.1186/s41182-016-0013-x
复制
发表时间：
2016
影响因子：
4.5
通讯作者：
Echoka E
中科院分区：
文献类型：
--
作者：
Mutua MK;Kimani-Murage E;Ngomi N;Ravn H;Mwaniki P;Echoka E
过去十年来，为提高全面免疫覆盖率做出了更多努力。对于按不同时间表延迟或为儿童接种疫苗的程度和后果知之甚少。疫苗的有效性取决于接种时间，提前、延迟或不按建议接种都不是最佳效果。疫苗非特异性效应的证据有据可查，并且可能与免疫接种的时间和顺序有关。本文记录了常规儿童疫苗的覆盖范围、时间安排和顺序。该研究于 2007 年至 2014 年间在内罗毕的两个非正规城市住区进行。共有 3856 名年龄在 12-23 个月且持有疫苗接种卡的儿童参与了分析。从所看到的卡片上记录的疫苗接种日期用于定义完整的免疫覆盖率、及时性和顺序。使用比例、中位数和卡普兰-迈耶曲线来评估和描述全面免疫覆盖、疫苗接种延迟和测序的水平。研究结果表明，67% 的儿童在 12 个月大时已完全免疫。麻疹、第三剂脊髓灰质炎疫苗和五价疫苗的缺失是未充分免疫的主要原因。第三剂脊髓灰质炎疫苗、五价疫苗和麻疹疫苗的延误时间最长。大约 22% 的完全免疫儿童以不按顺序接种疫苗，其中 18% 的儿童没有按照建议接种五价疫苗和脊髓灰质炎疫苗。结果显示，错过机会的比例较高，而后期常规儿童疫苗接种的覆盖率较低。需要新的策略，使医疗保健提供者和家长/监护人能够共同努力，提高所有必需疫苗接种的完成率。特别是，需要更多地关注多剂量疫苗（脊髓灰质炎疫苗、五价疫苗和肺炎球菌结合疫苗）。本文的在线版本 (doi:10.1186/s41182-016-0013-x) 包含补充材料，可供授权用户使用。
More efforts have been put in place to increase full immunization coverage rates in the last decade. Little is known about the levels and consequences of delaying or vaccinating children in different schedules. Vaccine effectiveness depends on the timing of its administration, and it is not optimal if given early, delayed or not given as recommended. Evidence of non-specific effects of vaccines is well documented and could be linked to timing and sequencing of immunization. This paper documents the levels of coverage, timing and sequencing of routine childhood vaccines. The study was conducted between 2007 and 2014 in two informal urban settlements in Nairobi. A total of 3856 children, aged 12–23 months and having a vaccination card seen were included in analysis. Vaccination dates recorded from the cards seen were used to define full immunization coverage, timeliness and sequencing. Proportions, medians and Kaplan-Meier curves were used to assess and describe the levels of full immunization coverage, vaccination delays and sequencing. The findings indicate that 67 % of the children were fully immunized by 12 months of age. Missing measles and third doses of polio and pentavalent vaccine were the main reason for not being fully immunized. Delays were highest for third doses of polio and pentavalent and measles. About 22 % of fully immunized children had vaccines in an out-of-sequence manner with 18 % not receiving pentavalent together with polio vaccine as recommended. Results show higher levels of missed opportunities and low coverage of routine childhood vaccinations given at later ages. New strategies are needed to enable health care providers and parents/guardians to work together to increase the levels of completion of all required vaccinations. In particular, more focus is needed on vaccines given in multiple doses (polio, pentavalent and pneumococcal conjugate vaccines). The online version of this article (doi:10.1186/s41182-016-0013-x) contains supplementary material, which is available to authorized users.