Determinants influencing self-paid vaccination coverage, in 0-5 years old Polish children
Determinants influencing self-paid vaccination coverage, in 0-5 years old Polish children
复制标题
DOI：
10.1016/j.vaccine.2013.09.056
复制
发表时间：
2013-11-19
期刊：
影响因子：
5.5
通讯作者：
Szych, Zbigniew
中科院分区：
文献类型：
--
作者：
Ganczak, Maria;Dmytrzyk-Danilow, Gabriela;Szych, Zbigniew
免疫接种是一项重要和具有成本效益的公共卫生干预措施，可保护人口免受疾病的侵害。在波兰，除了国家免疫方案所列的免费疫苗外，还建议自费接种肺炎球菌、脑膜炎球菌、轮状病毒、水痘、流感感染和混合疫苗。本研究的目的是测量2009年6月至2010年1月期间在波兰西南部一个地区随机选择的3家全科医生诊所就诊的0-5岁儿童自费疫苗接种的覆盖率和影响因素。连续就诊儿童的父母被邀请参与并完成关于社会人口学数据和其他与付费疫苗接种相关因素的问卷调查。回答率：93.3%。在308名同意参与的父母（18-50岁，中位数31岁）中，77.9%（95%CI：73.0-82.2%）的孩子接种了至少一种付费疫苗。最常选择的是联合疫苗（62.3%），其次是肺炎球菌（36.4%）、流感（14.3%）、脑膜炎球菌（13.3%）和轮状病毒（12.7%）疫苗。大多数家长承认，他们的决定是基于一名医护人员主动告知他们这个话题。多变量回归模型显示，父母的因素：年龄>= 25岁，高社会经济地位，有一个孩子，和卫生系统因素，即实践地点都与儿童免疫的可能性更大。疫苗的高成本与儿童免疫的机会降低五倍以上有关。所观察到的幼儿自费疫苗高覆盖率主要受联合疫苗的影响。由于疫苗的成本是免疫接种的一个重要障碍，在国家计划中逐步引入一些目前自费的疫苗将是有价值的。今后关于自费疫苗接种覆盖率的干预措施应更有针对性，特别侧重于有一个以上子女的低收入年轻父母。(C)2013爱思唯尔有限公司保留所有权利。
Immunization is an important and cost-effective public health intervention to protect the population from illness. In Poland, in addition to free of charge vaccines, listed in the national program on immunization, self-paid vaccinations for pneumococcal, meningococcal, rotavirus, varicella, influenza infections and combination vaccines are recommended. The study objective was to measure the coverage and influencing determinants of self-paid vaccinations in 0-5-year-old children seen between June 2009 and January 2010 at 3 randomly selected GP practices located in one region in the south-western part of Poland. Parents of the children who were seen consecutively were invited to participate and complete questionnaires on socio-demographic data and other factors related to paid vaccination. The response rate: 93.3%. Among the 308 parents (18-50 years old, median 31 years) who agreed to participate, 77.9% (95%CI: 73.0-82.2%) had their child vaccinated with at least one paid vaccine. Combination vaccines were most commonly chosen (62.3%), followed by a pneumococcal (36.4%), influenza (14.3%), meningococcal (13.3%), and rotavirus (12.7%) vaccine. Most parents admitted that their decision was based on a healthcare worker's initiative informing them about the topic. The multi-variable regression model revealed that parent's factors: age >= 25 years, high socio-economic status, having one child, and health system factor, i.e. practice location were each associated with greater odds of child immunization The high cost of a vaccine was associated with more than five times lower chance to immunize a child. Observed high coverage rate regarding self-paid vaccines among young children was influenced mostly by combination vaccines. As the cost of a vaccine was an important barrier for the immunization, the gradual introduction of some of currently self-paid vaccines in a national program would be of value. Future interventions on self-paid vaccination coverage should be more tailored, focusing especially on young parents with low income who have more than one child. (C) 2013 Elsevier Ltd. All rights reserved.