Vaccinating My Way-Use of Alternative Vaccination Schedules in New York State
Vaccinating My Way-Use of Alternative Vaccination Schedules in New York State
复制标题
DOI：
10.1016/j.jpeds.2014.09.013
复制
发表时间：
2015-01-01
影响因子：
5.1
通讯作者：
McNutt, Louise-Anne
中科院分区：
文献类型：
--
作者：
Nadeau, Jessica A.;Bednarczyk, Robert A.;McNutt, Louise-Anne
目的利用免疫信息系统数据确定按替代方案接种疫苗的儿童，并确定替代方案使用对疫苗覆盖率的影响。研究设计对2009年1月1日至2011年8月14日在纽约州外出生的儿童进行评估，以确定与使用替代方案一致的接种模式。如果9个月大的儿童在41天后在全州强制免疫信息系统中记录了至少3次疫苗接种，则被归类为试图遵守疾病控制和预防中心公布的推荐疫苗接种时间表或替代时间表。结果在222628名接受研究的儿童中，遵循替代计划的儿童比例为25%。这些儿童在9个月大时更新的可能性(15%)明显低于那些遵循常规时间表的儿童(90%，P<；0.05)。与遵循常规计划的儿童相比，遵循替代计划的儿童平均多接受2次疫苗接种(P<；0.05)。结论在本研究中，几乎每4名儿童中就有1人似乎故意偏离常规计划。故意偏离导致疫苗接种覆盖率低，使儿童容易受到感染，并增加疫苗可预防的疾病暴发的可能性。
Objective To identify children vaccinated following an alternative vaccine schedule using immunization information system data and determine the impact of alternative schedule use on vaccine coverage.Study design Children born in New York State, outside New York City, between January 1, 2009 and August 14, 2011 were assessed for vaccination patterns consistent with use of an alternative schedule. Children who by 9 months of age had at least 3 vaccination visits recorded in the statewide mandatory immunization information system after 41 days of age were classified as either attempting to conform to the Centers for Disease Control and Prevention published recommended vaccination schedule or an alternative schedule. The number of vaccination visits and up-to-date status at age 9 months were compared between groups.Results Of the 222 628 children studied, the proportion of children following an alternative schedule was 25%. These children were significantly less likely to be up-to-date at age 9 months (15%) compared with those conforming to the routine schedule (90%, P < .05). Children following an alternative schedule on average had about 2 extra vaccine visits compared with children following a routine schedule (P < .05).Conclusions Almost 1 in 4 children in this study appear to be intentionally deviating from the routine schedule. Intentional deviation leads to poor vaccination coverage leaving children vulnerable to infection and increasing the potential for vaccine-preventable disease outbreaks.