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目的掌握北京市外来儿童预防接种状况,以制定科学的免疫预防策略。方法对北京市2004年强化免疫活动中口服脊髓灰质炎(脊灰)减毒活疫苗(OPV)、麻疹减毒活疫苗(MV)、百白破联合疫苗(DPT)、流行性乙型脑炎疫苗(JEV)免疫状况,以及卡介苗(BCG)、OPV、MV、DPT接种率进行分析。结果①共调查外来儿童168 010人,建卡率74.9%,建证率80.5%,两指标均随年龄的增加而下降;②OPV漏种率22.0%,零剂次免疫率为17.8%,两指标均随年龄的增加而上升,部分外来人口流入地区上述指标高于全市水平;“服苗后无记录”为零剂次免疫儿童主要原因,构成比随年龄的增加而上升。③MV、DPT、JEV零剂次免疫率分别为13.1%、13.6%、14.6%,补种前迁出率23.7%~28.3%。④调查流动儿童聚居地BCG、OPV、DPT、MV合格接种率60%~70%,流动儿童散居地均>90%,全程免疫覆盖率分别为54.4%和87.6%。结论大年龄组外来儿童免疫预防管理薄弱,外来儿童预防接种卡(证)丢失造成接种信息中断,应加快建立预防接种信息化管理系统。外来人口分布的变化使流入地免疫规划管理负荷加大,应提高原有的人员配置和管理水平。流动儿童聚居地区免疫规划管理难度大,强化免疫效果难以保持,应探索外来儿童免疫规划常规管理长效机制。
Objective To understand the vaccination status of infants from Beijing to formulate a scientific immunization strategy. Methods The live attenuated oral polio vaccine (OPV), live attenuated measles vaccine (MV), diphtheria combined vaccine (DPT), epidemic encephalitis B Vaccine (JEV) immune status, as well as BCG, OPV, MV, DPT vaccination rates were analyzed. Results ① A total of 168,010 foreign children were investigated, with a card-building rate of 74.9% and a building permit rate of 80.5%. Both indicators decreased with increasing age. ②OPV leakage rate was 22.0% and zero-dose immunization rate was 17.8% All increased with the increase of age. Some of the above-mentioned indicators of inflow into the area were higher than the level of the whole city. The main reason for the zero-dose immunization was “no record after service”, and the composition ratio increased with the increase of age. ③MV, DPT, JEV zero-dose immunization rates were 13.1%, 13.6%, 14.6%, before the replantation rate of 23.7% ~ 28.3%. (4) The eligible immunization rates of migrant children in BCG, OPV, DPT and MV were 60% -70% and that of floating children were> 90%. The whole immunization coverage was 54.4% and 87.6% respectively. Conclusions Immunization prevention and management of foreign children in large age group is weak. Vaccination information is interrupted due to the loss of vaccination card for foreign children, and a vaccination information management system should be established. Changes in the distribution of migrants to the influx of immunization planning management load increases, should improve the original staffing and management level. The management of immunization programs in migrant children’s populated areas is difficult and the effect of intensive immunization is difficult to maintain. The long-term mechanism for routine management of immunization programs for foreign children should be explored.