重庆市农村和城市1～6岁儿童二类疫苗接种率及影响因素分析

摘要

Objective To learn about the immunization status of extra expanded program of immunization (EPI) Vaccines among rural children aged 1 -6 years old in a county of Chongqing,and explore the influencing factors.Method 600 children aged 1 -6 years from 10 villages of one rural district and 374 from 7 communities of one urban district were cho-sen as the subjects.χ2 test was used to compare the difference of the immunization rate of extra EPI Vaccines between rural and urban children,and logistic regression was used to analyze the influencing factors. Results The immunization rate of extra EPI Vaccines among rural children and urban children were 46.8%and 63.1%respectively (χ2 =624.4,P<0.01 ).For all of the 6 vaccines,the immunization rates of urban children were higher than that of rural children (P<0.01). The biggest difference in the rates between urban and rural children was found in Rotavirus Vaccine and Varicella Zoster Vaccine, 28.5% and 26.7% higher in urban children,and the smallest difference was found in 7 valented Pneumococcal Conjugate Vaccine,2.7% higher in urban children.Multivariate analysis results showed that gender,illness in the past 6 month, methods of delivery,doctors’skills and waiting time were the main influencing factors of immunization rate of extra EPI Vaccines among rural children. Conclusion The immunization rate of extra EPI Vaccines in rural children is much lower than in urban children.And the most important influencing factors are the health status of children and the provision of health service.%目的了解重庆市某县农村1～6岁儿童二类疫苗接种率并探索其影响因素。方法采用随机整群抽样的方法抽取重庆市1个县600名和1个区374名1～6岁儿童作为研究对象，用χ2检验比较农村和城市儿童二类疫苗接种率的差别，并用Logistic作影响因素分析。结果农村和城市儿童至少接种过1种二类疫苗的比例分别为46.8％和63.1％（χ2＝624.4，P＜0.01）。且6种二类疫苗，城市儿童的接种率均高于农村儿童（P＜0.01）。其中轮状病毒疫苗和水痘疫苗接种率的差别最大，城市儿童比农村儿童分别高出28.5％和26.7％，7价肺炎球菌结合疫苗接种率的差别最小，城市儿童仅比农村儿童高2.7％。多因素分析显示，儿童近半年内生病次数、分娩方式、医生技术和在医院等待时间是影响农村儿童二类疫苗接种率的主要因素。结论农村儿童的二类疫苗接种率明显低于城市儿童，接种率主要受孩子健康状况和卫生服务提供的影响。