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丁亚兴, 陈伟, 李永成, 孙静, 高志刚, 张颖. 天津市2004 — 2017年首剂次含麻疹成分疫苗禁忌分析[J]. 中国公共卫生, 2019, 35(7): 886-890. DOI: 10.11847/zgggws1120596
引用本文: 丁亚兴, 陈伟, 李永成, 孙静, 高志刚, 张颖. 天津市2004 — 2017年首剂次含麻疹成分疫苗禁忌分析[J]. 中国公共卫生, 2019, 35(7): 886-890. DOI: 10.11847/zgggws1120596
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Ya-xing DING, Wei CHEN, Yong-cheng LI, . Contraindications to first dose measles-containing vaccine among 8 months – 14 years old children in Tianjin city, 2004 – 2017[J]. Chinese Journal of Public Health, 2019, 35(7): 886-890. DOI: 10.11847/zgggws1120596
Citation: Ya-xing DING, Wei CHEN, Yong-cheng LI, . Contraindications to first dose measles-containing vaccine among 8 months – 14 years old children in Tianjin city, 2004 – 2017[J]. Chinese Journal of Public Health, 2019, 35(7): 886-890. DOI: 10.11847/zgggws1120596
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天津市2004 — 2017年首剂次含麻疹成分疫苗禁忌分析

Contraindications to first dose measles-containing vaccine among 8 months – 14 years old children in Tianjin city, 2004 – 2017

    摘要
  • 摘要:
    目的 分析天津市2004 — 2017年首剂次含麻疹成分疫苗（MCV1）接种禁忌状况。
    方法 利用天津市免疫规划信息管理系统收集2004 — 2017年出生队列儿童MCV1接种禁忌和不同地区接种医生情况；利用全国麻疹监测信息报告管理系统分析2009 — 2017年8月龄～14岁麻疹病例MCV1未免疫原因，综合评价儿童MCV1接种禁忌状况。
    结果 天津市2004 — 2017年出生队列共有1 974 513名儿童，MCV1禁忌报告率为3.28 %（64 670例），短期禁忌88.44 %（57 191例），长期禁忌11.56 %（7 479例）。不同禁忌种类中，急性疾病、严重慢性疾病、慢性疾病的急性发作期最多（59.27 %）。不同地区间，滨海新区和市区禁忌报告率较高。禁忌报告率从2004年的0.14 %逐渐升高到2013年的6.22 %，然后迅速下降到2017年的2.76 %。天津市288家接种门诊，接种医生1 401人，滨海新区和市区接种医生年龄和免疫规划工作年限较长。接种医生专业分布中，以护理专业为主（58.74 %）。2009 — 2017年天津市报告8月龄～14岁麻疹病例749例，60.35 %无MCV1免疫史，未免疫原因主要为短期禁忌（44.91 %）和长期禁忌（18.14 %）。
    结论 禁忌的规定直接影响麻疹免疫策略的落实，目前禁忌掌握参差不齐，亟待制定科学可行的统一禁忌标准。

     

    Abstract:
    Objective To analyze the contraindications to first dose of measles-containing vaccine (MCV1) among children in Tianjin city between 2004 and 2017.
    Methods We collected data on reported cases of contraindication to MCV1 in a birth cohort of 1 974 513 children born between 2004 and 2017 and the information on medical personnel providing vaccination service to the children from the Information System for Planned Immunization of Tianjin city. The information on reasons not having MCV1 vaccination of the measles cases aged 8 months to 14 years reported in Tianjin city between 2009 and 2017 were also extracted from National Information Management System for Measles Surveillance. Then we analyzed all the data collected to comprehensively evaluate contraindications to MCV1 among the children.
    Results Among all the children of the cohort, 64 670 cases of contraindication to MCV1 were reported and the prevalence rate of contraindication was 3.28%. Of the contraindications, 88.44% (57 191 cases) and 11.56% (7 479 cases) were short- and long-term contraindications. The majority (59.27%) of the contraindications were acute diseases, severe chronic diseases, and acute onset of chronic diseases and more contraindication cases were reported in Binhai New District and urban regions. The prevalence of contraindications increased from 0.14% in 2004 to 6.22% in 2013, and then decreased to 2.76% in 2017. There were totally 1 401 medical staff providing vaccination service at 288 immunization clinics in the city during the period; 58.74% of the staff were majored in nursing and the staff in Binhai New District and urban regions were generally at elder age and with more work experience. There were 749 measles cases aged 8 months – 14 years reported in the city between 2009 – 2017 and 60.35% of the cases were without MCV1 vaccination; main reasons for the cases not having MCV1 vaccination were due to short-term (44.91%) and long-term contraindications (18.14%).
    Conclusion The regulation on contraindications to MCV1 vaccination directly affects the implementation of immunization strategies and the discrimination of the contraindication is uneven among various vaccination providers, suggesting that standardized confirmation of contraindications to MCV1 vaccination needs to be implemented urgently in Tianjin city.

     

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