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

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.