接种医生疫苗信息获取与二类疫苗推荐行为分析

王茜; 韩开益; 涂诗意; 侯志远

doi:10.11847/zgggws1135050

接种医生疫苗信息获取与二类疫苗推荐行为分析

doi: 10.11847/zgggws1135050

1.
复旦大学公共卫生学院国家卫健委卫生技术评估重点实验室，上海 200032
2.
英国伦敦卫生与热带医学院传染病流行病学系

基金项目: 英国国家健康研究所项目（EPIDZL9012）

详细信息

作者简介:
王茜（1995 – ），女，河南南阳人，硕士在读，研究方向：社会医学与卫生事业管理

通讯作者:
侯志远，E-mail：zyhou@fudan.edu.cn

中图分类号: R 186
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- 文章访问数: 374
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- 被引次数: 0
出版历程
- 接收日期: 2021-04-14
- 网络出版日期: 2021-12-13
- 刊出日期: 2022-07-01

Access to vaccine information and recommendation practice of non-EPI vaccines among vaccination service providers in China

1.
School of Public Health, Fudan University, Shanghai 200032, China

摘要

摘要: 目的了解中国接种医生疫苗信息获取和二类疫苗推荐行为，为提高接种医生二类疫苗推荐意愿提供建议。方法于2019年1月，采用二阶段整群抽样对中国安徽、陕西和深圳3个省（市）的555名接种医生进行线上问卷调查，了解其社会人口学特征、二类疫苗推荐行为、获取疫苗信息的渠道和来源，并对二类疫苗推荐行为进行单因素和多因素分析。结果仅有51.53 % 的接种医生经常推荐二类疫苗。通过培训和会议、医务人员、专业书籍和媒体获取疫苗信息的接种医生分别占83.60 %、61.08 %、36.64 %、58.92 %；疫苗信息来源为疾病预防控制中心、疫苗生产厂家和政府的接种医生分别占97.48 %、31.17 %、29.73 %。多因素logistic回归分析结果显示，在深圳工作（OR = 0.66，95 % CI = 0.51～0.85）、职业为护士（OR = 0.65，95 % CI = 0.46～0.92）的接种医生经常推荐二类疫苗的可能性更小；而年龄在45岁以上（OR = 2.04，95 % CI = 1.01～4.11），获取疫苗信息的渠道为培训和会议（OR = 2.11，95 % CI = 1.62～2.76）、专业书籍（OR = 1.28，95 % CI = 1.08～1.51），获取疫苗信息的来源为疫苗生产厂家（OR = 1.55，95 % CI = 1.11～2.18）的接种医生经常推荐二类疫苗的可能性更大。结论中国接种医生二类疫苗推荐水平较低，需要加强接种医生从培训和会议、专业书籍等渠道获取信息，提高其二类疫苗推荐意愿。
- 推荐行为 /
- 二类疫苗 /
- HPV疫苗 /
- 接种医生
Abstract: Objective To investigate the access to vaccine information and recommendation practice of non-Expanded Programme on Immunization (EPI) vaccines among vaccination service providers (VSPs) in China and to provide suggestions on promoting recommendation intention of non-EPI vaccines among VSPs. Methods A cross-sectional online survey was conducted among 584 VSPs recruited using two-stage cluster sampling in Anhui and Shaanxi province and Shenzhen municipality in central, western, and eastern China during January 2019. The participants′ information on socio-demographic characteristics, recommendation practice of non-EPI vaccines, channels and sources for getting knowledge about vaccination were collected with a self-administered questionnaire. Univariate chi-square test and multivariate logistic regression model were adopted in data analyses. Results Of the 555 participants with valid responses, only 51.53% reported frequent recommendation of non-EPI vaccines to clinic attendees. Among the participants, 83.60%, 61.08%, 36.64%, and 58.92% reported getting information on non-EPI vaccines from training programmes/seminars, medical workers, professional books, and media and the proportions of the participants getting the information disseminated by Chinese Center for Disease Control and Prevention (CDC), vaccine manufacturers, and government agencies were 97.48%, 31.17%, and 29.73%, respectively. The results of multivariate logistic regression analysis indicated that the participants working in Shenzhen municipality (odds ratio [OR] = 0.66, 95% confidence interval [95% CI]: 0.51 – 0.85), being nurses (OR = 0.65, 95% CI: 0.46 – 0.92) were less likely to carry on recommendation of non-EPI vaccines; while, the participants aged over 45 years (OR = 2.04, 95% CI: 1.01 – 4.11), getting non-EPI vaccine-related information from training programmes/seminars (OR = 2.11, 95% CI: 1.62 – 2.76)/professional books (OR = 1.28, 95% CI: 1.08 – 1.51) and disseminated by vaccine manufacturers (OR = 1.55, 95% CI: 1.11 – 2.18) were more likely to recommend non-EPI vaccines to clinic attendees. Conclusion The practice of recommendation on non-EPI vaccines among VSPs is at a low level in China. The results of the study suggest that effective measures such as promoting dissemination of non-EPI vaccine-related information in training programmes/seminars and professional books should be implemented to increase the VSPs′ recommendation practice.
- recommendation practice /
- non-EPI vaccine /
- human papillomaviruse vaccine /
- vaccination service providers

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表 1 接种医生二类疫苗推荐行为的单因素分析

变量		经常推荐二类疫苗		χ² 值	P 值	经常推荐HPV疫苗		χ² 值	P 值
变量		人数	%	χ² 值	P 值	人数	%	χ² 值	P 值
工作地点	安徽省	94	54.34	1.310	0.519	56	32.37	12.030	0.002
	陕西省	129	51.60			111	44.40
	深圳市	63	47.73			68	51.52
地区	农村	66	52.38	0.047	0.828	28	22.22	27.029	< 0.001
	城市	220	51.28			207	48.25
性别	男性	46	63.89	5.058	0.025	36	50.00	1.987	0.159
	女性	240	49.69			199	41.20
年龄组（岁）	≤ 25	27	42.86	10.044	0.018	22	34.92	6.791	0.079
	26～35	117	47.95			99	40.57
	36～45	100	53.76			79	42.47
	> 45	42	67.74			35	56.45
教育水平	高中及以下	24	52.17	0.040	0.980	16	34.78	3.229	0.199
	专科	123	51.90			94	39.66
	本科及以上	139	51.10			125	45.96
职业	医生	60	60.61	9.789	0.007	48	48.48	4.910	0.086
	护士	169	46.69			141	38.95
	公共卫生工作者	57	60.64			46	48.94
信息渠道为培训和会议	否	30	32.97	15.019	< 0.001	31	34.07	3.054	0.081
	是	256	55.17			204	43.97
信息渠道为医务人员	否	134	62.04	15.626	< 0.001	107	49.54	7.498	0.006
	是	152	44.84			128	37.76
信息渠道为专业书籍	否	166	47.43	6.387	0.011	133	38.00	7.319	0.007
	是	120	58.54			102	49.76
信息渠道为媒体	否	110	48.25	1.673	0.196	93	40.79	0.382	0.536
	是	176	53.82			142	43.43
信息来源为疾控中心	否	3	21.43	5.211	0.022	4	28.57	1.116	0.291
	是	283	52.31			231	42.70
信息来源为疫苗生产厂家	否	184	48.17	5.552	0.018	151	39.53	3.974	0.046
	是	102	58.96			84	48.55
信息来源为政府	否	205	52.56	0.560	0.454	159	40.77	1.330	0.249
	是	81	49.09			76	46.06

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表 2 接种医生二类疫苗推荐行为的多因素logistic回归分析

变量	参照组	二类疫苗推荐行为
		模型1						模型2
		β	$S_{\bar x}$	Wald χ²值	P 值	OR 值	95 % CI	β	$S_{\bar x}$	Wald χ²值	P 值	OR 值	95 % CI
工作地点
陕西省	安徽省	– 0.20	0.13	2.22	0.136	0.82	0.64 ～ 1.06	– 0.21	0.18	1.37	0.242	0.81	0.57 ～ 1.15
深圳省		– 0.42	0.13	10.11	0.001	0.66	0.51 ～ 0.85	– 0.49	0.20	6.05	0.014	0.61	0.42 ～ 0.91
年龄（岁）
26 ～ 35	≤ 25	0.03	0.14	0.05	0.829	1.03	0.79 ～ 1.35	0.12	0.15	0.59	0.440	1.13	0.83 ～ 1.52
36 ～ 45		0.17	0.22	0.66	0.420	1.19	0.78 ～ 1.82	0.36	0.18	3.84	0.050	1.43	1.00 ～ 2.05
> 45		0.71	0.36	3.99	0.046	2.04	1.01 ～ 4.11	0.94	0.40	5.52	0.019	2.57	1.17 ～ 5.63
职业
护士	医生	– 0.43	0.18	5.95	0.015	0.65	0.46 ～ 0.92	– 0.50	0.15	11.16	0.001	0.61	0.45 ～ 0.81
公共卫生工作者		0.08	0.27	0.10	0.760	1.09	0.64 ～1.85	0.05	0.32	0.03	0.870	1.05	0.57 ～ 1.95
信息渠道为培训和会议
是	否	0.75	0.14	30.14	< 0.001	2.11	1.62 ～ 2.76
信息渠道为专业书籍
是	否	0.24	0.09	7.90	0.005	1.28	1.08 ～1.51
信息来源为疫苗生产厂家
是	否							0.44	0.17	6.50	0.011	1.55	1.11 ～ 2.18

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表 3 接种医生HPV疫苗推荐行为的多因素logistic回归分析

变量	参照组	HPV疫苗推荐行为
		模型1						模型2
		β	$S_{\bar x}$	Wald χ²值	P 值	OR值	95 % CI	β	$S_{\bar x}$	Wald χ²值	P 值	OR值	95 % CI
地区
城市	农村	1.16	0.32	13.18	< 0.001	3.18	1.70 ～ 5.95	1.11	0.35	9.73	0.002	3.03	1.51 ～ 6.07
年龄（岁）
26 ～ 35	≤ 25	0.15	0.33	0.21	0.647	1.16	0.61 ～ 2.21	0.20	0.33	0.38	0.537	1.22	0.65 ～ 2.32
36 ～ 45		0.27	0.33	0.66	0.417	1.31	0.68 ～ 2.50	0.30	0.31	0.92	0.339	1.35	0.73 ～ 2.49
> 45		0.88	0.49	3.28	0.070	2.42	0.93 ～ 6.28	1.00	0.49	4.16	0.041	2.72	1.04 ～ 7.11
教育水平
专科	高中及以下	0.61	0.21	8.24	0.004	1.84	1.21 ～ 2.78	0.60	0.23	7.08	0.008	1.83	1.17 ～ 2.85
本科及以上		0.71	0.27	6.92	0.009	2.03	1.20 ～ 3.44	0.73	0.27	7.56	0.006	2.08	1.23 ～ 3.51
信息渠道为培训和会议
是	否	0.26	0.09	8.76	0.003	1.30	1.09 ～ 1.55
信息渠道为专业书籍
是	否	0.45	0.17	6.92	0.008	1.57	1.12 ～ 2.21
信息来源为疫苗生产厂家
是	否							0.45	0.22	3.96	0.046	1.56	1.01 ～ 2.42

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