目的 了解2013年山东省5岁以下儿童国家免疫规划和扩大国家免疫规划后的疫苗接种情况,探讨接种率的影响因素,为制订今后免疫规划和相应策略提供依据。方法 于2013年采取分层整群随机抽样方法,调查山东省17市1 502名5岁以下儿童和家庭的人口学特征、一类疫苗和二类疫苗的接种情况,并对相关因素进行多因素Logistic回归分析。结果 山东省5岁以下儿童五种免费疫苗接种率均在90%以上,城市和农村至少接种过一种二类疫苗的比例分别为71.1%和83.7%(χ²=34.152,P＜0.05)。五种二类疫苗中,除了水痘疫苗外,农村儿童的接种率均高于城市儿童,其中差异最大的是HIB疫苗,差异最小的是水痘疫苗。多因素分析显示,儿童年龄、城市农村、家庭人均年收入以及对医疗机构提供预防接种服务的满意度均是影响二类疫苗接种的相关因素。结论 山东省5岁以下儿童一类疫苗接种率保持在较高水平,但二类疫苗接种率不高,城乡差异大,医疗机构提供的预防接种服务有待改善。

Objective To survey implementation of national expanded immunization program in children under 5 years old in Shandong province,and analyse its influencing factors,then to provide scientific basis for formulating strategies and policies of health literacy. Methods A sample of 1 502 children under five years old in the 17 cities of Shandong province in 2013 was included in this study through stratified cluster sampling.The basic demographic characteristics and the vaccination status of the children were investigated and influencing factors were analyzed by multivariate Logistic regression analysis. Results The coverage rate of children under 5 years old was over 90%.The urban and rural coverage rate of category B vaccines were 71.1% and 83.7% (χ²=34.152,P＜0.05) respectively.The coverage rates of rural children were higher than the urban children of category B vaccines except varicella vaccine.The results of multivariate regression analysis demonstrated that age,urban,census and annual household income were considered as the influencing factors. Conclusions The coverage rate of children under 5 years old in Shandong province is higher,whereas the overage rate of category B vaccine is rather lower,urban and rural shows heterogeneity.Vaccination services provided by medical institutions are expected to be improved.