目的 了解中国西部部分地区儿童乙肝疫苗首剂(HepB1)及时接种率及影响因素。方法 采用横断面研究和多阶段抽样,通过问卷调查及抄录预防接种证信息的方法,2011年9月-10月调查了西部14个县2 999名0~35月龄儿童乙肝疫苗首剂接种情况。结果 调查地区儿童乙肝疫苗首剂接种率和及时接种率分别为99.3%、68.5%;单因素分析显示,性别、民族、年龄、出生地点、家庭人均纯收入、看护人文化程度、低体重因素对乙肝疫苗首剂及时接种率的影响均有统计学意义(P<0.05)。多因素分析显示,儿童低体重(OR=3.182,95%CI:2.129~4.756)、儿童出生在家里或医院外的其他地方(OR=4.691,95%CI:2.824~7.794)是乙肝疫苗首剂及时接种率的影响因素。结论 调查地区乙肝疫苗首剂接种率较高,及时接种率较低。提高住院分娩率,加强预防接种人员对乙肝疫苗接种禁忌症的正确认识是提高儿童乙肝疫苗首剂及时接种率的关键。

Objective To understand the timely vaccination rate of the first dose of hepatitis B vaccine (HepB1) and its related factors in some areas of western China. Methods A cross-sectional study with three-stage stratified random sampling method was conducted from September to October in 2011, and a total of 2 999 children aged 0~35 months in 14 counties of western China were chosen to provide information on their first dose of hepatitis B vaccine from "vaccination certificate". Results The vaccination rate of HepB1 and the timely vaccination rate of HepB1 were 99.3% and 68.5% respectively. Univariate analysis showed that gender, ethnicity, age, birth place, household net income per capita, caregiver′s educational level, and low birth weight were significantly correlated with the timely vaccination rate of HepB1 (P<0.05); Multivariate analysis indicated that low birth weight (OR=3.182, 95%CI: 2.129~4.756) and birth in home and other places except hospital (OR=4.691, 95%CI: 2.824~7.794) were the factors associated with of the timely vaccination rate of HepB1. Conclusions The vaccination rate of HepB1 is high in the investigated areas, while the timely vaccination rate of HepB1 is relatively low. Improving the hospital delivery rate and strengthening the correct understanding of contraindications for hepatitis B vaccination are the key to improve the timely vaccination rate of HepB1.