Article(id=1240977222996127878, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240977214964036360, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202411534, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1732723200000, receivedDateStr=2024-11-28, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773801626204, onlineDateStr=2026-03-18, pubDate=1748102400000, pubDateStr=2025-05-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773801626204, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773801626204, creator=13701087609, updateTime=1773801626204, updator=13701087609, issue=Issue{id=1240977214964036360, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='10', pageStart='1729', pageEnd='1920', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773801624289, creator=13701087609, updateTime=1773825591019, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241077738770068227, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240977214964036360, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241077738770068228, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240977214964036360, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1796, endPage=1801, ext={EN=ArticleExt(id=1240977223461695654, articleId=1240977222996127878, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Investigation of varicella vaccination behavior and influencing factors among age-eligible children, Chuxiong Prefecture, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the current status of varicella vaccination among age-eligible children in Chuxiong Prefecture and its influencing factors, in order to provide a reference basis for improving the varicella vaccination rate among age-eligible children throughout the prefecture.

Methods

Using multi-stage stratified random sampling, a questionnaire survey was conducted from May to August 2023 among guardians of children aged 1-14 years in three counties and cities of Chuxiong Prefecture, which included basic information, varicella vaccination information, varicella, and knowledge of varicella vaccine. To analyze the influencing factors of varicella vaccination in age-eligible children.

Results

A total of 1 924 questionnaires were collected and 1 921 questionnaires were valid, with a validity rate of 99.84%. 1 918 study participants were finally included in the analysis, with a varicella vaccination rate of 35.82% among children and an overall knowledge rate of varicella and varicella vaccine among guardians of 58.33%. The results of multifactorial analysis showed that living in the city (OR=2.00, 95%CI: 1.62-2.48), per capita monthly family income >10 000 (vs. per capita monthly family income <2 000, OR=2.47, 95%CI: 1.33-4.59), and parental occupation of medical personnel or retired (vs. occupation of housework and inactive work, OR=1.63, and 95%CI: 1.03-2.58), and future willingness to be vaccinated against varicella (OR=5.06, 95%CI: 3.39-7.56) had higher varicella vaccination rates among age-eligible children.

Conclusion

The varicella vaccination rate is low among age-eligible children in Chuxiong Prefecture, and publicity and education on vaccination should be strengthened to increase the willingness of parents of age-eligible children to receive the vaccine, thereby increasing the varicella vaccination rate.

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目的

了解楚雄州适龄儿童的水痘疫苗接种现状及其影响因素,为提高全州适龄儿童水痘疫苗接种率提供参考依据。

方法

采用多阶段分层随机抽样,于2023年5~8月对楚雄州三个县市1~14岁的儿童的监护人进行问卷调查,调查内容包括基本情况、水痘疫苗接种信息、水痘以及水痘疫苗知识等。分析适龄儿童水痘疫苗接种的影响因素。

结果

本研究共收集问卷1 924份,有效问卷1 921份,有效率99.84%,最终1 918名研究对象纳入分析,儿童水痘疫苗接种率为35.82%,监护人水痘及水痘疫苗知识的总知晓率为58.33%。多因素分析结果显示,居住在城市(OR=2.00,95% CI:1.62~2.48)、家庭人均月收入>10 000(与家庭人均月收入<2 000对比,OR=2.47,95% CI:1.33~4.59)、家长职业为医务人员或离退休(与职业为家务及待业对比,OR=1.63,95% CI:1.03~2.58)、未来愿意接种水痘疫苗(OR=5.06,95% CI:3.39~7.56)的适龄儿童水痘疫苗接种率更高。

结论

楚雄州适龄儿童水痘疫苗接种率低,应加强对疫苗接种的宣教工作,提高适龄儿童家长对疫苗的意愿,从而提高水痘疫苗的接种率。

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赵智娴,E-mail:
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桑瑾与李天虎同为第一作者。

桑瑾(2001—),女,硕士在读,研究方向:流行病与卫生统计学;

李天虎(1990—),男,本科,主管医师,研究方向:免疫规划管理

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桑瑾(2001—),女,硕士在读,研究方向:流行病与卫生统计学;

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The current status of non-national immunization program vaccine use in Erqi District,Zhengzhou City from 2016-2023[J]. Modern Disease Control and Prevention, 2024, 35(9): 686-690. (In Chinese), articleTitle=The current status of non-national immunization program vaccine use in Erqi District,Zhengzhou City from 2016-2023, refAbstract=null)], funds=[Fund(id=1240996920315925294, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240977222996127878, awardId=CPMAQT_YM0333, language=CN, fundingSource=疫苗与免疫青年人才托举项目(CPMAQT_YM0333), fundOrder=null, country=null), Fund(id=1240996920433365814, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240977222996127878, awardId=2022ZX006, language=CN, fundingSource=云南省疾病预防控制中心科研(2022ZX006), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1240996911512080710, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240977222996127878, xref=1., ext=[AuthorCompanyExt(id=1240996911516275013, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240977222996127878, companyId=1240996911512080710, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Yunnan Provincial Center for Disease Control and Prevention, Kunming, Yunnan 650022, China), AuthorCompanyExt(id=1240996911524663624, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240977222996127878, companyId=1240996911512080710, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.云南省疾病预防控制中心,云南 昆明 650022)]), AuthorCompany(id=1240996911633715539, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240977222996127878, xref=2., ext=[AuthorCompanyExt(id=1240996911637909845, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240977222996127878, companyId=1240996911633715539, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.楚雄州疾病预防控制中心)]), AuthorCompany(id=1240996911717601623, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240977222996127878, xref=3., ext=[AuthorCompanyExt(id=1240996911725990233, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240977222996127878, companyId=1240996911717601623, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.昆明医科大学)])], figs=[ArticleFig(id=1240996917681902314, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240977222996127878, language=EN, label=Fig.1, caption=Timing of a Single Dose of Varicella Vaccine, figureFileSmall=45tebcNkfkZkJplYJLBPBw==, figureFileBig=XD5az3deqvacXfB9BkxIcQ==, tableContent=null), ArticleFig(id=1240996917866451696, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240977222996127878, language=CN, label=图1, caption=一剂次水痘疫苗接种时间, figureFileSmall=45tebcNkfkZkJplYJLBPBw==, figureFileBig=XD5az3deqvacXfB9BkxIcQ==, tableContent=null), ArticleFig(id=1240996917983892216, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240977222996127878, language=EN, label=Table 1, caption=

Basic information on varicella vaccination of children aged 1-14 years old in Chuxiong Prefecture

, figureFileSmall=null, figureFileBig=null, tableContent=
项目调查人数接种人数接种率(%)χ2P
儿童
性别3.0550.080
95332333.89
96536437.72
年龄分组(岁)25.878<0.001
1~460520233.38
5~966028643.33
10~1465319930.47
人群类型2.7450.253
散居儿童32011535.94
幼托儿童47918638.83
学生1 11938634.50
监护人
与儿童关系7.2500.027
母亲1 20444937.29
父亲40512230.12
其他30911637.54
居住地类型51.359<0.001
城市87438844.39
农村1 04429928.64
民族1.1370.566
汉族1 62857835.50
彝族2248738.84
其他少数民族662233.33
文化程度21.041<0.001
小学及以下2648431.82
初中96732433.51
高中/中专44216437.10
大专1576742.68
本科及以上884854.55
职业24.194<0.001
家务及待业2147735.98
公务员/企事业单位784355.13
个体工商业者30511337.05
农民1 18939232.97
其他职业1326246.97
家庭人均月收入(元)22.292<0.001
≤2 00054417732.54
2 001~5 00097333534.43
5 001~10 00034514140.87
>10 000563460.71
家中子女的数量(个)0.8420.656
157020736.32
21 30546235.40
≥3431841.86
居住地水痘发病水平49.457<0.001
高(元谋)64129946.65
中(牟定)63819931.19
低(楚雄)63918929.58
水痘和水痘疫苗知识0.6510.420
≤5.25(平均分)84231036.82
>5.251 07637735.04
未来接种水痘疫苗的意愿71.555<0.001
愿意1 66765739.41
不愿意2513011.95
通过医务人员处获取疫苗信息0.1230.726
1 57056535.99
34312034.99
通过传统平台获取疫苗信息0.3100.578
1 25244335.38
66024236.67
通过新媒体平台获取疫苗信息0.8040.370
1 24545536.55
66723034.48
通过周围人群获取疫苗信息0.5600.454
1 54654835.45
36513737.53
), ArticleFig(id=1240996918080361215, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240977222996127878, language=CN, label=表1, caption=

楚雄州1~14岁儿童水痘疫苗接种的基本情况

, figureFileSmall=null, figureFileBig=null, tableContent=
项目调查人数接种人数接种率(%)χ2P
儿童
性别3.0550.080
95332333.89
96536437.72
年龄分组(岁)25.878<0.001
1~460520233.38
5~966028643.33
10~1465319930.47
人群类型2.7450.253
散居儿童32011535.94
幼托儿童47918638.83
学生1 11938634.50
监护人
与儿童关系7.2500.027
母亲1 20444937.29
父亲40512230.12
其他30911637.54
居住地类型51.359<0.001
城市87438844.39
农村1 04429928.64
民族1.1370.566
汉族1 62857835.50
彝族2248738.84
其他少数民族662233.33
文化程度21.041<0.001
小学及以下2648431.82
初中96732433.51
高中/中专44216437.10
大专1576742.68
本科及以上884854.55
职业24.194<0.001
家务及待业2147735.98
公务员/企事业单位784355.13
个体工商业者30511337.05
农民1 18939232.97
其他职业1326246.97
家庭人均月收入(元)22.292<0.001
≤2 00054417732.54
2 001~5 00097333534.43
5 001~10 00034514140.87
>10 000563460.71
家中子女的数量(个)0.8420.656
157020736.32
21 30546235.40
≥3431841.86
居住地水痘发病水平49.457<0.001
高(元谋)64129946.65
中(牟定)63819931.19
低(楚雄)63918929.58
水痘和水痘疫苗知识0.6510.420
≤5.25(平均分)84231036.82
>5.251 07637735.04
未来接种水痘疫苗的意愿71.555<0.001
愿意1 66765739.41
不愿意2513011.95
通过医务人员处获取疫苗信息0.1230.726
1 57056535.99
34312034.99
通过传统平台获取疫苗信息0.3100.578
1 25244335.38
66024236.67
通过新媒体平台获取疫苗信息0.8040.370
1 24545536.55
66723034.48
通过周围人群获取疫苗信息0.5600.454
1 54654835.45
36513737.53
), ArticleFig(id=1240996919695168263, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240977222996127878, language=EN, label=Table 2, caption=

Guardian’s knowledge of varicella and varicella vaccine

, figureFileSmall=null, figureFileBig=null, tableContent=
题目(正确答案)正确(%)错误(%)
主要通过呼吸道飞沫传播,得病会传染给周围人吗(是)1 369(71.38)549(28.62)
以分批出现全身性丘疹、水泡、结痂为主要临床特征吗(是)1 535(80.03)383(19.97)
需要隔离治疗吗(是)1 508(78.62)410(21.38)
可能出现并发症,严重者可危及生命吗(是)1 161(60.53)757 (39.47)
得过水痘后可获得持久免疫,不会再感染吗(是)884(46.09)1 034(53.91)
一部分得过水痘的人免疫力低下时可能会得带状疱疹吗(是)939(48.96)979(51.04)
无免疫力的人接触带状疱疹病人有可能得水痘(是)764(39.83)1 154(60.17)
水痘是由细菌引起的传染病吗(否)1 303(67.94)615(32.06)
水痘疫苗从一岁开始接种吗(是)606(31.61)1 312(63.39)
), ArticleFig(id=1240996919812608781, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240977222996127878, language=CN, label=表2, caption=

监护人水痘及水痘疫苗知识知晓情况

, figureFileSmall=null, figureFileBig=null, tableContent=
题目(正确答案)正确(%)错误(%)
主要通过呼吸道飞沫传播,得病会传染给周围人吗(是)1 369(71.38)549(28.62)
以分批出现全身性丘疹、水泡、结痂为主要临床特征吗(是)1 535(80.03)383(19.97)
需要隔离治疗吗(是)1 508(78.62)410(21.38)
可能出现并发症,严重者可危及生命吗(是)1 161(60.53)757 (39.47)
得过水痘后可获得持久免疫,不会再感染吗(是)884(46.09)1 034(53.91)
一部分得过水痘的人免疫力低下时可能会得带状疱疹吗(是)939(48.96)979(51.04)
无免疫力的人接触带状疱疹病人有可能得水痘(是)764(39.83)1 154(60.17)
水痘是由细菌引起的传染病吗(否)1 303(67.94)615(32.06)
水痘疫苗从一岁开始接种吗(是)606(31.61)1 312(63.39)
), ArticleFig(id=1240996919921660693, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240977222996127878, language=EN, label=Table 3, caption=

Logistic regression results of factors related to varicella vaccination

, figureFileSmall=null, figureFileBig=null, tableContent=
变量βSEWald χ2POR值(95%CI)
常量-2.090.5117.00<0.0010.12
儿童年龄组 (岁)(Ref:1~4)
5~90.570.1319.96<0.0011.76(1.37~2.26)
10~140.020.130.030.8591.02(0.79~1.32)
与儿童关系(Ref:母亲)
父亲-0.420.149.410.0020.66(0.51~0.86)
其他0.240.162.280.1311.27(0.93~1.74)
居住地类型(Ref:城市)
农村-0.620.1129.54<0.0010.54(0.43~0.67)
职业(Ref:家务及待业)
公务员/企事业单位0.510.303.010.0831.67(0.94~2.98)
个体工商业者-0.160.200.640.4260.85(0.57~1.26)
农民-0.190.181.100.2950.83(0.58~1.18)
其他职业0.490.244.200.0411.64(1.02~2.63)
家庭人均月收入(元)(Ref:≤2 000)
2 001~5 0000.220.132.990.0841.25(0.97~1.61)
5 001~10 0000.300.163.480.0621.35(0.99~1.86)
>10 0001.240.3314.09<0.0013.45(1.81~6.60)
居住地水痘发病水平(Ref:低)
0.250.152.760.0971.28(0.96~1.71)
1.180.1467.86<0.0013.27(2.47~4.33)
未来接种水痘疫苗的意愿(Ref:不愿意)
意愿1.750.2169.00<0.0015.73(3.80~8.66)
), ArticleFig(id=1240996920060072734, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240977222996127878, language=CN, label=表3, caption=

水痘疫苗接种现状相关因素logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量βSEWald χ2POR值(95%CI)
常量-2.090.5117.00<0.0010.12
儿童年龄组 (岁)(Ref:1~4)
5~90.570.1319.96<0.0011.76(1.37~2.26)
10~140.020.130.030.8591.02(0.79~1.32)
与儿童关系(Ref:母亲)
父亲-0.420.149.410.0020.66(0.51~0.86)
其他0.240.162.280.1311.27(0.93~1.74)
居住地类型(Ref:城市)
农村-0.620.1129.54<0.0010.54(0.43~0.67)
职业(Ref:家务及待业)
公务员/企事业单位0.510.303.010.0831.67(0.94~2.98)
个体工商业者-0.160.200.640.4260.85(0.57~1.26)
农民-0.190.181.100.2950.83(0.58~1.18)
其他职业0.490.244.200.0411.64(1.02~2.63)
家庭人均月收入(元)(Ref:≤2 000)
2 001~5 0000.220.132.990.0841.25(0.97~1.61)
5 001~10 0000.300.163.480.0621.35(0.99~1.86)
>10 0001.240.3314.09<0.0013.45(1.81~6.60)
居住地水痘发病水平(Ref:低)
0.250.152.760.0971.28(0.96~1.71)
1.180.1467.86<0.0013.27(2.47~4.33)
未来接种水痘疫苗的意愿(Ref:不愿意)
意愿1.750.2169.00<0.0015.73(3.80~8.66)
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楚雄州适龄儿童水痘疫苗接种行为及影响因素的调查研究
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桑瑾 1, 3 , 李天虎 2 , 周榕溶 1 , 龚琼宇 1 , 陈玉娟 1 , 李颖 1 , 李月月 1 , 赵智娴 1
现代预防医学 | 儿少卫生与妇幼保健 2025,52(10): 1796-1801
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现代预防医学 | 儿少卫生与妇幼保健 2025, 52(10): 1796-1801
楚雄州适龄儿童水痘疫苗接种行为及影响因素的调查研究
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桑瑾1, 3, 李天虎2, 周榕溶1, 龚琼宇1, 陈玉娟1, 李颖1, 李月月1, 赵智娴1
作者信息
  • 1.云南省疾病预防控制中心,云南 昆明 650022
  • 2.楚雄州疾病预防控制中心
  • 3.昆明医科大学
  • 桑瑾(2001—),女,硕士在读,研究方向:流行病与卫生统计学;

    李天虎(1990—),男,本科,主管医师,研究方向:免疫规划管理

通讯作者:

赵智娴,E-mail:
Investigation of varicella vaccination behavior and influencing factors among age-eligible children, Chuxiong Prefecture
Jin SANG1, 3, Tian-hu LI2, Rong-rong ZHOU1, Qiong-yu GONG1, Yu-juan CHEN1, Ying LI1, Yue-yue LI1, Zhi-xian ZHAO1
Affiliations
  • Yunnan Provincial Center for Disease Control and Prevention, Kunming, Yunnan 650022, China
出版时间: 2025-05-25 doi: 10.20043/j.cnki.MPM.202411534
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目的

了解楚雄州适龄儿童的水痘疫苗接种现状及其影响因素,为提高全州适龄儿童水痘疫苗接种率提供参考依据。

方法

采用多阶段分层随机抽样,于2023年5~8月对楚雄州三个县市1~14岁的儿童的监护人进行问卷调查,调查内容包括基本情况、水痘疫苗接种信息、水痘以及水痘疫苗知识等。分析适龄儿童水痘疫苗接种的影响因素。

结果

本研究共收集问卷1 924份,有效问卷1 921份,有效率99.84%,最终1 918名研究对象纳入分析,儿童水痘疫苗接种率为35.82%,监护人水痘及水痘疫苗知识的总知晓率为58.33%。多因素分析结果显示,居住在城市(OR=2.00,95% CI:1.62~2.48)、家庭人均月收入>10 000(与家庭人均月收入<2 000对比,OR=2.47,95% CI:1.33~4.59)、家长职业为医务人员或离退休(与职业为家务及待业对比,OR=1.63,95% CI:1.03~2.58)、未来愿意接种水痘疫苗(OR=5.06,95% CI:3.39~7.56)的适龄儿童水痘疫苗接种率更高。

结论

楚雄州适龄儿童水痘疫苗接种率低,应加强对疫苗接种的宣教工作,提高适龄儿童家长对疫苗的意愿,从而提高水痘疫苗的接种率。

水痘疫苗  /  非免疫规划疫苗  /  接种率  /  影响因素  /  适龄儿童
Objective

To understand the current status of varicella vaccination among age-eligible children in Chuxiong Prefecture and its influencing factors, in order to provide a reference basis for improving the varicella vaccination rate among age-eligible children throughout the prefecture.

Methods

Using multi-stage stratified random sampling, a questionnaire survey was conducted from May to August 2023 among guardians of children aged 1-14 years in three counties and cities of Chuxiong Prefecture, which included basic information, varicella vaccination information, varicella, and knowledge of varicella vaccine. To analyze the influencing factors of varicella vaccination in age-eligible children.

Results

A total of 1 924 questionnaires were collected and 1 921 questionnaires were valid, with a validity rate of 99.84%. 1 918 study participants were finally included in the analysis, with a varicella vaccination rate of 35.82% among children and an overall knowledge rate of varicella and varicella vaccine among guardians of 58.33%. The results of multifactorial analysis showed that living in the city (OR=2.00, 95%CI: 1.62-2.48), per capita monthly family income >10 000 (vs. per capita monthly family income <2 000, OR=2.47, 95%CI: 1.33-4.59), and parental occupation of medical personnel or retired (vs. occupation of housework and inactive work, OR=1.63, and 95%CI: 1.03-2.58), and future willingness to be vaccinated against varicella (OR=5.06, 95%CI: 3.39-7.56) had higher varicella vaccination rates among age-eligible children.

Conclusion

The varicella vaccination rate is low among age-eligible children in Chuxiong Prefecture, and publicity and education on vaccination should be strengthened to increase the willingness of parents of age-eligible children to receive the vaccine, thereby increasing the varicella vaccination rate.

Varicella vaccine  /  Non-national immunization program vaccine  /  Vaccination rate  /  Influencing factors  /  Age-eligible children
桑瑾, 李天虎, 周榕溶, 龚琼宇, 陈玉娟, 李颖, 李月月, 赵智娴. 楚雄州适龄儿童水痘疫苗接种行为及影响因素的调查研究. 现代预防医学, 2025 , 52 (10) : 1796 -1801 . DOI: 10.20043/j.cnki.MPM.202411534
Jin SANG, Tian-hu LI, Rong-rong ZHOU, Qiong-yu GONG, Yu-juan CHEN, Ying LI, Yue-yue LI, Zhi-xian ZHAO. Investigation of varicella vaccination behavior and influencing factors among age-eligible children, Chuxiong Prefecture[J]. Modern Preventive Medicine, 2025 , 52 (10) : 1796 -1801 . DOI: 10.20043/j.cnki.MPM.202411534
水痘是由水痘——带状疱疹病毒(Varicella-zoster virus, VZV)原发感染引起的发热出疹性疾病,传染性极强[1],主要通过呼吸道飞沫或直接接触水痘疱疹液传播,容易引起幼托机构、学校等集体机构的聚集性疫情[2],云南省超过40%的学校突发公共卫生事件由水痘引起[3]。在托幼儿童和小学生中发生的聚集性疫情,疫情严重者可能采取停课等一系列措施,给儿童及其家长的生活带来严重影响,同时也会给开展疫情防控的卫生机构和学校带来额外的社会经济负担[4]。水痘仍是我省所面临的重要公共卫生问题。接种水痘疫苗(Varicella vaccine, VarV)是预防水痘最有效的措施,它能有效预防感染后引发的严重并发症,减少病人住院或死亡的风险[5]。目前,VarV尚未纳入我国的国家儿童免疫规划,遵循自愿自费接种。VarV接种率在地区之间差异较大[6-11]。楚雄州水痘报告发病率常年位居云南省前五位,为进一步做好水痘疫情防控。本研究对楚雄州适龄儿童水痘疫苗接种现状及影响因素开展调查,为全州未来水痘疫情防控提供参考依据。
调查对象为1~14岁儿童的监护人。纳入标准:在调查地居住超过3个月,知情同意自愿参加本次调查者;儿童家长有认知能力。排除标准:不能独立阅读中文;无法正常沟通的人(如精神异常的人);因其他原因导致调查无法完成。采用横断面调查样本量公式计算调查所需样本量,取P=50%保证最大样本量,第一类错误概率α=0.05(双侧)(Z=1.96),容许误差δ=5%,设计效应deff=1.5,考虑10%无应答率或应答不全,每个调查地区至少需要调查640人,共需调查1930人。采用多阶段抽样方法于2023年5~8月在楚雄州按照水痘发病率的高(元谋县)、中(楚雄市)、低(牟定县)选择3个县(区)作为调查现场;将每个调查县区选择一个社区和一个乡镇,每个社区/乡镇按照人口数量降序排列,按人口比例抽取5个行政村(社区),从每个行政村(社区)随机抽取64名调查对象。
调查内容包括儿童和监护人基本信息、儿童VarV接种信息、监护人水痘及水痘疫苗相关知识等。其中儿童VarV接种行为的信息通过云南省免疫规划信息管理系统和儿童预防接种证获得;水痘及水痘疫苗相关知识每题回答正确得1分,回答错误0分,满分9分,得分越高表示知识水平越高,知识的总知晓率=每道题答对人数之和/(答题人数×9)×100%。由统一培训的专业人员对儿童家长进行面对面调查,填写调查问卷。
问卷调查员由市和县级疾病预防控制中心免疫规划专业人员组成,调查前由省级疾病预防控制中心对调查员统一培训,确保调查标准的一致性。使用Epidata 3.1软件建立数据库,由专业人员进行数据双录入,并进行逻辑校对,保证数据录入准确。
采用SPSS 21.0软件描述调查对象基本特征。计数资料采用人数、构成比和率进行描述。采用χ2检验进行单因素分析。采用logistic回归模型(后退法)进行多因素分析,检验水准α=0.05。
本次调查通过了云南省疾病预防控制中心伦理委员会审查(批准文号伦理审批2022-21号),所有调查对象在调查前均签署了知情同意书。
本次研究共发放问卷1 924份,有效问卷1 921份,问卷有效回收率99.84%;经数据清洗核查,1 918名研究对象最终纳入分析。被调查儿童中,男性、女性分别占49.68%、50.31%,1~4岁、5~9岁、10~14岁分别占31.54%、34.41%、34.05%,散居儿童、幼托儿童、学生分别占16.68%、24.97%、58.34%。被调查儿童的监护人中,母亲、父亲、其他监护人分别占62.77%、21.12%、16.11%,居住在城市和农村分别占45.57%、54.43%,汉族、彝族、其他少数民族分别占84.88%、11.67%、3.44%,小学及以下、初中、高中/中专、大专、本科及以上文化程度分别占13.76%、50.42%、23.04%、8.19%、4.59%,家务及待业、公务员/企事业单位、个体工商业者、农民、其他职业分别占11.16%、4.07%、15.90%、61.99%、6.88%,家庭人均月收入≤2 000元、2 001~5 000元、5 001~10 000元、>10 000元分别占28.36%、50.73%、17.99%、2.92%。详见表1
监护人对水痘和水痘疫苗知识的总知晓率为58.33%。其中监护人对水痘临床表现、隔离治疗、主要传播途径等知识掌握较好,回答正确率分别是80.03%、78.36%、71.38%,但是对水痘疫苗接种起始年龄、自然感染的免疫持久性、带状疱疹传染引起水痘方面的知识掌握较差,回答错误率分别是63.39%、60.17%、51.04%。详见表2
调查对象中接种过水痘疫苗的有687人,接种率为35.82%,其中接种2剂的占5.11%。1剂次水痘疫苗2022年接种人数最多,占17.46%。详见图1
单因素分析结果显示,儿童年龄分组、监护人与儿童关系、居住地类型、监护人文化程度、监护人职业、家庭人均月收入、居住地水痘发病率水平、未来接种水痘疫苗意差异均有统计学意义(P<0.05),详见表1。以是否接种过水痘疫苗作为因变量,以单因素分析P<0.05的变量为自变量进行多因素logistic回归,结果显示:5~9岁组儿童、其他职业、家庭人均月收入>10 000元、居住在水痘发病率高的地区、未来愿意接种水痘疫苗为保护因素,适龄儿童水痘疫苗接种率高。而居住在农村、调查对象父亲为危险因素,适龄儿童水痘疫苗接种率低。详见表3
研究结果显示,楚雄州1~14岁儿的水痘疫苗的接种率较低,接种率低于全国调查的平均水平[12]。目前,水痘疫苗仍属于非免疫规划疫苗,需要自愿自费接种,因此接种率低。
分析结果显示,城市适龄儿童水痘疫苗接种率高于农村适龄儿童。可能与社会环境因素有关,包括免疫服务可及性、便利性和医务人员专业性等。对于城市社区而言,接种点的接种服务时间灵活性和拥挤程度是造成非免疫规划疫苗接种率存在差异性的重要影响因素,接种点提供的接种服务时间越灵活、人力资源投入越多、接种等待时间越短,越有利于非免疫规划疫苗接种率的提升;农村地区儿童、留守儿童有时因交通条件不便利、家中老人关于疫苗知识观念不强等直接导致非免疫规划疫苗接种率很低[13-14]。家长职业为其他(包括医务人员、离退休人员等)的适龄儿童水痘疫苗接种率更高、家庭人均月收入>10 000的适龄儿童水痘疫苗接种率也越高。相关研究表明,家庭中有医学相关专业从业人员[15]、事业单位或企业有稳定收入工作的人员,儿童非免疫规划疫苗接种情况明显优于普通家庭,并且家长文化程度、学历水平与非免疫规划疫苗接种率、疫苗认可程度成正比[16]。居住在水痘发病率高的适龄,水痘疫苗的接种率越高,这可能由于在水痘高发地区,居民可能感受到水痘疾病的威胁更加明显,特别是家长对于孩子感染水痘的担忧可能更为强烈。因此,面对水痘的高发风险,家长可能会更加积极地寻求接种疫苗来避免孩子感染。
未来有接种水痘疫苗意愿人群中水痘疫苗的接种率更高。意愿是产生行为的一个提前。如果家长或监护人明确表示未来有接种意愿,通常说明他们已经在认知、态度和行为上为接种做好了准备。相反,那些表示没有接种意愿的人,往往缺乏足够的健康信念或对疫苗接种的认同,因此接种率低。建议在未来的研究中增加对监护人接种意愿,从社会学和心理学方面来研究其主要影响因素,从而开展有针对性的干预措施,提高适龄儿童水痘疫苗的接种率。
因此,针对目前接种率低的现状,建议预防接种接种服务与管理部门和接种单位要针对不同地区、不同文化程度、不同收入家庭做好水痘及水痘疫苗接种的专业宣传教育,加强对农村地区儿童家长的宣教工作,强调水痘疫苗预防水痘发生的重要性和必要性;接种单位应加强管理和宣传,接种服务做到便民、便捷,减少因为接种点原因导致接种意愿降低的情况[17]。应继续加强预防接种管理,提高居民对预防接种服务的认可度。开展多种途径的预防接种知识宣传活动,提高居民疫苗接种知识和预防接种意识,有效发挥非免疫规划疫苗预防和控制疾病的作用[18]。加大宣传力度,加深儿童家长对水痘疫苗及其他非免疫规划疫苗的了解,进一步提升水痘疫苗接种意愿,提高儿童接种率,保护儿童免受水痘危害。
本研究存在一定的局限性,本次调查中影响水痘疫苗接种现状的因素可能并未全部涉及到,今后应该进一步扩大可能影响因素的分析范围;作为横断面研究,无法确定研究因素与适龄儿童接种现状的因果关系;如果被调查对象对问题误解,仍然可能存在信息偏倚。
综上所述,楚雄州适龄儿童水痘疫苗接种率低。因此,应加强对疫苗接种的宣教工作,提高适龄儿童家长对疫苗的意愿,从而提高水痘疫苗的接种率。
  • 疫苗与免疫青年人才托举项目(CPMAQT_YM0333)
  • 云南省疾病预防控制中心科研(2022ZX006)
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2025年第52卷第10期
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doi: 10.20043/j.cnki.MPM.202411534
  • 接收时间:2024-11-28
  • 首发时间:2026-03-18
  • 出版时间:2025-05-25
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  • 收稿日期:2024-11-28
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疫苗与免疫青年人才托举项目(CPMAQT_YM0333)
云南省疾病预防控制中心科研(2022ZX006)
作者信息
    1.云南省疾病预防控制中心,云南 昆明 650022
    2.楚雄州疾病预防控制中心
    3.昆明医科大学

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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