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台灣兒童疫苗接種的社會差異:以三合一疫苗及流感疫苗為例

Social Disparity of Childhood Immunization in Taiwan: The Cases of diphtheria-tetanus-pertussis (DTP) and Influenza Vaccines

摘要


Objectives: This study aims to examine the social disparity of child vaccination in Taiwan using both of diphtheria-tetanus-pertussis (DTP) vaccine and influenza vaccine as examples. Methods: Data for the analysis came from the Taiwan Birth Cohort Study. We included 20,099 children who completed interview surveys at both 6 months and 18 months old, with a response rate of 83.4%. The dependent variables were whether vaccinated with DTP (any DTP or DTaP) and influenza vaccine; the independent variables used were parents' educational attainment, monthly family income, and urbanization of residential areas. Results: The vaccination rate of any DTP vaccine and influenza vaccine reached 97.1% and 59.9%, respectively. The multiple logistic regression analysis showed that: after controlling children’s sex, maternal nationality and age at birth, the odds ratio of taking DTaP vaccine was two times higher for the highest socioeconomic groups than that of their lowest counterparts (p<0.001), while the influenza vaccination rates were higher only in the groups of the highest family income group and higher urbanization. Conclusions: Our study reconfirmed that socioeconomic status affects childhood vaccination. The efficacy of vaccine and compulsory vaccination policy play an essential role in increasing coverage rate of childhood immunization, and free of charge could be an important strategy to tackle disparities of childhood immunization across different socioeconomic groups.

關鍵字

兒童 疫苗接種 社經差異

並列摘要


Objectives: This study aims to examine the social disparity of child vaccination in Taiwan using both of diphtheria-tetanus-pertussis (DTP) vaccine and influenza vaccine as examples. Methods: Data for the analysis came from the Taiwan Birth Cohort Study. We included 20,099 children who completed interview surveys at both 6 months and 18 months old, with a response rate of 83.4%. The dependent variables were whether vaccinated with DTP (any DTP or DTaP) and influenza vaccine; the independent variables used were parents' educational attainment, monthly family income, and urbanization of residential areas. Results: The vaccination rate of any DTP vaccine and influenza vaccine reached 97.1% and 59.9%, respectively. The multiple logistic regression analysis showed that: after controlling children’s sex, maternal nationality and age at birth, the odds ratio of taking DTaP vaccine was two times higher for the highest socioeconomic groups than that of their lowest counterparts (p<0.001), while the influenza vaccination rates were higher only in the groups of the highest family income group and higher urbanization. Conclusions: Our study reconfirmed that socioeconomic status affects childhood vaccination. The efficacy of vaccine and compulsory vaccination policy play an essential role in increasing coverage rate of childhood immunization, and free of charge could be an important strategy to tackle disparities of childhood immunization across different socioeconomic groups.

參考文獻


WHO. Immunization. Available at: http://www.who.int/topics/immunization/about/en/index.html.Accessed August 25, 2010.
行政院衛生署、台灣省衛生處、台北市衛生局、高雄市衛生局:中華民國七十四年衛生統計(一)公務統計。台北市:行政院衛生署,1986;266。Department of Health, Executive Yuan, R.O.C.(Taiwan), Department of Health, Taiwan Province, Department of Health, Taipei City Government, Department of Health, Kaohsiung City Government.Health Statistic (1) Public Affairs Statistics in 1985.Taipei: Department of Health, Executive Yuan, R.O.C.(Taiwan), 1986; 266. [In Chinese]
行政院衛生署疾病管制局:兒童健康手冊。http://www.cdc.gov.tw/ct.asp?xItem=2614&ctNode=160&mp=1。引用2010/12/11。Center of Disease Control, Department of Health, Executive Yuan, R.O.C. (Taiwan). Child healthcare handbook. Available at: http://www.cdc.gov.tw/ct.asp?xItem=2614&ctNode=160&mp=1 . Accessed December 11, 2010. [In Chinese]
Akmatov, MK,Kretzschmar, M,Krämer, A,Mikolajczyk, RT(2007).Determinants of childhood vaccination coverage in Kazakhstan in a period of societal change: implications for vaccination policies.Vaccine.25,1756-63.
Angelillo, IF,Ricciardi, G,Rossi, P,Pantisano, P,Langiano, E,Pavia, M(1999).Mothers and vaccination: knowledge, attitudes, and behaviour in Italy.Bull World Health Organ.77,224-9.

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