台北縣12至23個月大幼兒預防接種之現況探討

Investigation of the Current Status of Immunization Among 12-to23-month-old Children in Taipei County, Taiwan

黃碧花(Bi-Hua Huang) ； 李蘭(Lee-Lan Yen) ； 陳瑾瑛(Chin-Ying Chen) ； 金傳春(Chwan-Chuen King)

《中華民國公共衛生學會雜誌》 11卷4期 (1992/12) Pp. 304-315

https://doi.org/10.6288/JNPHARC1992-11-04-05

摘要

臺灣地區於1982年發生小兒麻痺大流行後（1,043名報告病例），幼兒預防接種問題又成爲眾所矚目的焦點。
本研究之目的在淤估計預防接種完成率，並瞭解影響延遲及未完成預防接種之因素。以等機率分層分段抽樣方法，自臺北縣內選取12至23個月大之幼兒爲樣本，於民國七十八年一月至七月間，針對幼兒母親以家庭訪視和電話訪問方式，共收得2,367位個案資料，完訪率達74%。
研究結果顯示：(1)完成全部預防接種者（包括一劑卡介苗，三劑白喉、百日咳、破傷風混合疫苗，三劑小兒麻痺疫苗，一劑麻疹疫苗，及四劑B型肝炎疫苗）佔77.9%；(2)各項預防接種之按時完成率均不高，上述疫苗的完成率分別爲45.1%，43.1%，43.1%，49.1%及53.9%；(3)延遲預防接種之主因爲小孩身體不適(24.2-42.3%)；(4)卡介苗及第一劑B型肝炎疫苗的預防注射地點，以前往醫院、診所接種者較多（分別爲46.8%和56.6%），其餘各項預防接種地點約以衛生所居高(62.5~71.4%)，但對衛生所的服務感到滿意的人僅佔(39.8%)；以及(5)幼兒母親有關預防接種之資訊來源雖以醫護人員爲主(61.5%)，仍顯不足，且知道卡介苗可預防結核病者僅佔45.4%，有45.9%的父母認爲「小孩出麻疹爲自然現像，不必打預防針」。
根據本研究結果，可知台灣地區的預防接種完成率仍有待提高。本研究因此對政府有關單位在未來要有效控制「疫苗可預防的傳染病」，提出下列幾點誠摯建議：(1)加強衛生所的服務品質；(2)鼓勵醫院和診所更主動積極地參與預防接種工作；(3)各項預防接種時間之安排宜考慮民眾的遵循行爲、疾病流行的可能性及該病原的傳染力，再做考量；(4)提高一歲幼兒第四劑B型肝炎疫苗及麻疹疫苗的完成率；以及(5)加強有關預防接種之衛生教育（包括預防接種原因、接種後可能反應及何種情況不宜接種等）。

並列摘要

Since the poliomyelitis epidemic of 1982 in Taiwan, which resulted in 1,043 cases, the problems of immunization have attracted public attention.
The objectives of this survey were: (1) to investigate the coverage rate of immunization among 12-to 23-month-old children; and (2) to identify the factors associated with vaccine failure and delay in receiving the recommended vaccinations (one dose of BCG, three doses of DPT, three doses of oral ploio vaccine, one dose of measles, and four doses of hepatitis B vaccine).
The subjects were selected by the ”probability proportional to size” sampling method from Taipei County from February to July 1988. A total of 2,367 mothers of children were questioned in personal and/or telephone interviews. The response rate was 74%.
Our study found that: (1) 77.9% of the children had completed their immunizations for the above vaccines; (2) the coverage rate for on-time completion for BCG was 45.1%, for DPT was 43.1%, for polio was 43.1%, for measles was 49.1%, and for hepatitis B was 53.9%; (3) the major reason for a delay in immunization was sickness of child; (4) most BCG (46.82%) and hepatitis B (56.57%) vaccinees were received at hospitals or in private clinics, while most other vacccines (62.48-71.43%) were received at health stations. Only 39.8% of these mothers were dissatisfied with the quality of service given at health stations, and (5) the majority (61.5%) of mothers acquired their information on immunizations from their medical staff; information at the public level was considered inadequate.
This study demonstrates that the completeness of immunizations in Taiwan needs further improvement. We recommend that effective vaccination in the future should focus on: (1) upgrading the quality of services at local health stations; (2) encouraging hospitals or private clinics to participate in immunization programs; (3) reevaluate immunization schedules to eliminate delays in immunization; (4) reinforce the need to complete the fourth dose of the hepatitis B vaccine and the measles vaccine; and (5) strengthen health education emphasizing the purpose of immunization, post-immunization reactions, and conditions for refusing or postponing immunization.

並列關鍵字

Immunization ； Taiwan