新疆维吾尔自治区2016－2017年免疫规划疫苗损耗调查

关静; 马超; 马会来; 王海蓉; 刘书起

Abstract

关静,马超,马会来,王海蓉,刘书起.新疆维吾尔自治区2016－2017年免疫规划疫苗损耗调查[J].Chinese journal of Epidemiology,2019,40(12):1590-1594

新疆维吾尔自治区2016－2017年免疫规划疫苗损耗调查

Vaccine loss related to the expanded immunization program in Xinjiang Uygur Autonomous Region, 2016-2017

Received:April 30, 2019

DOI：10.3760/cma.j.issn.0254-6450.2019.12.016

KeyWord: 免疫规划疫苗损耗系数

English Key Word: Expanded Program on Immunization Vaccine Loss coefficient

FundProject:

Author Name	Affiliation	E-mail
Guan Jing	Immunization Program Department, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi 830011, China
Ma Chao	Chinese Field Epidemiology Training Program, National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 102206, China	machao@chinacdc.cn
Ma Huilai	Chinese Field Epidemiology Training Program, National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Wang Hairong	Immunization Program Department, Fukang Center for Disease Control and Prevention, Changji 831500, China
Liu Shuqi	Immunization Program Department, Xinyuan Center for Disease Control and Prevention, Yili 835800, China

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Abstract:

目的了解新疆维吾尔自治区预防接种单位免疫规划（EPI）疫苗的损耗现状，为进一步精细化管理和使用EPI疫苗提供依据。方法采取分层整群抽样方法抽取135个接种单位，调查2016-2017年6种EPI疫苗接种和使用数据，包括常规免疫和脊髓灰质炎疫苗群体性补充免疫活动中疫苗领发和使用数量、疫苗报废记录，以及接种单位的地区类型、服务模式、接种周期、日均接种量等。采用描述流行病学方法计算和分析疫苗的损耗系数。结果单人份的无细胞百白破联合疫苗（DTaP）和三价脊髓灰质炎减毒活疫苗（tOPV）损耗系数最低，分别为1.00和1.02；多人份的二价脊髓灰质炎减毒活疫苗（bOPV）、A群脑膜炎球菌多糖疫苗（MPV-A）、白喉破伤风联合疫苗（DT）、卡介苗（BCG）损耗系数分别为1.58、1.67、1.68、3.02。城市、农村、牧区接种单位EPI疫苗损耗系数范围分别为1.00~2.84、1.00~3.71、1.00~2.27；乡级集中、村级集中、分散接种模式的损耗系数分别为1.00~3.00、1.00~4.41、1.00~1.94。接种周期越长或日均接种量越小，损耗系数越大。结论新疆维吾尔自治区预防接种单位多人份EPI疫苗损耗较高，并受地区和接种服务形式的影响。需根据地区类型、接种单位服务形式等加强精细化的疫苗管理，减少疫苗损耗和浪费。

English Abstract:

Objective To assess the vaccine loss related to the Expanded Program on Immunization (EPI) in Xinjiang Uygur Autonomous Region so as to improve the management of vaccines. Methods A total of 135 vaccination clinics were randomly selected, using a stratified cluster sampling method. In each clinic, data on vaccination was collected between 2016 and 2017, including the number of doses in routine immunization program and supplementary immunization activities (i.e., vaccine doses in vials that were opened for use) on polio vaccine, number of doses administered to children and the number of doses discarded (e.g., expired vaccine or broken vials that had not been opened for use), etc. Coefficient on vaccine loss was calculated with the following equation:vaccine loss coefficient=(number of vaccine doses used)/(number of vaccine doses administered). The vaccine discard rate appeared as:number of vaccine doses discarded)/number of vaccine doses used. Results For vaccines in single-dose vials[diphtheria-tetanus-pertussis vaccine (DTaP) and trivalent oral polio virus vaccine (tOPV)], the loss coefficients appeared as 1.00 and 1.02, respectively. For vaccines in multi-dose vials[bivalent oral polio vaccine (bOPV), group A meningococcal polysaccharide vaccine (MPV-A), diphtheria-tetanus combined vaccine (DT) and bacilli Calmette-Guérin (BCG) vaccine], the loss coefficients were 1.58, 1.67, 1.68, and 3.02, respectively. The coefficients of EPI vaccine loss in urban, rural, and pastoral area vaccination clinics ranged between 1.00-2.84, 1.00-3.71, and 1.00-2.27, respectively. Loss coefficients ranged between 1.00-3.00, 1.00-4.41, and 1.00-1.94, respectively, were seen in township clinics, village clinics, and decentralized vaccination clinics. Coefficients on larger vaccine loss were associated with longer intervals between clinic sessions and with fewer vaccinations administrations per day. Conclusions In Xinjiang, coefficients on the loss of multi-dose EPI vaccines were high. The coefficients on loss were different from the levels of region and types of clinics, and time interval between clinic sessions. Programs on refining the management and distribution of EPI vaccines, to minimize the vaccine loss were recommended.

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