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Up-to-date or Complete Immunization Coverage and Their Related Factors

영유아의 예방접종 및 그 관련요인

  • Lee, Moo-Sik (Department of Preventive Medicine and Public Health, College of Medicine, Konyang University) ;
  • Kim, Eun-Young (Korea Health Industry Development Institute) ;
  • Kim, Keon-Yeop (Department of Preventive Medicine, School of Medicine, Kyungpook National University) ;
  • Lee, Jin-Yong (Department of Preventive Medicine and Public Health, College of Medicine, Konyang University) ;
  • Jang, Min-Young (Department of Preventive Medicine and Public Health, College of Medicine, Konyang University) ;
  • Hong, Jee-Young (Department of Preventive Medicine and Public Health, College of Medicine, Konyang University)
  • 이무식 (건양대학교 의과대학 예방의학교실) ;
  • 김은영 (한국보건산업진흥원) ;
  • 김건엽 (경북대학교 의학전문대학원 예방의학교실) ;
  • 이진용 (건양대학교 의과대학 예방의학교실) ;
  • 장민영 (건양대학교 의과대학 예방의학교실) ;
  • 홍지영 (건양대학교 의과대학 예방의학교실)
  • Received : 2012.09.27
  • Accepted : 2012.12.06
  • Published : 2012.12.31

Abstract

Objectives: Understanding the predictor of immunization status in childhood is critical issue to improve National Immunization Program (NIP). The aims of this study were to verify the status of up-to-date or complete immunization coverage and to investigate its related factors. Methods: As of 2005, according to local residence registry data, there were 2,188 children who aged 12 to 35 months in Nonsan city, Korea. We conducted household survey for aged 12 to 35 months children, using questionnaires to obtain data on the status of immunization such as BCG, DTaP (diphtheria, tetanus, and pertussis), Polio, and MMR (mump, measles, rubella). Finally 1,472 participated in the survey. The operating definitions used in this study were following; "Complete immunization rate" refers to the rate of children who received all immunization within recommended age intervals fully "on-time"; "The 4:3:1 series" means status of receiving the fourth diphtheria-tetanus-pertussis (4 DTP), the third Polio (3 Polio), and the first measles-mumps-rubella (1 MMR) doses. Multivariate logistic regression analyses were used to determine factors affecting complete vaccination coverage of children. Results: Immunization rates of vaccine based on the vaccination card were from 92.7% to 96.4% except 4th DTaP (79.3%). Complete immunization rate of Korea NIP was 74.0% and that of the 4:3:1 series was 77.1%. A parent as primary caregiver (OR 0.59, 95% CI 0.39-0.87 at 19-35 months of children's age) and first-born children (OR 1.79, 95% CI 1.05-3.03 at 24-35 months of children's age) were significantly related to complete immunization coverage of Korea NIP. And a parent as primary care giver (OR 0.58, 95% CI 0.38-0.88 at 19-35 months of children's age) and first-born children (OR 1.94, 95% CI 1.21-3.14 at 19-35 months, OR 2.23, 95% CI 1.27-3.91 at 24-35 months of children's age) were significantly related to complete immunization rate of 4:3:1 series. Conclusions: Government should take actions to increase complete immunization rate. In particular, intervention on the secondary caregiver and non-first-born children should be needed.

Keywords

Vaccination coverage;Related factors;National Immunization Program

References

  1. Korea Center for Disease and Control. Epidemiology and Prevention of Vaccine- Preventable Disease, 2005, pp.3-18 (Korean)
  2. Ehreth J. The value of vaccination: a global perspective. Vaccine 2003;21:4105-4117 https://doi.org/10.1016/S0264-410X(03)00377-3
  3. Zaza S, Briss PA, Hariss KW. Preventive Service, What works to promote health, Oxford University Press, 2005, pp.3-79
  4. Anderson RM, May RM. Immunization and herd immunity. Lancet 1990;335:641-645 https://doi.org/10.1016/0140-6736(90)90420-A
  5. WHO. WHO UNICEF review of national immunization coverage 1980-1999. WHO Department of Immunization vaccines and Biological Vaccine Assessment and Monitoring team, 2001
  6. Fedson DS. Adult immunization: summary of the national vaccine advisory committee. JAMA 1994;272;1133-1137 https://doi.org/10.1001/jama.1994.03520140063039
  7. Dannetun E, Tegnell A, Hermansson G, Torner A, Giesecke J. Timliness of MMR vaccinatation-influence on vaccination coverage. Vaccine 2004;22(31):4228-4232 https://doi.org/10.1016/j.vaccine.2004.04.018
  8. Dombkowski KJ, Lantz PM, Freed GL. Role of health insurance and a usual source of medical care in age-appropriate vaccination. Am J Public Health 2004;94(6):960-966 https://doi.org/10.2105/AJPH.94.6.960
  9. Hak E. Schonbeck Y, De Melker H, Van Essen GA, Sanders EA. Negative attitude of highly educated parents and health care workers towards future vaccinations in the Dutch childhood vaccination program. Vaccine 2005;23(24):3103-3107 https://doi.org/10.1016/j.vaccine.2005.01.074
  10. Public Health Service. Healthy People 2000: national health promotion and disease prevention objectives. Washington DC, US DHSS, 1990
  11. US DHHS. Healthy People 2010, 2nd. with understanding and improving health and objectives for improving health, 2 Vols. Washington DC, US DHHS, 2000
  12. Bae SS. A study on introducing Voucher type National Immunization Program. Korea Ministry of Health Welfare, 2001, pp.35-38 (Korean)
  13. Choi SA. The use of immunization registry in public health center and its applications. MPH thesis. Seoul: Seoul National University, Graduate School of Public Health, 2003 (Korean)
  14. Jin SM, Lee SG. Vaccination status in school entry aged-children and associated factors on timeliness of vaccination. J Korean Soc Matern Child Health 2007; 11(1):44-53 (Korean) https://doi.org/10.21896/jksmch.2007.11.1.44
  15. Kim YT. Demonstration project for expansion of National Immunization Program Coverage. J Korea Med Assoc 2005;48(6):579-586 (Korean) https://doi.org/10.5124/jkma.2005.48.6.579
  16. Korea Center for Disease and Control. Monthly Newsletter for National Immunization Program, 2006 (Korean)
  17. Brenner RA, Simons-Morton BG, Bhaskar B, Das A, Clemens JD; NIH-D.C. Initiative Immunization Working Group. Prevalence and predictors of immunization among inner-city infants: a birth cohort study. Pediatrics. 2001;108(3):661-670. https://doi.org/10.1542/peds.108.3.661
  18. Atkinson WL, Pickering LK, Schwartz B, Weniger BG, Iskander JK, Watson JC, Centers for Disease Control and Prevention. General recommendations on immunization. Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP). Morb Mort Wkly Rep 2002; 51(RR-2):1-35
  19. Strine TW, Barker LE, Mokdad AH, Luman ET, Sutter RW, Chu SY. Vaccination coverage of Foreign-born children 19 to 35 months of age:findings from the National Immunization Survey, 1999-2000. Pediatrics 2002;110(2):e15 https://doi.org/10.1542/peds.110.2.e15
  20. Mell LK, Ogren DS, Davis RL, Mullooly JP, Black SB, Shinefield HR, Zangwill KM, Ward JI, Marcy SM, Chen RT, Centers for Disease Control and Prevetion Vaccine Safety Datalink Project. Compliance with national immunization guidelines for children younger than 2 years, 1996-1999. Pediatrics 2005;115(2):461-467 https://doi.org/10.1542/peds.2004-1891
  21. Choi YK, Kim KY, Lee MS, Na BJ, Kim EY, Shim YB, Kim HJ, Lee KY, Go WY, Kim YT. Timeliness of infant immunization rate of public health center. J Korean Soc Matern Child Health 2008;12(2):181-198 (Korean) https://doi.org/10.21896/jksmch.2008.12.2.181
  22. Bobo JK, Gale JL, Thapa PB, Wassilak SG. Risk factors for delayed immunization in a random sample of 1163 children from Oregon and Washington. Pediatrics 1993; 91(2):308-314
  23. Rodewald L, Maes E, Stevenson J, Lyons B, Stokley S, Szilagyi P. Immunization performance measurement in a changing immunization environment. Pediatrics 1999; 103(4):889-897
  24. CDC. National, state, and urban area vaccination coverage among children aged 19-35 months - United States, 2004. Morb Mort Wkly Rep 2005:54(29);717-721
  25. Zell ER, Dietz V, Stevenson J, Cochi S, Bruce RH. Low vaccination levels of US preschool and school-age children-retrospective assessments of vaccination coverage, 1991-1992. JAMA 1994;271(11):833-839 https://doi.org/10.1001/jama.1994.03510350043035
  26. Center for Disease Control and Prevention. Reported vaccine-preventable disease-United States, 1993, and the Childhood Immunization Initiative. Morb Mort Wkly Rep 1997; 43;57-60
  27. Santoli JM, Setia S, Rodewald LE, O'Mara D, Gallo B, Brink E. Immunization pockets of need: science and practice. Am J Prev Med 2000;19(3S):89-98 https://doi.org/10.1016/S0749-3797(00)00209-9
  28. Miller LA, Hoffman RE, Baron AE, Marine WM, Melinkovich P. Risk factors for delayed immunization against measles, mumps, and rubella in Colorado two-year-olds. Pediatrics 1994;94(2):213-219
  29. Luman ET, McCauley MM, Stokley S, Chu SY, Pickering LK. Timeliness of childhood immunizations. Pediatrics 2002; 110(5):935-939 https://doi.org/10.1542/peds.110.5.935
  30. Dombkowski KJ, Lantz PM, Freed GL. Risk factors for delay in age-appropriate vaccination. Public Health Rep 2004;119(2): 144-155 https://doi.org/10.1177/003335490411900207
  31. Heininger U, Zuberbuhler M. Immunization rates and timely administration in pre-school and school-aged children. Eur J Pediatr 2006;165(2):124-129 https://doi.org/10.1007/s00431-005-0014-y
  32. Chung DS, Song MS, Kang DH, Kim SH. Study on the Factors Affecting Inadequate Vaccine Coverage in Children. Korea J Fam Med 1993;14(3):147-155 (Korean)
  33. Trauth JM, Zimmerman RK, Musa D, Mainzer H, Nutini JF. Do beliefs of inner-city parents about disease and vaccine risks affect immunization? J Natl Med Assoc 2002; 94(9):820-32
  34. Park B, Lee YK, Cho LY, Go UY, Yang JJ, Ma SH, Choi BY, Lee MS, Lee JS, Choi EH, Lee HJ, Park SK. Estimation of Nationwide Vaccination Coverage and Comparison of Interview and Telephone Survey Methodology for Estimating Vaccination Status. J Korean Med Sci 2011;26(6): 711-719 https://doi.org/10.3346/jkms.2011.26.6.711
  35. Lee MS, Kim JH, Kim KH, Hong JY, Lee JY, Kim KY. Evaluation on the Accuracy of Vaccination Card for National Immunization Program in a 2005 Population-Based Survey in Nonsan, Korea. J Agric Med Community Health 2011;36(2):113-119 https://doi.org/10.5393/JAMCH.2011.36.2.113
  36. Kim EY, Lee MS. Related Factors of Age-Appropriate Immunization among Urban-Rural Children Aged 24-35 Months in a 2005 Population-Based Survey in Nonsan, Korea. Yonsei Med J 2011;52(1): 104-112 https://doi.org/10.3349/ymj.2011.52.1.104