Abstract: Objective To investigate the current status of child immunization during 2008-2012 in rural western and central China. Methods Gansu, Guizhou, Guangxi and Shaanxi were selected as the investigated provinces.Maternal and child health intervention coverage questionnaire developed according to the maternal and child death predictive software LiST(the Lives Saved Tool) was applied in the one-time cross-sectional investigation. Results Bacille Calmette-Guéri(BCG) vaccine coverage rate was the highest in 2012, which reached to 99% in the investigated regions, followed by the measles vaccine, all above 95%.Polio vaccine, diphtheriatetanus and pertussis (DPT) vaccine, Hepatitis B vaccine coverage rates were around 80%.National unplanned vaccines such as flu bloodthirsty bacillus vaccine, pneumococcal vaccine, rotavirus vaccine rates were all lower than 10%.The eligible-age child vaccination rates for BCG vaccine, measles vaccine, Hepatitis B vaccine among children born in 2012 in investigated region were 96.4%, 89.4%, 79.3% respectively, while the other eligible-age child vaccination rates were all lower than 60%. Conclusions Improving eligible vaccination rate should be taken as an important indicator in evaluating the quality of rural immunization.Children from minority, lower education family and with younger parents should be received higher attention.Concerning the confirmed effects of haemophilus influenzae type B vaccine and pneumococcal vaccine, whether those will be included into national immunization planning framework needs future program verification.

Key words: rural China, children, immunization, coverage, risk factor

摘要： 目的 了解中西部农村地区近五年儿童计划免疫接种情况, 为制定针对性的接种策略提供参考依据。方法 选取甘肃、贵州、广西、陕西四省作为研究地点, 根据国际妇幼死亡预测软件LiST(the Lives Saved Tool), 开发“妇幼卫生干预覆盖调查问卷”, 采用一次性横断面抽样入户调查, 按照调查母亲提供的儿童免疫接种卡, 逐项填写相关信息。结果 2012年度调查地区儿童卡介苗接种覆盖率最高, 达到99%以上, 其次为麻疹疫苗, 达到95%以上;脊髓灰质炎疫苗、百白破疫苗、乙肝疫苗的覆盖率在80%左右, 国家计划外疫苗如流感嗜血杆菌疫苗、肺炎球菌疫苗、轮状病毒疫苗接种率均在10%以下;调查地区2012年出生儿童卡介苗、麻疹、乙肝疫苗的适龄接种覆盖率分别为96.4%、89.4%、79.3%, 其它疫苗适龄接种覆盖率均在60%以下。结论 免疫接种服务可以有效改善低龄儿机体免疫能力, 是农村儿童免疫工作质量提升的重要内容;在目标人群上, 少数民族、低教育程度家庭、低龄生育父母的儿童需得到更多关注;在接种范围上, 扩大农村地区B型流感嗜血杆菌、肺炎球菌的接种覆盖, 有待进一步论证和试点。

关键词: 农村地区, 儿童, 免疫接种, 覆盖现状, 影响因素