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Incomplete Vaccination Among Children With Special Health Care Needs in Zhejiang, China: Analysis of Retrospective Data
Objective: There is a lack of data relating to vaccination of children with special health care needs (CSHCN) and its influencing factors in China. We investigated the disease spectrum of CSHCN at the Vaccination Consultation Clinic in Zhejiang province as well as the underlying factors of vaccinati...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6506790/ https://www.ncbi.nlm.nih.gov/pubmed/31119119 http://dx.doi.org/10.3389/fped.2019.00173 |
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author | Li, Mingyan Ji, Chai Wang, Bin Yao, Dan Wang, Xia Zeng, Yan Shao, Jie |
author_facet | Li, Mingyan Ji, Chai Wang, Bin Yao, Dan Wang, Xia Zeng, Yan Shao, Jie |
author_sort | Li, Mingyan |
collection | PubMed |
description | Objective: There is a lack of data relating to vaccination of children with special health care needs (CSHCN) and its influencing factors in China. We investigated the disease spectrum of CSHCN at the Vaccination Consultation Clinic in Zhejiang province as well as the underlying factors of vaccination recommendations of these children. Methods: In this study, we retrospectively analyzed the data of 4,525 CSHCN, who visited to our clinic for a vaccination consultation from January 1, 2016 to May 30, 2018. Descriptive data were presented as mean ± standard deviation (SD) and percentages. Multivariate analysis was performed with non-conditional bivariate logistic regression to identify the underlying factors of vaccination recommendations. Subsequent information regarding the following vaccination and the occurrence of AEFI were also collected and analyzed. Results: The main diseases consulted were those relating to the circulatory and nervous systems as well as neonatal diseases. The distribution of diseases varied by age: 53.6% infants under 12 months were counseled for circulatory system diseases, while 44.6% children aged 12~24 months and 54.7% children over 25 months were counseled for nervous system diseases. According to the evaluation reports issued by the consultation clinic, 75.0% of CSHCN were recommended to be vaccinated normally, 21.2% were recommended to defer specific vaccination, while only 3.8% were recommended to defer all vaccinations. In logistic regression analysis, age, history of adverse events following immunization (AEFI) and the number of diseases combined were all strong correlative factors for vaccination recommendations. Children who were aged over 25-month-old (OR = 1.34, 95%CI: 1.11–1.61) or had a history of AEFI (OR = 3.77, 95%CI: 2.83~5.01) or those who had numerous diseases combined (OR = 2.00, 95%CI: 1.46~2.75) tended to have a higher rate of deferred vaccination recommendation. Among those CSHCN who received nationally-recommended vaccines, the estimated AEFI rate was 24.29/100 000. No uncommon or rare serious adverse reactions were detected. Conclusion: Age, history of AEFI, and the number of diseases combined were important factors that affected the vaccination recommendations of CSHCN. Most CSHCN can be safely vaccinated according to the nationally-recommended schedule. |
format | Online Article Text |
id | pubmed-6506790 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-65067902019-05-22 Incomplete Vaccination Among Children With Special Health Care Needs in Zhejiang, China: Analysis of Retrospective Data Li, Mingyan Ji, Chai Wang, Bin Yao, Dan Wang, Xia Zeng, Yan Shao, Jie Front Pediatr Pediatrics Objective: There is a lack of data relating to vaccination of children with special health care needs (CSHCN) and its influencing factors in China. We investigated the disease spectrum of CSHCN at the Vaccination Consultation Clinic in Zhejiang province as well as the underlying factors of vaccination recommendations of these children. Methods: In this study, we retrospectively analyzed the data of 4,525 CSHCN, who visited to our clinic for a vaccination consultation from January 1, 2016 to May 30, 2018. Descriptive data were presented as mean ± standard deviation (SD) and percentages. Multivariate analysis was performed with non-conditional bivariate logistic regression to identify the underlying factors of vaccination recommendations. Subsequent information regarding the following vaccination and the occurrence of AEFI were also collected and analyzed. Results: The main diseases consulted were those relating to the circulatory and nervous systems as well as neonatal diseases. The distribution of diseases varied by age: 53.6% infants under 12 months were counseled for circulatory system diseases, while 44.6% children aged 12~24 months and 54.7% children over 25 months were counseled for nervous system diseases. According to the evaluation reports issued by the consultation clinic, 75.0% of CSHCN were recommended to be vaccinated normally, 21.2% were recommended to defer specific vaccination, while only 3.8% were recommended to defer all vaccinations. In logistic regression analysis, age, history of adverse events following immunization (AEFI) and the number of diseases combined were all strong correlative factors for vaccination recommendations. Children who were aged over 25-month-old (OR = 1.34, 95%CI: 1.11–1.61) or had a history of AEFI (OR = 3.77, 95%CI: 2.83~5.01) or those who had numerous diseases combined (OR = 2.00, 95%CI: 1.46~2.75) tended to have a higher rate of deferred vaccination recommendation. Among those CSHCN who received nationally-recommended vaccines, the estimated AEFI rate was 24.29/100 000. No uncommon or rare serious adverse reactions were detected. Conclusion: Age, history of AEFI, and the number of diseases combined were important factors that affected the vaccination recommendations of CSHCN. Most CSHCN can be safely vaccinated according to the nationally-recommended schedule. Frontiers Media S.A. 2019-05-01 /pmc/articles/PMC6506790/ /pubmed/31119119 http://dx.doi.org/10.3389/fped.2019.00173 Text en Copyright © 2019 Li, Ji, Wang, Yao, Wang, Zeng and Shao. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Li, Mingyan Ji, Chai Wang, Bin Yao, Dan Wang, Xia Zeng, Yan Shao, Jie Incomplete Vaccination Among Children With Special Health Care Needs in Zhejiang, China: Analysis of Retrospective Data |
title | Incomplete Vaccination Among Children With Special Health Care Needs in Zhejiang, China: Analysis of Retrospective Data |
title_full | Incomplete Vaccination Among Children With Special Health Care Needs in Zhejiang, China: Analysis of Retrospective Data |
title_fullStr | Incomplete Vaccination Among Children With Special Health Care Needs in Zhejiang, China: Analysis of Retrospective Data |
title_full_unstemmed | Incomplete Vaccination Among Children With Special Health Care Needs in Zhejiang, China: Analysis of Retrospective Data |
title_short | Incomplete Vaccination Among Children With Special Health Care Needs in Zhejiang, China: Analysis of Retrospective Data |
title_sort | incomplete vaccination among children with special health care needs in zhejiang, china: analysis of retrospective data |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6506790/ https://www.ncbi.nlm.nih.gov/pubmed/31119119 http://dx.doi.org/10.3389/fped.2019.00173 |
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