Investigation And Evaluation Of The Status Of Children 's Vaccination Record

Objective:1. Investigation on the current status of examination of vaccination certificate among children in kindergarten and school in each province.2. To access the vaccination rate and the examination of vaccination certificate among children in kindergarten and schoolMethods:To understand the current status and application of examination of vaccination certificate among children in kindergarten and school With an unified questionnaire.Three project areas were selected respectively from the western middle and eastern regions, and two kindergartens and two primary schools then were selected from each project areas. The vaccination rate of children in these kindergartens and schools was investigated and its impact and effectiveness was assessed in 2014.Results:1.The management and technical requirements of examination of vaccination certificate.The policy of examination or schemes of vaccination certificate were draw up in 32 provinces, and among them 24 provinces were issued with Health and Education sectors jointly,4 provinces were issued with disease control and prevention institution by itself. Clear work lows to guide work existed in 26 province and also 26 provinces had requirement of data report.10 provinces took the policy of examination as assessment index of Health and Education sectors.4 provinces did not take the whole vaccinations as inspection when entering school, which mainly were BCG、 DT、MenAC、HepA、JE and so on.The site of check of 19 provinces were on school, and of 4 provinces were on vaccination units, and 7 provinces were on school and vaccination units respectively worked examination inspection personnel of 13 provinces were participators or school physicians and 11 provinces were school physicians or teachers.Reports of 14 provinces worked by school and other 18 provinces worked by vaccination units.2. The current status and application of examination of vaccination certificate.The examination rate in kindergarten and school had reached to 99.70% in every province in 2013 and the rate had reached to 98.87% in kindergarten while to 98.56% in primary school.The rate of permit in kindergarten and primary school was 97.71% and 97.15% respectively and the rate of reissue was 98.54% and 95.11% respectively in some provinces which reported data in kindergarten and school discretely. The all-course vaccination rate in kindergarten and primary school was 82.61% and 77.40% respectively and the reseeding rate was 92.78% and 86.33% respectively in these provinces. The whole reseeding rate in all provinces was 89.99%.3. The current status of examination of vaccination certificate among children in project areas.The project areas were Chaoyang district in Beijing, Gan-jingzi district in Dalian city, Nanchang county in Jiangxi province, and Tongxin county in Ningxia.1359 children were surveyed in nine kindergartens and nine primary schools in which had 555 children in kindergarten and 794 children primary schools.The certificate holding rate of these children was 99.90%.The vaccination rate in kindergarten of BCG, HepB1-3,PV1-3,PV4,DTP1-3,DTP4, MCV1,MCV2, JEV1-2,HepA1,MPV-A1-2,MPV-A+C1 was respectively 99.64%, 100.00%,100.00%,75.00%,100.00%,98.20%,99.82%,97.66%,92.25%,97.30%, 99.10%,75.90% before examination of vaccination certificate and was 99.82%, 100.00%,100.00%,96.80%,100.00%,98.74%,100.00%,98.56%,98.02%,98.74%, 99.10%,97.70% after examination of vaccination certificate. Among them the vaccination rate of PV4 and MPV-A+Cl had a significantly improvement. The all-course vaccination rate of NIPV was 65.68% before examination of vaccination certificate and was 94.15% after it which has significantly improvement.The vaccination rate in primary school of BCG, HepB1-3,PV1-3, PV4, DTP1-3100.00%, DTP4,MCV1,MCV2,JEV1-2, HepA1, MPV-A1-2,MPV-A+C1, MPV-A+C2, DT was 99.88%,99.88%,100.00%,91.52%,00.00%,99.25%,99.88%, 95.80%,95.90%,96.52%,98.38%,97.64%,33.76%,33.51% before examination of vaccination certificate and was 99.88%,99.75%, PV1-3100.00%,97.82%,100.00%, 99.38%,99.88%,98.88%,97.01%,99.13%,97.89%,98.38%,55.77%,83.76% after examination of vaccination certificate. Among them the vaccination rate of MPV-A+C2 and DT were low before examination of vaccination certificate and had a significantly improvement after it. The all-course vaccination rate of NIPV was 21.79% before examination of vaccination certificate and was 69.34% after it which has significantly improvement.The vaccination rate of PV4, MPV-A+C1, MPV-A+C2 and DT of children in kindergarten and school were very low, and the reissue rate of them were respectively 96.80%、97.70%、51.77% and 83.76%, while the last two were very low. The rate of MPV-A+C2 among primary school children in different census register existed differences, which in the locality was higher than that of other places. The rate of other vaccination had no statistical difference. The rate of vaccination in 3 and 6 years old children were 65.68% and 21.79%, ad became 94.15% and 69.34% after examination of vaccination certificate. The all-course vaccination rate in all age groups in regions had significant improvement after examination of vaccination certificate and chi-square test value was less than 0.05, except the two years of age group in Beijing and Ningxia and between four to five years of age group in Beijing and Dalian.Conclusions:1.Every province had worked examination of vaccination certificate, but the requirement, vaccine categories, site of check, inspection personnel, technique process and requirement of monitoring report after examination of vaccination certificate were different. Optimizing the technique process and making uniformly formulate plans would make for implementation and assessment of examination of vaccination certificate.2.The vaccination rate of PV4、MPV-A+Cl in kindergarten and of MPV-A+C2、 DT in primary school were certified to be low t hrough field investigation, and could be increased markedly. The examination of vaccination certificate could increase the rate of part vaccination and the all-course vaccination rate.3. The all-course vaccination rate of NIPV of three to seven years old children can be evaluated hrough examination of vaccination certificate mong children in kindergarten and school, and can make up for the deficiency of difficulty in finding children who had low vaccination rate aiming at one to two yeas old children with present situation investigation.4.making up program of examination of vaccination certificate mong children in kindergarten and school, and setting up monitoring system of vaccination rate was suggested. It can provide a reference to develop evaluation of vaccination rate in preschoolers and improve work of examination of vaccination certificate and vaccination rate.