提高儿童轮状病毒疫苗接种率的多成分干预措施:随机对照试验

IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES The Lancet Regional Health: Western Pacific Pub Date : 2024-08-05 DOI:10.1016/j.lanwpc.2024.101153
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引用次数: 0

摘要

背景轮状病毒疫苗尚未纳入香港政府的儿童免疫接种计划。这项随机对照试验研究了一个简单的干预方案能否提高香港儿童对轮状病毒疫苗的接种率。方法 从香港两家公立医院招募产后母亲,采用组块随机法将她们随机分配到三个组别,调查人员和研究人员不知道组块大小。对照组受试者获得了轮状病毒的公共信息。干预组 1 的受试者会额外收到:主要轮状病毒信息,以及显示提供轮状病毒疫苗的私人诊所和搜索诊所指南的网页超链接,以及疫苗接种提醒。干预组 2 的受试者除了接受与干预组 1 相同的干预措施外,还获得了在特定医疗中心免费接种轮状病毒疫苗的代金券。轮状病毒疫苗接种情况在儿童约 8 个月大时进行收集。母亲对轮状病毒疫苗的态度在报名时和研究结束时进行评估。研究结果从2021年2月16日至7月30日,共招募了788名符合条件的母亲,并随机分配到对照组(263人)、干预组1(263人)和干预组2(262人)。全套干预措施(干预组 2 相对于对照组)将轮状病毒疫苗接种率提高了 1.7 倍(95% 置信区间 [CI] = 1.49-1.97)或 33 个百分点(从 48% 提高到 81%)。提供主要轮状病毒信息和疫苗接种提醒(干预组 1 相对于对照组)以及消除经济障碍(干预组 2 相对于干预组 1)可使接种率分别提高 1.17 倍(95% CI = 0.99-1.38)或 8 个百分点,以及 1.46 倍(95% CI = 1.29-1.66)或 25 个百分点。干预方案对低收入家庭的影响最大,强调了消除接种疫苗的经济障碍以促进公平的重要性。将轮状病毒疫苗纳入常规儿童免疫接种计划可进一步保护更多幼儿免受轮状病毒感染,并改善公平性。
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Multiple-component interventions to increase rotavirus vaccine uptake in children: a randomised controlled trial

Background

Rotavirus vaccine has not been included in the Hong Kong Government's Childhood Immunisation Programme. This randomised controlled trial examined whether a simple intervention package can increase rotavirus vaccine uptake in Hong Kong children.

Methods

Postpartum mothers were recruited from two public hospitals in Hong Kong and randomly allocated into three groups using block randomisation, with block sizes kept unknown to investigators and research staff. Control-subjects received public rotavirus information. Subjects in intervention group 1 additionally received: key rotavirus information with a hyperlink to a webpage showing private clinics providing rotavirus vaccines and guidance on searching the clinics, and vaccination reminders. Subjects in intervention group 2 received the same intervention as group 1, plus tokens to receive free rotavirus vaccines at specific health centres. Rotavirus vaccination status was collected when children were approximately 8 months old. Maternal attitudes towards rotavirus vaccine were assessed at enrolment and at the end of the study. This trial has been registered in the Chinese Clinical Trial Register (Ref.:ChiCTR2000039791).

Findings

From 16 February to 30 July 2021, 788 eligible mothers were recruited and randomly allocated to control group (n = 263), intervention group 1 (n = 263), and intervention group 2 (n = 262). The full intervention package (intervention group 2 relative to control group) increased rotavirus vaccine uptake by 1.7 times (95% confidence interval [CI] = 1.49–1.97) or by 33 percent-points (from 48% to 81% uptake). Provision of key rotavirus information with vaccination reminders (intervention group 1 relative to control group) and removal of financial barrier (intervention group 2 relative to intervention group 1) increased uptake by 1.17 times (95% CI = 0.99–1.38) or 8 percent-points, and by 1.46 times (95% CI = 1.29–1.66) or 25 percent-points, respectively.

Interpretation

A multiple-component intervention package, and in particular providing free vaccine, could increase the uptake of rotavirus vaccine in Hong Kong children. The impact of the intervention package was greatest in low-income families, emphasising the importance of removing financial barriers to vaccination to promote equity. Incorporating rotavirus vaccine into the routine CIP could further protect more young children from rotavirus infection and improve equity.

Funding

This work was supported by the Health and Medical Research Fund by the Health Bureau, Government of Hong Kong SAR [Ref.: 19180202].

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来源期刊
The Lancet Regional Health: Western Pacific
The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health
CiteScore
8.80
自引率
2.80%
发文量
305
审稿时长
11 weeks
期刊介绍: The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.
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