BACKGROUND: The efficacy of routine childhood immunization depends on timely vaccine uptake and facility use patterns. This study examined the association between pediatric vaccination facility use patterns and routine childhood immunization uptake among children up to age eight years. METHODS: As part of the Kochi Adjunct Study of the Japan Environment and Children's Study (JECS), we analyzed data from 1,644 participants whose Maternal and Child Health Handbook photographs were collected in the eighth year of the cohort study. Maternal and Child Health Handbook records determined immunization completion. Participants were categorized into four groups based on pediatric vaccination facility use patterns: single facility use throughout, multiple facility use during the first period, multiple facility use during the second period, and multiple facility use throughout both periods. Maternal and child characteristics were collected via paper-based questionnaires. Associations between facility use patterns, sociodemographic factors, and immunization completion were analyzed using chi-square tests and logistic regression. RESULTS: Overall, routine childhood immunization completion was observed in 1,259 (76.6%) participants. Chi-square tests indicated that marital status, educational level, lower parity, never smoking, not attending nursery, and breastfeeding practice for infants aged four months old were significantly associated with routine childhood immunization completion. Single facility use throughout the immunization period was observed in 1,011 (61.5%) participants. Multiple facility use (38.5%) was associated with higher odds of routine childhood immunization incompletion than single facility use. This association was the strongest for those who used multiple facilities throughout the vaccination period (adjusted odds ratio, 1.90; 95% confidence interval, 1.24-2.91). CONCLUSIONS Single pediatric facility use was associated with higher routine immunization uptake. Our findings suggest that encouraging the use of one medical institution for a child's vaccinations may be a useful approach to consider when addressing vaccination coverage challenges.
Humans ; Japan ; Female ; Male ; Infant ; Child, Preschool ; Health Facilities/statistics & numerical data* ; Child ; Vaccination/statistics & numerical data* ; Adult ; Immunization/statistics & numerical data* ; Cohort Studies ; Infant, Newborn

BACKGROUND: Japan lacks comprehensive reports on the nationwide voluntary vaccine coverage. The effectiveness of public subsidies in promoting vaccination has not been fully investigated. Therefore, we aimed to estimate the nationwide coverage of voluntary vaccines, compare it with that of national immunization program (NIP)-included vaccines, and investigate the effectiveness of public subsidies. METHODS: We obtained nationwide monthly vaccine market data for rotavirus, Haemophilus influenzae type b (Hib), diphtheria, tetanus toxoid, acellular pertussis, inactivated poliovirus (DTaP-IPV), and mumps vaccines; estimated recipient numbers; and calculated coverage as the proportion of children from October 2011 to March 2022. Regarding the NIP-included vaccine, we compared vaccine coverage calculated from nationwide annual market data with that estimated by World Health Organization (WHO)/United Nations Children's Fund (UNICEF), using Bland-Altman analysis. RESULTS: The estimates of Hib and DTaP-IPV vaccine coverage derived from market data were slightly higher than the WHO/UNICEF estimates, with mean differences of 0.05 (95% CI: 0.02-0.07) for Hib and 0.03 (95% CI: 0.01-0.05) for DTaP-IPV. The coverage of the rotavirus vaccine gradually increased long before the implementation of national subsidies, reaching 0.9 in 2020. Hib vaccine coverage had already achieved 1.0 by January 2012. The coverage of the DTaP-IPV vaccine was approximately 0.6-0.8 in 2013, reaching 1.0 in 2014. The coverage of mumps vaccine increased gradually from 2011 to 2021. CONCLUSIONS Despite the possibility of overestimation, our estimates may serve as a valuable surrogate for actual vaccine coverage in Japan. An increasing trend in rotavirus and mumps vaccine coverage was observed when these vaccines were categorized as voluntary. Although vaccination policies differ from country to country, it would be beneficial to share findings on the impact of subsidies in Japan with other countries.
Japan ; Humans ; Vaccination Coverage/statistics & numerical data* ; Infant ; Immunization Programs/statistics & numerical data* ; Rotavirus Vaccines ; Haemophilus Vaccines ; Child, Preschool ; Poliovirus Vaccine, Inactivated ; Vaccines

Objective: To evaluate the effectiveness of hepatitis B vaccination in Fujian province. Methods: Based on the hepatitis B immunization strategy of China, a cohort study was designed, involving the population in Fujian province. The population under study was divided into natural exposure birth cohort before 1992 and the immunization birth cohort after 1992 (including voluntary vaccination cohort and standardized vaccination cohort). By cleaning the database of hepatitis B cases which directly reported through network and looked into the incidence and related death outcomes of acute hepatitis B from 2004 to 2017, the incidence levels of hepatitis B and immunization effects were analyzed and evaluated among different birth cohorts. Results: During the observation period, the overall prevalence of hepatitis B in Fujian province was 44.594 per 100 000, with mortality rate as 0.010 per 100 000. The incidence of natural exposure cohort of birth was 56.885 per 100 000. The incidence of voluntary vaccination cohort of birth was 14.502 per 100 000. Compared with the voluntary vaccination cohort, the risk of hepatitis B increased significantly in the natural exposed cohort (RR=3.923), and the difference was statistically significant (P=0.000 7), with attributable risk as 42.383 per 100 000. The attributable risk ratio was 74.507. The population attributable risk ratio was 70.967%. The population attributable risk was 35.448 per 100 000. The attributable rate in standardized vaccination cohorts born after 2002 was 2.336 per 100 000. Compared with the cohorts born before 1992, the RR was 24.347 (P=0.000 0), the attributable risk was 54.549 per 100 000, and the attributable risk ratio was 95.893%, the population attributable risk ratio was 95.300%, the population attributable risk was 47.371 per 100 000, comparing to the natural exposed population. Conclusions: The effectiveness of hepatitis B immunization program had been remarkable in Fujian province since 1992. However, further studies on the persistency of hepatitis B vaccine immunization and its public health significance still needed to be carried out.
China/epidemiology* ; Cohort Studies ; Hepatitis B/prevention & control* ; Hepatitis B Vaccines/administration & dosage* ; Humans ; Immunization ; Incidence ; Odds Ratio ; Prevalence ; Risk Factors ; Vaccination/statistics & numerical data*

Objective: Through analyzing the epidemiological characteristics of hepatitis A and E and the situation of vaccination, to promote the recommendation profile on Hepatitis E vaccination program, in China. Methods: Three phases of time span were divided as 2004-2007, 2008-2011 and 2012-2015, with age groups divided as <20, 20-29, 30-39 and ≥40. Incidence rates in both different phases and age groups were compared. Numbers of Hepatitis A and E vaccines released and used, were described. Results: Between 2004 and 2015, a declining trend in the reported incidence of hepatitis A (t=-12.15, P<0.001), but an increasing trend in hepatitis E (t=6.63, P<0.001) were noticed. The mean number of hepatitis A cases declined from 6 515 to 1 986 between 2004 and 2007 while the number of hepatitis E cases increased from 1 491 to 2 277 between 2012 and 2015. The peaks of hepatitis E appeared persistent annually, in March. The incidence of hepatitis A declined in three regions, with the western region (3.46/100 000) much higher than the eastern (1.13/100 000) or central regions (1.14/100 000) (χ(2)=32 630, P<0.01). The incidence of hepatitis E increased both in the central (1.74/100 000) and western regions (1.58/100 000), but more in the eastern region (2.66/100 000) (χ(2)=6 009, P<0.01). Incidence of hepatitis A declined in all age groups and declined by 84.36% among the 0-19 group. However, the incidence of hepatitis E showed an increasing trend among the ≥20 group. Incidence rates appeared higher in the older age groups. The coverage of hepatitis A vaccine increased from 62.05% to 93.54%, but with a negative association seen between the coverage of Hepatitis A vaccine and the incidence (F=10.69, χ(2)<0.05). Conclusion: The incidence of Hepatitis A declined sharply in China while hepatitis E was still increasing from 2004 to 2015, calling for the expansion on the coverage of Hepatitis E vaccine in the whole population.
Adolescent ; Adult ; Aged ; China/epidemiology* ; Health Care Surveys ; Hepatitis A/epidemiology* ; Hepatitis A Vaccines/administration & dosage* ; Hepatitis E/epidemiology* ; Humans ; Immunization/statistics & numerical data* ; Immunization Programs ; Incidence ; Middle Aged ; Population Surveillance ; Vaccination/statistics & numerical data* ; Young Adult

PURPOSE: To improve the quality of the vaccination program, analyze the cause and identify the influencing factors for not being registered in the National Immunization Registry Information System even once. METHODS: We conducted one-on-one household visit interview surveys after, using a list supplemented with addresses from the Ministry of the Interior. We identified the basic respondent information, information on relevant children (those born in 2012), the reasons for omission from computerized vaccination registration, and the actual residence of the registered children. RESULTS: The total number of unvaccinated children born in 2012 was 1,870. The final contact result of the household surveys was 1,254 successful contacts, 51 refused to be interviewed, and 565 were not found. The reason for missed vaccination registration was 928 cases of long-term stay overseas, 241 cases of missing registration owing to intentional refusal of vaccination, and 57 cases of illness. A comparison of complete vaccination rates between non-registrants and those of computerized registrants revealed rates of 17.9% and 96.3% for the 3 doses hepatitis B vaccine, 14.9% and 95.6% for the 4doses DTaP vaccine, 16.1% and 97.4% for the 3 doses polio vaccine, and 3.9% and 92.5% for the 3 (or 2) doses Japanese encephalitis vaccine, respectively. CONCLUSION: Vaccination is the most effective national health policy and one of the most remarkable accomplishments in medical history. Through great effort, Korea has started to transcribe vaccination records since 2000, and the records are now reaching a considerable level. However, there is an unregistered population of around 0.3%. Several measures can be taken to improve the registration rate in the vaccination records, such as managing non-registrants through education and interviews, and sharing vaccination data with foreign countries. The non-registrant management plan should include periodically compiling a list of children who are not registered in the National Immunization Registry Information System, conducting of household visits using survey forms, and data analysis to establish appropriate measures.
Child* ; Diphtheria-Tetanus-acellular Pertussis Vaccines ; Education ; Encephalitis, Japanese ; Family Characteristics ; Health Policy ; Hepatitis B Vaccines ; Humans ; Immunization* ; Information Systems* ; Korea ; Poliomyelitis ; Statistics as Topic ; Surveys and Questionnaires ; Vaccination*

PURPOSE: The purpose of this study was to survey the current state of measles vaccination in university nursing students during a measles outbreak and to identify factors influencing nursing students' vaccination rate. METHODS: In 2014, this study used a self-administered questionnaire to survey 380 university nursing students. Factors influencing measles vaccination were identified through logistic regression analysis using variables between the vaccinated and nonvaccinated groups. RESULTS: Measles vaccination rate was 52.1%. The vaccination rate was significantly higher in juniors, seniors, and those who had heard about measles. In relation to health beliefs, the measles vaccination rate was higher when perceived benefits were high and perceived barriers were low. CONCLUSIONS: A systematic measles vaccination program targeting nursing students upon their entry to university is needed. In order to increase the measles vaccination rate, application of effective promotion campaigns and education programs is necessary.
Adult ; Disease Outbreaks/*prevention & control ; Female ; *Health Knowledge, Attitudes, Practice ; Humans ; Immunization Programs/*statistics & numerical data ; Male ; Measles/*prevention & control ; Republic of Korea ; Students, Nursing/*psychology ; Surveys and Questionnaires ; Universities ; Vaccination/*psychology ; Young Adult

PURPOSE: The adult tetanus, reduced diphtheria, and acellular pertussis (Tdap) vaccine has been introduced in order to provide individual protection and reduce the risk of transmitting pertussis to infants. We assessed the knowledge and acceptability of the Tdap vaccine around pregnancy. MATERIALS AND METHODS: This study was a cross-sectional survey of women of childbearing age (20-45 years) who visited obstetrics and gynecologic units of primary, secondary, or tertiary hospitals. They were asked to fill in a questionnaire assessing their knowledge, attitudes, and acceptability of Tdap. RESULTS: The questionnaire was completed by 308 women; 293 (95.1%) had not received information from doctors about Tdap, and 250 (81.2%) did not know about the need for vaccination. A significantly important factor related to subjects' intention to be vaccinated, identified by stepwise multiple logistic regression, was the knowledge (OR 13.5, CI 3.92-46.33) that adult Tdap is effective in preventing pertussis for infants aged 0-6 months. Additionally, 276 (89.6%) considered the recommendation of obstetric doctors as the most influencing factor about Tdap vaccination. CONCLUSION: In Korea, most women of childbearing age seem to be neither recommended nor adequately informed about the vaccination, although our population was not a nationwide representative sample. Information given by healthcare workers may be critical for improving awareness and preventing pertussis.
Adult ; Cross-Sectional Studies ; Diphtheria ; Diphtheria-Tetanus-acellular Pertussis Vaccines/*administration & dosage ; Female ; Health Knowledge, Attitudes, Practice/*ethnology ; Humans ; Immunization/*statistics & numerical data ; Infant ; Logistic Models ; Multivariate Analysis ; Patient Acceptance of Health Care/*ethnology/statistics & numerical data ; Pregnancy ; Republic of Korea/epidemiology ; Risk ; Surveys and Questionnaires ; Tetanus ; Vaccination ; Whooping Cough/diagnosis/ethnology

OBJECTIVETo review the re-examination sampling method and procedure of national immunization survey for the national immunization program vaccines coverage at the township level by the national level in 2013, China.

METHODSAccording to the result of immunization coverage at the township level through self-assessment by county, all townships were stratified by whether a township with ≥ 90% immunization coverage for the second dose of measles-containing vaccines (MCV2), and a township was urban or rural. After then, 2 townships for each province were randomly sampled from those strata through the surveyselect procedure of the statistics analysis system 9.2 (SAS 9.2).

RESULTS64 townships were randomly sampled from 32 provincial units for the re-examination, i.e. an urban township and a rural township each province, of which there were 38 townships with ≥ 90% MCV2 coverage and 26 townships with < 90% MCV2 coverage. There were 24 urban townships, 2 rural townships with < 90% MCV2 coverage and 8 urban townships, 30 rural townships with ≥ 90% MCV2 coverage, respectively.

CONCLUSIONSBased on the information of the self-assessment result of immunization coverage survey by counties, Stratified randomized sampling were employed for the re-examination through the Surveyselect procedure of statistics analysis system (SAS) to implement the sampling procedure. This can enhance the sampling efficiency, ensure the randomness of the sample, and make the survey much more representative and comparable.

China ; Humans ; Immunization ; Immunization Programs ; statistics & numerical data ; Measles Vaccine ; Rural Population ; Sampling Studies ; Surveys and Questionnaires ; Urban Population ; Vaccination ; statistics & numerical data ; Vaccines

OBJECTIVETo investigate the changes of epidemiological characteristics of measles in Beijing before and after Supplementary Immunization Campaigns (SIA) (2007-2010 vs 2011-2014) of measles-containing vaccine (MCV) among children aged between 8 months and 14 years in 2010.

METHODSDescriptive epidemiological analysis was conducted on surveillance data of measles cases (clinical cases and laboratory confirmed cases), with the occurrence during 2007-2014, and of outbreaks, with the occurrence during 2009-2014, from National Notifiable Disease Reporting System. MapInfo geographic information system (Version 8.5) was used to illustrate the distribution of measles incidence by district. Annual measles incidence was classified into 5 groups at the same intervals between the upper and lower limits to analyze the morbidity of the different areas.

RESULTSIn total, 7 722 and 3 132 measles cases were reported during 2007-2010 and 2011-2014, with the annual incidence of 11.59 and 3.84 cases per 100 000 population, respectively. Comparing with the results during 2007-2010, total number of measles cases and average annual incidence during 2011-2014 were decreased by 59.4%, and 66.9%, respectively. Among measles cases during 2011-2014, percentage of cases aged 15 years or above were 57.7%(56/97), 62.0%(49/79), 65.5%(370/565), and 71.4% (1 707/2 391), respectively, which increased by years. During 2007-2010, the highest risk age for adults was 20-34, while 2011-2014, 5 years older: 25-39. During 2009-2010, 2011-2012, and 2013-2014, 50.3% (447/889), 30.3% (10/33), and 57.8% (201/348), respectively, of measles cases aged 8-17 months were unvaccinated by MCV. Percentages of measles cases aged 0-7 months, 8 months-14 years, 15-39 years and 40 years or above during 2013-2014, who visited hospitals 7-21 days before disease onset, were 59.8% (238/398), 49.3% (237/481), 32.2% (529/1641), and 37.6% (164/436), respectively. A total of 11 nosocomial measles outbreaks occurred during 2013-2014, which was much higher than that during 2009-2010 (2 nosocomial outbreaks). And universities accounted for the majority of outbreak settings of schools (3/4). All 11 outbreaks among grouped employees during 2009-2012 occurred in factories, restaurants, or large shopping centers, while the largest proportion (6/16) of that kind of outbreaks during 2013-2014 occurred in office buildings.

CONCLUSIONSSIA of MCV in 2010 effectively decreased measles transmission in Beijing. But routine immunization of MCV still needed to be improved. The issue of adult measles has been a prominent problem. Hospitals, office buildings and universities were the focus of prevention of measles transmission.

Adolescent ; Adult ; Beijing ; epidemiology ; Child ; Child, Preschool ; Cross Infection ; Disease Outbreaks ; Geographic Information Systems ; Humans ; Immunization Programs ; statistics & numerical data ; Incidence ; Infant ; Measles ; epidemiology ; Measles Vaccine ; administration & dosage ; Restaurants ; Schools ; Vaccination ; statistics & numerical data ; Young Adult

OBJECTIVETo analyze the immunization status of category II vaccine in Chinese Mainland in 2012.

METHODSThe completeness of report unit by township and county, including 31 provinces (cities, municipalities) and Xinjiang Production and Construction Corps, the number of doses and the number of counties covered for category II vaccine at different areas, average types of category II vaccine by county were analyzed by descriptive epidemiological methods, according to monthly report of vaccination data for category II vaccines by township in 2012 which all of provinces and population were almost covered, through the National Immunization Program(NIP) monitoring information system of China.

RESULTSA total of 29 kinds of category II vaccine with 90 843 530 doses were reported in 2012, and the total average dose was 674.2 per 10 000 people. The report completeness by county and township were 83.32% (29 557/35 472) and 80.01% (396 652/495 756) respectively. The reported doses of rabies vaccine for human use, Haemophilus influenza type b vaccine and influenza vaccine was the top third vaccine, among those for all kinds of category II vaccine, which were 17 027 259, 13 996 206, 11 324 518 respectively, and 126.4, 103.9, 84.1 doses per 10 000 people. In 2773 county units, varicella attenuated live vaccine, influenza vaccine, rabies vaccine for human use were the top three kinds of category II vaccine in terms of the number of county where vaccines have been used in 2012, which were 2442(88.06%), 2415(87.09%), 2366(85.32%) respectively. Guangdong province with 12 266 531 doses was the highest report doses for category II vaccine whereas Qinghai province with 57 767 doses was the lowest number in 2012. Regarding to the average report doses by province, the highest or lowest number was 2425.0 doses per 10 000 people in Shanghai province, and 101.7 doses per 10 000 people in Qinghai province separately.

CONCLUSIONMany kinds of category II vaccine with a large amount have been used in China, and there are significant different among areas. Surveillance and management for category II vaccines should be future improved.

China ; epidemiology ; Humans ; Immunization Programs ; statistics & numerical data ; Population Surveillance ; Vaccination ; statistics & numerical data