接种方式.docx

1 Intervention background: Hepatitis B virus (HBV) infection, which was highly prevalent in China, is a main cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma.1 Beasley RP, Hwang LY, Lin CC. Hepatocellular carcinoma and hepatitis B virus: a prospective study of 22,707 men in Taiwan. Lancet 1981;2:1129–33. As HBV infection usually occurs during infancy or early childhood when it is most likely to become chronic, the vaccination of infants beginning at birth is the key strategy in preventing chronic HBV infection. In China, the hepatitis B vaccine (HepB) was first used in 1987 and was recommended for infants by the Ministry of Health in 1992. Since then, universal infant hepatitis B vaccination has been implemented in China and great efforts have been made to achieve a high HepB coverage among children. HepB was freely provided to infants (but with a user fee of about US$ 1.10) from 2002 and infants have been vaccinated without any charge since 2005. Today, 5 mg recombinant yeast vaccine is recommended for infants, and the HepB vaccination program consists of a first dose within 24 h after birth, followed by further doses at 1 and 6 months of age. Screening of pregnant women for HBsAg is not compulsory. 城乡二元 结构，不同接种地点 Because of the dual structure in urban and rural economy in china, there are different injection sites between urban and rural areas. This article is to focus on the injection pattern in rural area in china. 2 intervention measures: Intervention1: different inoculative pattern 80年代,我县计划免疫冷链运转主要采取双月运转的分散接种方式,即由乡村医生每两个月上门给适龄儿童接种一次 自1993年1月开始在全县范围内实行了以乡(镇)卫生院为中心的集中式接种,即以乡为单位开设计划免疫接种门诊,每月在固定时间,固定地点,由固定的专业人员对辖区内所有适龄儿童按儿童免疫程序接种各种疫苗。 张凤举.儿童预防接种率影响因素浅析[J].中国乡村医生杂志,1992,1:35-36. 刘志田,王延俊,邹俊香. 三种计划免疫接种形式的调查分析.中国计划免疫,2002,8(4):188. 目前有三种接种形式,即村接种门诊、乡接种门诊（接种门诊设在乡卫生院）和乡执行接种门诊（接种门诊设在各村）。,乙肝疫苗接种率分别为74·3%、 80·0%和89·3%，经济效益平均每1 000人收入50元、1 520元和1 770元。疫苗损耗系数分别1·677、1·529和1·619。 乡接种门诊和乡执行接种门诊的共同特点是接种由乡卫生院的防保医生执行,全是中专及以上学历,主要从事预防工作,专业性强,严格执行计划免疫规程,接种、登记分工