Survey On Acceptance Of New Immunization Program After Polio Vaccine Conversion And Current Status Of Polio Vaccination

BackgroundPolio vaccines have two types,inactivated polio paccine(IPV)and oral polio vaccine.IPV contains three serotypes I,II,and III.OPV is classified into trivalent OPV(tOPV),divalent OPV(bOPV),and monovalent OPV(mOPV)depending on the number of serotypes contained.The WHO decided that the removal of type II components was required in OPV because of the worldwide confirmation of the elimination of type II wild polioviruses.In April 2016,155 countries that still use OPV in the world coordinated the polio vaccine conversion.The vaccine was converted from bOPV to bOPV and one dose of IPV was introduced.China implemented a new poliomyelitis vaccine immunization program on May 1,2016,that is,1 dose of IPV at 2 months of age and 1 dose of bOPV at 3,4 months,and 4 years of age.At this stage,global IPV supply is insufficient.ObjectiveAfter understanding the polio vaccine conversion,the child guardians and immunization service providers know and receive information on polio and immunization programs,understand the status of polio vaccine vaccination and analyze the influencing factors,so as to provide basis for effective implementation of new immunization strategies.Methods3 districts/counties were selected in district/county with a population size of 300,000 or more in Shaanxi Province according to high,medium,and low economic levels.A simple random sampling method selects 4 to 6 inoculation units.When the inoculation unit selects the children who are immunized with the new polio vaccine immunization program for 4 to 5 months of age(the children in the local information system),a questionnaire survey is conducted on the guardians.Select all the staff of the immunization planning section of the disease control department in the investigation area/county and doctors of the inoculation unit to conduct the survey.This study defines the percentage of guardians who are willing to vaccinate children against polio in accordance with national immunization procedures as acceptance.The proportion of immunization service providers who are willing to vaccinate or recommend to guardians according to national immunization procedures is defined as acceptance,≥90%.For high acceptance,80%to 90%is moderate,and≤80%is low.43.88%of immunization service providers encountered problems and difficulties due to insufficient vaccine supply.34.67%of them were inconvenient to vaccinate,which was mainly reflected in the control of bopv dosage.ResultsThe on-site investigation was conducted in 10 townships,3 sub-district offices and 2 community service centers in 3 districts and counties.A total of 600 child guardians were investigated and 572 valid questionnaires(95.33%)were retrieved.The male to female ratio of children is 0.95:1.The proportion of mothers is>50%.Parents’education is mainly in junior high school,and parents’ occupations are mainly farmers.For child guardians,the sources of information for polio vaccines and immunization programs are mainly vaccinated doctors and inoculations,73%and 52%,respectively.82%of child guardians pay attention to what kind of vaccine is vaccinated when children are vaccinated,72%of child guardians care about the safety of the vaccine,and 72%of child guardians think that the current polio vaccine is safe,but 22%said it is not clear.7%think it is not safe.After the discontinuation of the OPV sugar pills,25%of the child guardians had hesitated.In the event of an IPV shortage,most child guardians will follow the doctor’s schedule.Some guardians will choose to wait for IPV,but fewer guardians choose not to vaccinate.87%of immunization service providers come from inoculation units,and academic qualifications are mainly specialized(57%).The analysis of the status of knowledge of polio and related knowledge by the immunization service providers showed that the situation was lowest in Luonan County.The 66%immunization service provider arranged the vaccination according to the national polio vaccine recomrImendation procedure.The actual inoculation survey showed that the proportion of the first dose of IPV in the three counties differed significantly,with Luonan as the highest(94%)and Dianbian as the lowest(78%).The main reasons for the late-planting and missed-planting of polio vaccines were the shortage of vaccines and the lack of vaccines at the time of inoculation.The ratio of the new polio program to the inoculation rate was 76%,mainly due to the fact that the inoculation changed from oral sugar pills to 10(61%),the vaccine was in short supply(42%),and the inoculation was changed from oral sugar piuls.For injections(41%),the program became a complex sequential immunization program(39%).30.61%of immunization service providers suggested that the dosage form of bopv should be changed,and it is best to change the dosage form to a single dose.12.24%suggested to ensure the supply of vaccines and ensure the timely vaccination of children.ConclusionChildren’s guardians have high acceptance of polio inoculation procedures,and the level of cognition of child guardians in the three regions is common.Primary immunization service providers have low acceptance of polio vaccines and vaccination procedures.Although the supply of vaccines is insufficient,the inoculation rates in the counties are high.Some districts and counties did not inoculate IPVs according to the national immunization program.The current problems faced by grassroots vaccination are mainly inadequate vaccines and inconvenient vaccination.