【摘要】 目的 了解接种人员为特殊健康状态儿童提供疫苗接种服务现状和意愿。方法 在中国3个市选取416家接种单位的接种人员开展问卷调查，分析为特殊健康状态儿童提供各项接种服务的比例、接种意愿评分(满分5分)及其影响因素。结果 共纳入调查对象442例，其中以免疫程序、疫苗说明书、相关技术指南、相关专家共识为主要参考开展儿童接种禁忌核查分别占97.96%、94.80%、79.19%、26.24%;以家长自述和医疗记录证明、仅家长自述判断儿童健康状态分别占81.22%、16.74%;通过免疫规划信息系统登记儿童健康相关信息占83.94%;当判断儿童可以接种但家长犹豫时首选鼓励接种、建议前往接种评估门诊、遵从家长意愿分别占43.89%、42.99%、11.76%。接种人员为儿童接种疫苗意愿评分中位数为4分；多因素分析显示，每年参加≥2次相关培训的调查对象意愿高(β=44.22,95%CI:15.63～72.80),非科室负责人、认为专家共识实用性较低的调查对象意愿低(β=-41.60,95%CI:-63.14～-20.07;β=-59.18,95%CI:-81.55～-36.82)。结论 接种人员主要按照国家相关规范或指南为特殊健康状态儿童提供疫苗接种服务且接种意愿高；有必要制订特殊健康状态儿童疫苗接种技术指导文件并加强接种人员培训。更多还原

【Abstract】 Objective To explore vaccination services for children with medical conditions and willingness of vaccination staff to vaccinate children with medical conditions.Methods We selected vaccination staff from 416 vaccination units in three cities of China for a questionnaire-based survey to determine vaccination services provided for children with medical conditions, willingness to vaccinate children with medical condition, and factors influencing willingness.Results Of 442 staff, 97.96%, 94.80%, 79.19%, and 26.24% screened for vaccination contraindications based on immunization schedules, vaccine package inserts, relevant guidelines, and relevant expert consensuses, respectively; 81.22% judged the health status of children according to parent descriptions combined with medical records, and 16.74% used parent descriptions only; 83.94% recorded children′s health information in an immunization program information system. For children with medical conditions who were able to be vaccinated in staff′s judgement but parents were hesitant, 43.89% encouraged vaccination, 42.99% suggested assessment in a specialized clinic, and 11.76% complied with parent desires. The median score for willingness to vaccinate children with medical conditions was 4 points out of a maximum of 5 points. Multivariate regression analysis showed that willingness was higher among staff who had received relevant trainings ≥2 times per year(β=44.22, 95% CI: 15.63-72.80). Willingness was lower among non-supervisory staff and staff who believed expert consensuses to be not very practical(β=-41.60, 95% CI:-63.14 to-20.07; β=-59.18, 95% CI:-81.55 to-36.82).Conclusions Vaccination staff generally provided vaccination services for children with medical conditions in accordance with national specifications or guidelines and had high willingness to vaccinate children. It is necessary to develop technical guidance for vaccination of children with medical conditions and to strengthen training for vaccination staff.更多还原