文章基本信息

标题：An Evaluation of Voluntary 2-Dose Varicella Vaccination Coverage in New York City Public Schools
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作者：Margaret K. Doll ; Jennifer B. Rosen ; Stephanie R. Bialek 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2015
卷号：105
期号：5
页码：972-979
DOI：10.2105/AJPH.2014.302229
语种：English
出版社：American Public Health Association
摘要：Objectives. We assessed coverage for 2-dose varicella vaccination, which is not required for school entry, among New York City public school students and examined characteristics associated with receipt of 2 doses. Methods. We measured receipt of either at least 1 or 2 doses of varicella vaccine among students aged 4 years and older in a sample of 336 public schools (n = 223 864 students) during the 2010 to 2011 school year. Data came from merged student vaccination records from 2 administrative data systems. We conducted multivariable regression to assess associations of age, gender, race/ethnicity, and school location with 2-dose prevalence. Results. Coverage with at least 1 varicella dose was 96.2% (95% confidence interval [CI] = 96.2%, 96.3%); coverage with at least 2 doses was 64.8% (95% CI = 64.6%, 64.9%). Increasing student age, non-Hispanic White race/ethnicity, and attendance at school in Staten Island were associated with lower 2-dose coverage. Conclusions. A 2-dose varicella vaccine requirement for school entry would likely improve 2-dose coverage, eliminate coverage disparities, and prevent disease. Varicella vaccine was licensed in the United States in 1995. 1 In 1996, the US Advisory Committee on Immunization Practices recommended a single dose of varicella vaccine for routine use among all children aged 12 to 18 months and children aged 19 months to 12 years without a history of varicella disease; 2 doses were recommended for susceptible persons aged 13 years and older. 1 Since licensure, varicella vaccination coverage in the United States has rapidly increased, 2–4 and sharp decreases in the incidence of varicella disease and varicella-related morbidity and mortality have been observed. 5–8 Outbreaks of varicella, however, continued to occur in the United States even among populations with high 1-dose coverage. 9–12 In 2006, the Advisory Committee on Immunization Practices updated its recommendation to a universal 2-dose varicella vaccine childhood schedule, with a catch-up vaccination recommendation for susceptible children, adolescents, and adults with only 1 dose of varicella vaccine. 13 Since the 2006 recommendation, 35 states and the District of Columbia have adopted 2-dose varicella school-entry requirements. 14 As of the 2013 to 2014 school year, New York State was 1 of the 15 remaining states without a 2-dose requirement. New York State Public Health Law §2164 defines immunization requirements for all schools in New York State; since 1999, the law has required 1 dose of varicella for school entry for all students born on or after January 1, 1998, who do not have a physician-documented history of chickenpox or serological evidence of varicella immunity. 15 In 2005, the state modified the law to include students born on or after January 1, 1994. With these rolling requirements, the regulation for 1 dose of varicella vaccine applied to all New York City students in kindergarten through 12th grade by the 2011 to 2012 school year. 15 In the absence of a 2-dose requirement, little is known regarding 2-dose varicella vaccination coverage in New York City public schools, which compose the largest public school system in the United States, with more than 1 million students. 16 Two-dose varicella coverage estimates in this population are not available from current national survey data: the Centers for Disease Control and Prevention (CDC) kindergarten vaccination assessment survey does not provide varicella 2-dose estimates where the vaccine is not required for school entry, 17–20 the National Immunization Survey of children aged 19 to 35 months only specifies coverage of 1 or more doses of varicella vaccine, 4 and the National Immunization Survey–Teen 2-dose coverage data for New York City is limited to children aged 13 to 17 years. 21,22 Recent CDC sentinel data published for New York City children only assessed 2-dose varicella coverage among children at 7 years of age. 14 We measured 2-dose varicella vaccination coverage in a sample of New York City public school students aged 4 years and older and assessed student characteristics associated with varicella vaccination.