Table_1_Vaccination Status of Children With Epilepsy or Cerebral Palsy in Hunan Rural Area and a Relative KAP Survey of Vaccinators.DOCX

Background: In China, the vaccination of children with epilepsy (EP) and cerebral palsy (CP) has no specific protocol. Parents are often concerned that vaccination of their children may cause complications due to negative recommendations from vaccinators, resulting in a decline in vaccination. It is therefore is essential to investigate the vaccination status of these specific populations, and the knowledge, attitudes, and practices (KAP) of vaccinators.
Methods: This study contains two parts. For the vaccination status survey, residency- and age-matched children whose medical expenditure were covered by the New Rural Cooperative Medical System in Hunan Province were enrolled. Children who were diagnosed with EP or CP were included as the case group, while children without any chronic disease were enrolled as the control group. The vaccination rates of the two groups were compared. For the KAP survey, vaccinators who registered in Hunan CDC were recruited as respondents, and questions were asked related to their experience and attitudes toward vaccinating children with EP or CP.
Results: The vaccination rates of the case group were significantly lower than the control group (P < 0.001), with the exception of BCG and Hep B1. Nine measles and two mumps cases were diagnosed in the case group, while there were no Vaccine Preventable Disease (VPD) cases in the control group. The vaccinators' knowledge of the issues related to the vaccination of children with EP or CP was weaker than their knowledge of general vaccination issues. Furthermore, when making a vaccination decision, seizure-free periods and EEG status were their main concerns.
Conclusion: The vaccination status of rural children with EP and CP is in jeopardy in Hunan, China, and there are several misunderstandings regarding the contraindications of vaccines among vaccinators. We suggest that measures are taken to improve this situation.

背景：目前中国针对癫痫（epilepsy, EP）与脑瘫（cerebral palsy, CP）儿童的疫苗接种尚无统一规范。接种人员常因负面建议让家长担忧为患儿接种疫苗可能引发并发症，进而导致该群体疫苗接种率下降。因此，针对这一特殊群体的疫苗接种现状，以及接种人员的知信行（Knowledge, Attitudes, and Practices, KAP）水平开展调查至关重要。
方法：本研究包含两部分。在疫苗接种现状调查中，本研究纳入湖南省新型农村合作医疗制度覆盖的、居住地与年龄相匹配的儿童：以确诊为癫痫或脑瘫的儿童作为病例组，无任何慢性疾病的儿童作为对照组，对比两组的疫苗接种率。在知信行调查中，本研究招募湖南省疾病预防控制中心（Center for Disease Control and Prevention, CDC）注册的接种人员作为调查对象，设计相关问题了解其为癫痫或脑瘫儿童接种疫苗的经验与态度。
结果：除卡介苗（BCG）与乙型肝炎疫苗第一剂（Hep B1）外，病例组的疫苗接种率均显著低于对照组（P < 0.001）。病例组中共确诊9例麻疹病例与2例流行性腮腺炎病例，而对照组未出现任何疫苗可预防疾病（Vaccine Preventable Disease, VPD）病例。接种人员针对癫痫与脑瘫儿童疫苗接种相关问题的认知水平弱于常规疫苗接种相关知识。此外，在作出疫苗接种决策时，无发作期与脑电图（Electroencephalogram, EEG）状态是其主要考量因素。
结论：中国湖南省农村癫痫与脑瘫儿童的疫苗接种现状堪忧，且接种人员对疫苗接种禁忌证存在诸多认知误区。本研究建议采取针对性措施改善这一现状。