Over the last 20 years, international organizations spearheaded by GAVI, the Vaccine Alliance—in partnership with national governments, the World Health Organization and UNICEF—have ensured that significantly more children in poor countries in Africa and elsewhere get routine vaccinations: 81 per cent today versus 59 per cent in 2000. And that has had a major impact—a 70 per cent drop in child mortality from vaccine-preventable diseases over two decades.
But what about the root causes of non-vaccination of the young: is the problem one of poverty alone, of the failure of domestic governments and their public-health departments to reach the most vulnerable communities, or simply of an inability to overcome deep-rooted social disadvantages? A new Canada-India study of tens of thousands of zero-dose children in India suggests that the causes of low-vaccination rates in lower-income countries is all of those and more.
The study analyses a quarter century of national survey data to better understand how social, economic and geographical inequalities in India shaped the chances of children remaining unvaccinated between 1992 and 2016. They found that India had made tremendous progress in reaching children with routine immunization. But they also found that, in 2016, children remained concentrated among disadvantaged groups, including the lowest-income households and children born to mothers who had no formal education.
As well, compared with vaccinated children, zero-dose children were more likely to suffer from malnutrition. For instance, in 1992, 41 percent of zero-dose kids had severely stunted growth; by 2016, the numbers had declined but were still disproportionate. “Over a 24-year period in India, child zero-dose status was shaped by large-scale social inequalities and remained a consistent marker of generalized vulnerability,” the researchers concluded. “Interventions that address this cycle of intergenerational inequities should be prioritized.”
Professor Johri pointed to the uniqueness of the work of her and her colleagues. “It’s the first to trace aggregate patterns in zero-dose children over time globally and in India,” said Johri, who is an overseas citizen of India as well as a Canadian citizen.
More globally, the Indian experience suggests that “child zero-dose vaccination status is an important marker of vulnerability linked to systematic disadvantage over the life course,” Johri said. “Identifying zero-dose children and intervening early to address the complex sources of disadvantage they face has the potential to transform life opportunities and combat intergenerational inequities. It should be a top priority for the international community.”
1. What does the author want to talk about?
2. What are the basic reasons of zero-vaccination of the children in poor countries?
3. What can we learn about the non-vaccinated children in 2016?
4. What difference did Professor Johri’s research have?
5. To other countries, what does Indian experience suggest?
问题1选项
A.Poor countries have achieved a lot in children vaccination in past 20 years.
B.WHO has done a great job to urge governments in Africa to vaccinate their children.
C.Child mortality has dropped sharply due to children vaccination in poor countries.
D.The basic reasons lie behind non-vaccination of the young in poor countries.
问题2选项
A.Poverty.
B.Inaction of governments.
C.Inability to solve social disadvantages.
D.More than the above.
问题3选项
A.The rate of non-vaccination dropped nearly to zero in 2016.
B.Governments was successful in solving social problems.
C.The vaccination rate depends on the status of social equality.
D.Vaccinated children can get enough nutrition in 2016.
问题4选项
A.She is an overseas citizen with double citizenship.
B.It started to study non-vaccinated children’s concentration globally and locally.
C.She found Indian children were malnutritional without vaccination.
D.They found out the difference from 1992 to 2016.
问题5选项
A.Government should encourage children to get vaccinated as early as possible.
B.Health care department has to put poor families into vaccination systems.
C.The young should be given adequate nutrition through early intervention.
D.It’s important to solve the social problems from the origin as early as possible.
第1题:D
第2题:D
第3题:C
第4题:B
第5题:D
第1题:
【选项释义】
What does the author want to talk about? 作者想谈论的是什么？
A. Poor countries have achieved a lot in children vaccination in past 20 years. A. 在过去的20年里，贫穷国家在儿童疫苗接种方面取得了很大的成就。
B. WHO has done a great job to urge governments in Africa to vaccinate their children. B. 世卫组织在敦促非洲各国政府为其儿童接种疫苗方面做了大量工作。
C. Child mortality has dropped sharply due to children vaccination in poor countries. C. 由于贫穷国家的儿童疫苗接种，儿童死亡率急剧下降。
D. The basic reasons lie behind non-vaccination of the young in poor countries. D. 贫穷国家的年轻人不接种疫苗背后的基本原因。
【考查点】主旨大意题。
【解题思路】文章开头介绍了贫穷国家儿童疫苗接种率提高，儿童死亡率下降，第二段提出一个问题：年轻人不接种疫苗的根本原因是什么？接下来通过贫穷国家零剂量儿童的现象来分析原因，由此可知本文主要谈论的是贫穷国家的年轻人不接种疫苗背后的基本原因。因此D选项正确。
【干扰项排除】
A选项“在过去的20年里，贫穷国家在儿童疫苗接种方面取得了很大的成就。”，B选项“世卫组织在敦促非洲各国政府为其儿童接种疫苗方面做了大量工作。”和C选项“由于贫穷国家的儿童疫苗接种，儿童死亡率急剧下降。”分别只提到了文章的某一个部分，不能概括全文的主旨大意，属于以偏概全。
第2题:
【选项释义】
What are the basic reasons of zero-vaccination of the children in poor countries? 贫穷国家的儿童没有接种疫苗的基本原因是什么？
A. Poverty. A. 贫穷。
B. Inaction of governments. B. 政府的不作为。
C. Inability to solve social disadvantages. C. 无力解决社会的不利因素。
D. More than the above. D. 多于上述内容。
【考查点】事实细节题。
【解题思路】根据题干关键词basic reasons of zero-vaccination of the children可以定位到文章第二段最后一句“加拿大和印度对印度数万名零剂量儿童进行的一项新研究表明，低收入国家疫苗接种率低的原因是上述所有原因，甚至更多（all of those and more）”，说明贫穷国家的儿童没有接种疫苗的基本原因是除了上文提到的之外还有更多。因此D选项“多于上述内容。”正确。
【干扰项排除】
A选项“贫穷。”，B选项“政府的不作为。”和C选项“无力解决社会的不利因素。”分别是原因之一，属于以偏概全。
第3题:
【选项释义】
What can we learn about the non-vaccinated children in 2016? 我们可以了解到关于2016年未接种疫苗的儿童的什么信息？
A. The rate of non-vaccination dropped nearly to zero in 2016. A. 2016年不接种疫苗的比率几乎降为零。
B. Governments was successful in solving social problems. B. 政府在解决社会问题方面是成功的。
C. The vaccination rate depends on the status of social equality. C. 疫苗接种率取决于社会平等的状况。
D. Vaccinated children can get enough nutrition in 2016. D. 接种疫苗的儿童在2016年可以获得足够的营养。
【考查点】推理判断题。
【解题思路】根据题干关键词the non-vaccinated children in 2016可以定位到文章第三段最后一句“但他们也发现，2016年，儿童仍然集中在弱势群体中（concentrated among disadvantaged groups），包括最低收入家庭和母亲没有接受过正规教育的儿童（the lowest-income households and children born to mothers who had no formal education）”，接着第四段最后一句说到“应该优先考虑解决代际不平等循环（address this cycle of intergenerational inequities）的干预措施”，说明儿童疫苗接种率低是因为社会不平等的原因。因此C选项“疫苗接种率取决于社会平等的状况。”正确。
【干扰项排除】
A选项“2016年不接种疫苗的比率几乎降为零。”，由They found that India had made tremendous progress in reaching children with routine immunization.（他们发现，印度在为儿童提供常规免疫接种方面取得了巨大进展。）可知，疫苗接种率取得了巨大进展，但不代表不接种疫苗的比率几乎降为零，属于过度推断；
B选项“政府在解决社会问题方面是成功的。”和D选项“接种疫苗的儿童在2016年可以获得足够的营养。”在文中没有提及，属于无中生有。
第4题:
【选项释义】
What difference did Professor Johri’s research have? 约翰里教授的研究有什么不同？
A. She is an overseas citizen with double citizenship. A. 她是一个拥有双重国籍的海外公民。
B. It started to study non-vaccinated children’s concentration globally and locally. B. 它开始在全球和本地研究未接种疫苗的儿童的集中度。
C. She found Indian children were malnutritional without vaccination. C. 她发现印度儿童在没有接种疫苗的情况下营养不良。
D. They found out the difference from 1992 to 2016. D. 他们发现了从1992年到2016年的差异。
【考查点】事实细节题。
【解题思路】根据题干关键词Professor Johri’s research可以定位到文章第五段第一、二句“约翰里教授指出了她和同事工作的独特性（uniqueness）。这是第一次在全球和印度（globally and in India）追踪零剂量儿童的总体模式（aggregate patterns）”，说明约翰里教授的研究的不同之处在于首次在全球和印度本地研究零剂量儿童的总体模式。因此B选项“它开始在全球和本地研究未接种疫苗的儿童的集中度。”正确。
【干扰项排除】
A选项“她是一个拥有双重国籍的海外公民。”是约翰里教授本人的身份，与其研究的独特性无关，属于出处错位；
C选项“她发现印度儿童在没有接种疫苗的情况下营养不良。”和D选项“他们发现了从1992年到2016年的差异。”是其研究的结果，不能体现独特性，属于出处错位。
第5题:
【选项释义】
To other countries, what does Indian experience suggest? 对其他国家来说，印度的经验说明了什么？
A. Government should encourage children to get vaccinated as early as possible. A. 政府应该鼓励儿童尽早接种疫苗。
B. Health care department has to put poor families into vaccination systems. B. 卫生保健部门要把贫困家庭纳入疫苗接种系统。
C. The young should be given adequate nutrition through early intervention. C. 应通过早期干预使年轻人获得足够的营养。
D. It’s important to solve the social problems from the origin as early as possible. D. 尽早从根源上解决社会问题是很重要的。
【考查点】事实细节题。
【解题思路】根据题干关键词Indian experience可以定位到文章最后一段倒数第一、二句“发现零剂量儿童并及早干预，以解决他们面临的不利条件的复杂来源（the complex sources of disadvantage），有可能改变生活机会，消除代际不平等（combat intergenerational inequities）。这应该成为国际社会的首要任务（a top priority）”，说明解决零剂量儿童问题的关键是解决社会不平等的问题。因此D选项“尽早从根源上解决社会问题是很重要的。”正确。
【干扰项排除】
A选项“政府应该鼓励儿童尽早接种疫苗。”和B选项“卫生保健部门要把贫困家庭纳入疫苗接种系统。”在文中没有提及，属于无中生有；
D选项“应通过早期干预使年轻人获得足够的营养。”，由Identifying zero-dose children and intervening early to address the complex sources of disadvantage they face（发现零剂量儿童并及早干预，以解决他们面临的不利条件的复杂来源）可知，及早干预的目的是解决儿童的不利条件，而不是使其获得足够的营养，属于曲解原文。
在过去的20年里，以全球疫苗免疫联盟为首的国际组织与各国政府、世界卫生组织和联合国儿童基金会合作，确保了非洲和其他地区贫困国家更多的儿童获得常规疫苗接种：如今，81%的儿童接受了常规疫苗接种，而2000年仅为59%。这产生了重大影响——二十年来，疫苗可预防疾病造成的儿童死亡率下降了70%。
但是，年轻人不接种疫苗的根本原因又是什么呢？这个问题是仅仅因为贫困，还是因为国内政府及其公共卫生部门未能覆盖最脆弱的社区，或者仅仅因为无法克服根深蒂固的社会劣势？加拿大和印度对印度数以万计的零接种儿童进行的一项新研究表明，低收入国家疫苗接种率低的原因是所有这些，甚至更多。
该研究分析了四分之一个世纪以来的全国调查数据，以更好地了解印度的社会、经济和地理不平等是如何在1992年至2016年间影响儿童未接种疫苗的几率的。他们发现，印度在为儿童提供常规免疫接种方面取得了巨大进步。但他们也发现，2016年，儿童仍然集中在弱势群体中，包括收入最低的家庭和母亲未受过正规教育的儿童。
此外，与接种过疫苗的儿童相比，零接种儿童更容易营养不良。例如，1992年，41%的零接种儿童发育严重迟缓；到2016年，这一数字有所下降，但仍然不成比例。研究人员总结说：“在印度的24年间，零接种儿童的状况是由大规模的社会不平等造成的，并且始终是普遍脆弱性的标志。应优先考虑解决这种代际不平等循环的干预措施。”
约翰里教授指出了她和同事们工作的独特性。身为印度海外公民以及加拿大公民的约翰里说：“这是首次在全球范围内以及在印度追踪零接种儿童随时间变化的总模式。”。
在全球范围内，印度的经验表明，“儿童零疫苗接种状况是一个重要的弱势标志，与一生中的系统性劣势有关，” 约翰里说。“识别零接种儿童并及早干预以解决他们所面临的复杂的劣势来源，有可能改变他们的生活机会并消除代际不平等。这应该是国际社会的当务之急。”
