2015-2017年江苏省无锡市新吴区疑似预防接种异常反应监测分析
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摘要
目的分析无锡市新吴区2015-2017年疑似预防接种异常反应(Adverse events following immunization,AEFI)的报告发生特征,评价预防接种的安全性和AEFI监测系统运转情况。方法通过AEFI信息管理系统,收集无锡市新吴区2015-2017年报告的AEFI个案数据,采用描述流行病学方法进行分析。根据《全国疑似预防接种异常反应监测方案》中监测指标要求评价AEFI监测系统运转情况。结果 2015-2017年无锡市新吴区共报告AEFI病例275例,报告发生率为49.71/10万剂。以一般反应为主(233例),占84.73%,均为发热/红肿/硬结;异常反应42例,占15.27%,其中以荨麻疹最多。报告数居前3位的疫苗分别是百白破疫苗(无细胞) 110例(占40.00%),A群流脑疫苗40例(占14.55%),麻风疫苗39例(占14.18%);发生率居前3位的分别是麻风疫苗(140.47/10万剂)、Hib疫苗(138.31/10万剂)和五联疫苗(119.86/10万剂)。AEFI病例主要集中在2岁及以下儿童,占90.91%(250/275);发生在接种后24 h内的AEFI占92.00%,48 h内及时报告率和调查率均为100.00%,全区各街道报告覆盖率100.00%。结论 AEFI的发生无地区差异,存在4～5月和11月前后两个高峰,AEFI的发生率与疫苗接种剂次数呈正相关,应重点加强对2岁及以下儿童在接种后24 h内AEFI的监测。新吴区疫苗接种服务质量和疫苗安全性均较高,AEFI监测系统运转良好。
Objective To analyze characteristics of adverse events following immunization(AEFI) in Xinwu District of Wuxi from 2015 to 2017,and to assess the safety of vaccination and the performance of AEFI surveillance system.Methods The data of AEFI reported from 2015 to 2017 were collected through the AEFI information management system and analyzed by descriptive epidemiology methods.According to the indicators in the national monitoring plan for AEFI,the operation of AEFI monitoring system was assessed.Results A total of 275 AEFI cases were reported in Xinwu District from 2015 to 2017.The incidence rate was 49.71/100 000.A total of 233(84.73%) cases were classified as common reaction,and the most common symptoms of vaccine reactions were fever,local swelling,and local induration.A total of 42 cases were abnormal ractions,accounting for15.27%.The primary symptom of abnormal reactions was urticaria.The top three vaccines with the highest number of cases were DTP(100 cases,40.00%),MPSV-A vaccine(40 cases,14.55%) and MR vaccine(39 cases,14.18%).The top three vaccine with the highest reported AEFI incidence were MR vaccine(140.47/100 000),Hib vaccine(138.31/100 000) and DTP-IPV-Hib vaccine(119.86/100 000).AEFI cases mainly concentrated in the age groups of 2 year-old(250/275,according for 90.91%).A total of 92.00% of cases occurred within 24 h of vaccination.The reporting rate within 48 h and the investigation rate within 48 h were both 100.00%.The report coverage rate of streets in all district was 100.00%.Conclusion There is no regional difference in the occurrence of AEFI.There are two peaks in 4 ～ 5 months and around November,respectively.The incidence rate of AEFI is positively correlated with the number of vaccination doses.Focus should be placed on monitoring AEFI for children of 2 year-old and younger within 24 h of vaccination.AEFI surverillance system performs well in Xinwu District of Wuxi City.The quality of preventive inoculation service and the safety of vaccines are both high.
Objective To analyze characteristics of adverse events following immunization(AEFI) in Xinwu District of Wuxi from 2015 to 2017,and to assess the safety of vaccination and the performance of AEFI surveillance system.Methods The data of AEFI reported from 2015 to 2017 were collected through the AEFI information management system and analyzed by descriptive epidemiology methods.According to the indicators in the national monitoring plan for AEFI,the operation of AEFI monitoring system was assessed.Results A total of 275 AEFI cases were reported in Xinwu District from 2015 to 2017.The incidence rate was 49.71/100 000.A total of 233(84.73%) cases were classified as common reaction,and the most common symptoms of vaccine reactions were fever,local swelling,and local induration.A total of 42 cases were abnormal ractions,accounting for15.27%.The primary symptom of abnormal reactions was urticaria.The top three vaccines with the highest number of cases were DTP(100 cases,40.00%),MPSV-A vaccine(40 cases,14.55%) and MR vaccine(39 cases,14.18%).The top three vaccine with the highest reported AEFI incidence were MR vaccine(140.47/100 000),Hib vaccine(138.31/100 000) and DTP-IPV-Hib vaccine(119.86/100 000).AEFI cases mainly concentrated in the age groups of 2 year-old(250/275,according for 90.91%).A total of 92.00% of cases occurred within 24 h of vaccination.The reporting rate within 48 h and the investigation rate within 48 h were both 100.00%.The report coverage rate of streets in all district was 100.00%.Conclusion There is no regional difference in the occurrence of AEFI.There are two peaks in 4 ～ 5 months and around November,respectively.The incidence rate of AEFI is positively correlated with the number of vaccination doses.Focus should be placed on monitoring AEFI for children of 2 year-old and younger within 24 h of vaccination.AEFI surverillance system performs well in Xinwu District of Wuxi City.The quality of preventive inoculation service and the safety of vaccines are both high.
引文
[1]卫生部.全国疑似预防接种异常反应监测方案[Z].2010-06-03.
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[3]陈敏,丁筱竹.2010-2013年南京市疑似预防接种异常反应监测分析[J].江苏预防医学,2015,26(1):25-27.
[4]朱涛英,栾荣生,鲁斌,等.成都市武侯区2011-2015年疑似预防接种异常反应监测分析[J].实用预防医学,2017,24(6):684-688.
[5]贾孝提,王佚楠.2010-2015年漯河市疑似预防接种异常反应监测分析[J].河南预防医学杂志,2017,28(5):348-351.
[6]蒋静凤,王旭雯.2015-2016年无锡市疑似预防接种异常反应监测分析[J].中国生物制品学杂志,2018,31(6):629-632.
[7]王涛,杨俊英,范肖肖,等.2015-2016年北京市昌平区疑似预防接种异常反应监测分析[J].中国疫苗和免疫,2017,23(3):317-321.
[8]WHO.Mass measles immunization campaigns:reporting and investigation adverse events following immunization[R].Geneva:Swiss,2002.
[9]吴冰冰,刘大卫,武文娣,等.2000-2010年麻疹减毒活疫苗疑似预防接种异常反应文献分析[J].中国疫苗和免疫,2011,17(2):118-121.
[10]叶家楷,李克莉,许涤沙,等.中国2015年疑似预防接种异常反应监测分析[J].中国疫苗和免疫,2017,23(5):481-492.
[11]许涤沙,李克莉,武文娣,等.中国2016年疑似预防接种异常反应监测数据分析[J].中国疫苗和免疫,2018,24(3):299-309.
[12]从克.许昌市2010-2014年疑似预防接种异常反应监测数据分析[J].微生物学免疫学进展,2016,44(1):43-47.
[13]赵瑞芳,姜宪尘,余新,等.衢州市衢江区2011-2014年疑似预防接种异常反应监测分析[J].上海预防医学,2017,29(5):364-367.
[14]陈敏,梁亚琼,徐鹭,等.2013-2016年南京市疑似预防接种异常反应监测分析[J].现代预防医学,2017,44(23):4284-4288.
[15]吴晓虹,章光明.金华市2015-2016年疑似预防接种异常反应监测分析[J].上海预防医学,2017,29(9):707-711.
[2]刘海田,邱德山,王怡.2013-2015年潍坊市疑似预防接种异常反应监测分析[J].微生物学免疫学进展,2017,45(4):47-52.
[3]陈敏,丁筱竹.2010-2013年南京市疑似预防接种异常反应监测分析[J].江苏预防医学,2015,26(1):25-27.
[4]朱涛英,栾荣生,鲁斌,等.成都市武侯区2011-2015年疑似预防接种异常反应监测分析[J].实用预防医学,2017,24(6):684-688.
[5]贾孝提,王佚楠.2010-2015年漯河市疑似预防接种异常反应监测分析[J].河南预防医学杂志,2017,28(5):348-351.
[6]蒋静凤,王旭雯.2015-2016年无锡市疑似预防接种异常反应监测分析[J].中国生物制品学杂志,2018,31(6):629-632.
[7]王涛,杨俊英,范肖肖,等.2015-2016年北京市昌平区疑似预防接种异常反应监测分析[J].中国疫苗和免疫,2017,23(3):317-321.
[8]WHO.Mass measles immunization campaigns:reporting and investigation adverse events following immunization[R].Geneva:Swiss,2002.
[9]吴冰冰,刘大卫,武文娣,等.2000-2010年麻疹减毒活疫苗疑似预防接种异常反应文献分析[J].中国疫苗和免疫,2011,17(2):118-121.
[10]叶家楷,李克莉,许涤沙,等.中国2015年疑似预防接种异常反应监测分析[J].中国疫苗和免疫,2017,23(5):481-492.
[11]许涤沙,李克莉,武文娣,等.中国2016年疑似预防接种异常反应监测数据分析[J].中国疫苗和免疫,2018,24(3):299-309.
[12]从克.许昌市2010-2014年疑似预防接种异常反应监测数据分析[J].微生物学免疫学进展,2016,44(1):43-47.
[13]赵瑞芳,姜宪尘,余新,等.衢州市衢江区2011-2014年疑似预防接种异常反应监测分析[J].上海预防医学,2017,29(5):364-367.
[14]陈敏,梁亚琼,徐鹭,等.2013-2016年南京市疑似预防接种异常反应监测分析[J].现代预防医学,2017,44(23):4284-4288.
[15]吴晓虹,章光明.金华市2015-2016年疑似预防接种异常反应监测分析[J].上海预防医学,2017,29(9):707-711.