2017—2021年赣州市赣县区疑似预防接种异常反应监测结果分析

Analysis of monitoring results of suspected abnormal vaccination reactions in Ganxian district of Ganzhou city from 2017 to 2021

目的:分析2017—2021年赣州市赣县区疑似预防接种异常反应(AEFI)监测结果。方法:通过中国免疫规划信息管理系统收集2017—2021年赣州市赣县区AEFI个案数据,采用描述性流行病学方法分析AEFI监测结果。结果:2017—2021年赣州市赣县区常规疫苗接种1176018剂次,共报告AEFI 621例,发生率约为52.81/10万,其中2017年AEFI报告发生率为68.04/10万(138/202814),2018年AEFI报告发生率为65.55/10万(175/266961),2019年AEFI报告发生率为61.13/10万(156/255180),2020年AEFI报告发生率为35.99/10万(75/208415),2021年AEFI报告发生率为31.73/10万(77/242648)。AEFI中严重AEFI占0.16%(1/621),非严重AEFI占99.84%(620/621);一般反应占76.33%(474/621),异常反应占20.45%(127/621),偶合症占3.22%(20/621),无疫苗质量事故、接种事故、心因性反应病例报告。2017—2021年赣州市赣县区AEFI 48 h内报告及时率为95.97%(596/621),其中2017年为97.10%(134/138),2018年为94.29%(165/175),2019年为96.79%(151/156),2020年为97.33%(73/75),2021年为94.81%(73/77)。2017—2021年赣州市赣县区每月均有AEFI病例报告,其中病例占比较高的前3位依次为6月15.14%(94/621)、7月12.08%(75/621)、8月11.27%(70/621),病例占比较低的前3位依次为11月4.83%(30/621)、1月4.99%(31/621)、12月5.15%(32/621)。621例AEFI中,以1~2岁为主,占64.41%(400/621),依次为0~1岁占22.87%(142/621),2~3岁占5.48%(34/621)。一般反应474例,发生率为40.31/10万;异常反应127例,发生率为10.80/10万;偶合症20例,发生率为1.70/10万;疫苗AEFI报告发生率前5位分别是百白破疫苗127例,发生率为69.34/10万;麻腮风疫苗106例,发生率为68.01/10万;乙脑减毒活疫苗93例,发生率为61.75/10万;狂犬病疫苗30例,发生率为55.91/10万;B型流感嗜血杆菌疫苗51例,50.70/10万。结论:2017—2021年赣州市赣县区AEFI主要为一般反应,48 h内报告及时率较高,发生主要集中在6、7、8月份和1~2岁儿童,AEFI监测系统运转正常,疫苗安全稳定。

Objective:To analyze monitoring results of suspected abnormal vaccination reactions(AEFI)in Ganxian district of Ganzhou city from 2017 to 2021.Methods:The data of AEFI cases in Ganxian district of Ganzhou city from 2017 to 2021 were collected through the China immunization planning information management system,and the results of AEFI reaction monitoring were analyzed by using the descriptive epidemiological method.Results:From 2017 to 2021,1,176,018 doses of conventional vaccines were administered in Ganxian district of Ganzhou city.A total of 621 cases of AEFI were reported with an incidence rate of approximately 52.81/100,000.The incidence rate of AEFI was 68,004/100,000(138/202,814)in 2017,65,555/100,000(175/266,961)in 2018,61,113/100,000(156/255,180)in 2019,3599/100,000(75/208,415)in 2020,and 3173/100,000(77/242,648)in 2021.Among the AEFI cases,severe AEFI accounted for 0.16%(1/621),and non-severe AEFI accounted for 99.84%(620/621);general reaction accounted for 76.33%(474/621),abnormal reactions accounted for 20.45%(127/621),and coincidence diseases accounted for 3.22%(20/621).There were no reports of vaccine quality accidents,vaccination accidents,or psychogenic reactions.The timely reporting rate of AEFI within 48 hours in Ganxian district of Ganzhou city from 2017 to 2021 was 95.97%(596/621),with 97.10%(134/138)in 2017,94.29%(165/175)in 2018,96.79%(151/156)in 2019,97.33%(73/75)in 2020,and 94.81%(73/77)in 2021.From 2017 to 2021,there were monthly reports of AEFI cases in Ganxian district of Ganzhou city,with the top three cases accounting for 15.14%(94/621)in June,12.08%(75/621)in July,and 11.27%(70/621)in August;and the he top three lowest proportion of cases were 4.83%(30/621)in November,4.99%(31/621)in January,and 5.15%(32/621)in December.Among the 621 cases of AEFI,the main age group was 1-2 years old,accounting for 64.41%(400/621),followed by 0-1 years old,accounting for 22.87%(142/621),and 2-3 years old,accounting for 5.48%(34/621).There were 474 cases of general reactions with an incidence rate of 4031/100,000,127 cases of abnormal reactions with an incidence rate of 10.80/100,000,and 20 cases of coincidence with an incidence rate of 1.70/100,000.The top five cases of AEFI vaccination were 127 cases of DPT vaccine with an incidence rate of 69.34/100,000;106 cases of MMR vaccine with an incidence rate of 68.01/100,000,and 93 cases of live attenuated Japanese encephalitis vaccine with an incidence rate of 61.75/100,000,30 cases of rabies vaccine with an incidence rate of 55.91/100,000,and 51 cases of Haemophilus influenza type B vaccine with an incidence rate of 50.70/100,000.Conclusions:From 2017 to 2021,AEFI in Ganxian district of Ganzhou city is predominated by general reactions with a high timely reporting rate within 48 hours.The susceptible population is the children aged 1-2 years old and AEFIs mainly occur in June,July,and August.Further,the AEFI monitoring system operates normally and the vaccine is safe and stable.