2001～2004年上海市普陀区预防接种不良反应监测分析

Surveillance of adverse events following immunization in Putuo District Shanghai, 2001-2004

[目的] 分析普陀区2001～2004年预防接种不良反应监测系统 (VAESS) 报告的疫苗不良反应. [方法] 由各级免疫预防人员收集接种后不良事件,并填写统一表格上报.根据不良事件的临床症状,确定为一般反应、异常反应或偶合症,并做统计分析. [结果] 2001～2004年,普陀区开展了14种疫苗912 938人次的接种,报告9种疫苗接种后不良事件504例,其中一般反应443例,异常反应58例,偶合症3例.9种疫苗的一般反应以弱、中度的局部红肿和发热为主要临床表现.全细胞百白破疫苗(DTwP)的一般反应报告率最高(359.27/10万),而且随接种针次的增多而升高.地鼠肾乙脑灭活疫苗、DTwP和卡介苗同时报告了异常反应,异常反应率报告分别为29.25/10万、27.56/10万和8.44/10万.乙脑灭活疫苗的第4针异常反应率最高,而DTwP第二针异常反应率高于其它针次. [结论] 加强预防接种规范化操作,掌握禁忌证,选用免疫效果好且安全性高的疫苗以减少预防接种不良反应的发生.继续加强监测网络的建设,提高敏感度.

[Objective] To summarize the adverse events reported to the Vaccine Adverse Events Surveillance System (VAESS) from 2001 to 2004 in Putuo District Shanghai. [Methods] The adverse events following immunization (AEFI) were colletcted and reported to VAESS by vaccination givers with certain form. All the accepted reports were classified as non-serious,serious reaction or opportunity cases according to the symptoms and medical records. [Results] During 2001-2004, VAESS had received 504 reports related to 9 vaccines in 912938 inoculations involving 14 vaccines. Among the adverse events reports, the amount of non-serious and serious events were 443 and 58 respectively, as well as 3 were accidental cases . The most commonly reported type of non-serious adverse events were injection-site swelling and fever which were mild or moderate. The diphtheria and tetanus toxoids and pertussis vaccine (DTwP) had the highest non-serious adverse events average reporting rate (359.27/100,000). It became higher with the increased of times of vaccination. The serious adverse events reports received in VAESS were contributed to the inactivated Japanese encephalitis vaccine (29.25/100,000), DTwP (27.56/100,000) and Babeillus Calmette Guerin (BCG) (8.44/100,000) vaccination. A fourth boost dose of the Japanese encephalitis vaccine had the highest serious adverse events reporting rate during its schedule, while it was more likely to have serious events reported after a second dose of DTwP. [Conclusion] To reduce the AEFI were should implement vaccination regulations rigorously, distinguish contraindications, and introduce safer vaccines gradually. In addition, extensive reporting net of AEFI is essential to improve the sensibility of VAESS for monitoring safety of vaccines.