东莞市2005～2009年疑似预防接种异常反应流行病学分析

Epidemiological Analysis on Adverse Events Following Immunization in Dongguan During 2005～2009

目的了解疑似预防接种异常反应(AEFI)的发生特征,评价疫苗的安全性,改善预防接种服务质量。方法采用描述性分析方法对发生的AEFI进行流行病学分析。结果东莞市2005～2009年共报告AEFI 1 371例,男性多于女性,主要发生在5、6月。≤1岁儿童占67.69%。AEFI发生率居前5位的疫苗分别是7价肺炎、甲流、23价肺炎、百白破和Hib。接种第4剂次不良反应的发生率最高(16.03/10万)。AEFI中一般反应占48.80%,异常反应占45.15%。临床损害列前3位的是发热/红肿/硬结(45.73%)、过敏性皮疹(26.91%)和无菌性脓肿(8.68%),70.61%的临床损害在接种当天发生。AEFI病例转归中,治愈745例(54.34%)、好转508例(37.05%)、后遗症1例(0.07%)、死亡5例(0.36%)。结论东莞市2005～2009年AEFI以1岁及以下儿童为主;7价肺炎、甲流、23价肺炎、百白破和Hib是AEFI重点监测疫苗;绝大部分AEFI属于一般反应和异常反应,并且大多可以治愈,不到1%会留下后遗症;死亡病例基本是偶合其他疾病所致。

Objectives Investigate the epidemiological characteristics of AEFI in Dongguan during 2005～2009 to evaluate the safety of vaccines,so as to improve the immunization service quality. Methods Descriptive epidemiological analysis was applied to analyze the incidences of AEFI. Results 1 371 AEFI cases were reported during 2005～2009,there were more males than females,mainly occurred in May and June.67.69% study subjects were younger than one year old.The top five vaccines leading to AEFI were 7-valent PCV,H1N1 Flu,23-valent PCV,DPT and Hib.AEFI cases mainly happened after the fourth inoculation(16.03/100.000).There were 48.80% general responses and 45.15% abnormal reactions in them.The top three clinical damages were fever/swelling/scleroma(45.73%),allergic erythra(26.91%) and aseptic abscesses(8.68%).70.61% clinical damages were taken place in vaccination days.In current study,745(54.34%) study subjects were cured,508(37.05%) were improved,1(0.07%) had sequela and 5(0.36%) died. Conclusions AEFI mainly took place in children less than one year old.7-valent PCV,H1N1 Flu,23-valent PCV,DPT and Hib were the key monitoring vaccines.The vast majority of AEFI were general responses and abnormal reactions,and most of them can be cured,less than 1% of them had sequela while they died because of other diseases.