2010年北京市石景山区疑似预防接种异常反应监测

Surveillance of adverse events following immunization in Shijingshan district of Beijing in 2010

目的分析北京市石景山区2010年疑似预防接种异常反应(Adverse Events Following Immunization,AEFI)的发生情况,评价AEFI监测系统运转情况。方法采用描述性方法对相关指标进行流行病学分析。结果 2010年共报AEFI48例,报告发生率19.11/10万,涉及11种疫苗,其中麻风疫苗报告发生率最高(89.46/10万),无细胞百白破疫苗AEFI报告发生数居首位(20例,占41.67%)。反应类型上一般反应占37.50%(多为发热/红肿/硬结16/18)、异常反应41.67%(多为皮疹18/20)、偶合症20.83%。病例主要发生在小年龄段人群(≤2岁发生数占70.83%)。发生时间主要集中在5～10月份(77.08%),多在接种后1d内发生(89.59%)。结论石景山区AEFI监测的完整性和敏感性比较高,但仍需要加强AEFI监测工作,规范预防接种操作,严格掌握禁忌症,减少AEFI发生。

Objective To evaluate implementation of surveillance system for adverse events following immunization （AEFI） and analyze occurrence of AEFI in Shijingshan district, Beijing in 2010.Methods Descriptive method was adopted in this study.Results In total, 48 cases of AEFI were reported in 2010 in Shijingshan, with an incidence rate of 19.11 per hundred thousand and involved 11 kinds of vaccines, with the highest reported incidence of AEFI with measles-rubella combined attenuated live vaccine （MR） （89.46/100 000）, and highest number of cases of AEFI with diphtheria-tetanus-acellular-pertussis vaccine （DTaP） （20 cases accounting for 41.67%）. In all the cases of AEFI, 37.50 percent presented general reactions, most involving fever, redness, swelling and induration at vaccinated sites （16/18）, and 41.67 percent presented abnormal reaction, most involving rash （18/20）, and coincidental illness （20.83%）. Most of the cases （70.83%） occurred at ages less than two years and during May to October （77.08%） and 89.59 percent of episodes occurred within one day after vaccination.Conclusion Sensitivity and completeness of AEFI surveillance in Shijingshan district, in general, is well, but it is necessary to improve it further, standardize vaccination and strictly distinguish contraindications before vaccination to reduce occurrence of AEFI.