2010年扬州市一类疫苗预防接种不良反应的监测

Monitoring and analysis on vaccination reactions of the vaccines included in the National Immunization Program in Yangzhou in 2010

目的监测扬州市一类疫苗预防接种反应发生情况。方法采用描述流行病学方法对扬州市预防接种反应监测资料进行分析研究。结果 2010年扬州市11种一类疫苗共接种741552剂次,报告预防接种反应363例,反应发生率为4.90/万;江都市最高为6.77/万、开发区最低为3.31/万,不同地区预防接种反应差异有统计学意义(χ2=25.17,P<0.01);7月最高为14.23/万,2月最低为1.32/万,不同时间预防接种反应差异有统计学意义(χ2=163.99,P<0.01);反应发生率以无细胞百白破三联(DPaT)最高为13.49/万,脊灰疫苗(PV)最低为0.46/万,不同疫苗预防接种反应差异有统计学意义(χ2=365.44,P<0.01);发生反应类型一般反应以发热为主,异常反应以过敏性皮疹为主;疑似预防接种反应监测及时报告率、调查率、诊断分类率和规范处置率均为100%。平均每报告处置1人的费用为0.07万元。结论扬州市预防接种反应发生率低,预防接种反应监测系统比较完善,建议加强预防接种反应监测、规范安全接种操作,增强工作责任心,提高反应处置能力,增加处置经费的投入。

Objective To monitor the reactions associated with the vaccines included in the National Immunization Program. Method Monitoring data of vaccination reactions in Yangzhou were studied and analyzed by descriptive epidemiology. Results The vaccines included in the National Immunization Program performed in Yangzhou in 2010 were 11 kinds. 741 552 vaccinations were performed. 363 cases of vaccination reactions were reported, with an incidence rate of 4.90/10 000,and Jiangdu had the highest rate,6.77/10 000, while Kaifa had the lowest rate,3.31/10 000.The incidence rates were significantly different in different districts（χ2=25.17,P〈0.01）.The highest incidence rate was 14.23/10 000 in July, and the lowest incidence rate was 1.32/10 000 in February. The incidence rates in different months had significant difference（χ2=163.99,P〈0.01）. All the 11 kinds vaccines had the vaccination reactions reported,and the DPaT had the highest incidence rate , 13.49/10 000,while the PV had the lowest incidence rate, 0.46/10 000,and there were significantly differences of vaccination reaction incidence among different kinds of vaccines（χ2=365.44,P〈0.01）.Fever was the main symptom of the common vaccination reactions. Among the adverse vaccination reactions, allergic skin rashes was the main symptom. The rate of the suspected vaccination reactions being reported within 24 hours, the investigation rate within 48 hours, the diagnostic classification rate and the standard handling rate were all 100%. Conclusions Yangzhou vaccination reaction monitoring system was perfect, and the vaccination reaction incidence rate was low. There were no statistical differences of abnormal vaccination reaction incidence among different districts, seasons, and genders. It was suggested to strengthen vaccination reaction monitoring, standardize immunization work and training, enhance our sense of responsibility, improve vaccination reaction response ability, and increase funds for handling vaccination reactions.