吉林省麻疹减毒活疫苗强化及常规免疫疑似接种异常反应监测

Surveillance of suspected adverse events following immunization during booster immunizations with live attenuated measles vaccine and routine immunization with measles-containing vaccines in Jilin Province

目的分析2010年吉林省麻疹减毒活疫苗(简称MV)强化免疫及2009～2010年麻疹类减毒活疫苗常规免疫疑似预防接种异常反应(Adverse events following immunization,AEFI)发生特征,探讨MV强化免疫及MV类常规免疫的安全性以及减少预防接种异常反应的措施。方法通过全省AEFI报告信息管理系统,收集MV强化免疫和MV类常规免疫AEFI报告的个案数据,采用描述性统计方法对相关指标进行流行病学分析。结果吉林省2010年MV强化免疫AEFI报告发生率为287.68/100万剂次;接种后≤3 d,AEFI报告333例,占总数的87.17%;2009～2010年MV类常规免疫报告AEFI发生率为62.35/100万剂次;接种后≤3 d,AEFI报告30例,占总数的58.82%。两种接种形式的AEFI报告中,男性均多于女性;临床损害均以过敏性反应多见,绝大多数病例预后良好。结论 MV类常规免疫较MV强化免疫AEFI报告发生率低,各地区的AEFI报告发生率存在一定差异,需进一步加强培训和技术指导,提高AEFI监测系统的敏感性和及时性;接种MV后≤3 d是监测的重点,应加强对受种儿童的访视,做好AEFI的主动监测,对出现的异常反应给予及时有效的治疗。

Objective To analyze the characters of suspected adverse events following immunization （AEFI） during booster immunization with live attenuated measles vaccine （MV） in 2010 and routine immunization with immunization with measles-containing vaccines in 2009 - 2010 in Jilin Province, and investigate the safety of booster and routine immunizations as well as the measure to reduce AEFI. Methods The data on AEFI during booster immunization with MV and routine immunization with measles-containing vaccines were collected from AEFI report system in Jilin Province, and the relevant indexes were analyzed for epidemiology by descriptive statistical method. Results The reported incidence of AEFI during booster immunization with MV in 2010 was 287.68 / 1 000 000 doses, of which 87. 17%（333 cases） appeared within 3 d after immunization. However, the reported incidence of AEFI during routine immunization with measles-containing vaccines in 2009 ~ 2010 was 62. 35 / 1 000 000 doses. Both the incidences were higher in male than in female vaccinees. The clinical lesions were mainly allergies, most of which showed good prognoses. Conclusion The incidences of AEFI were lower during routine immunization than during booster immunization, and showed a certain difference in various regions. Training and technical guiding shall be strengthened to improve the sensitivity and punctuality of AEFI reporting system. Surveillance shall he focused on period within 3 d after immunization. The follow-up of vaccinated children shall be strengthened, and active surveillance shall be carried out to treat the AEFI cases timely and effectively.