首剂麻疹减毒活疫苗接种后疑似预防接种反应监测敏感性和主要临床损害分析

Sensitivity of AEFI surveillance and clinical suffering of first dose of MV immunization

目的分析8-10月龄儿童麻疹减毒活疫苗（measlesattenuatedlivevaccine，MV）接种后疑似预防接种异常反应（adverseeventsfollowip immunization，AEFI）监测的敏感性和MV主要AEFI临床危害。方法通过中国免疫规划监测信息管理系统和儿童预防接种信息管理系统，收集2009-2011年丹阳市8-10月龄儿童MVAEFI常规监测个案数据；实施30d内全程主动监测，收集240例8-10月龄MVAEFl个案数据。采用描述性方法进行流行病学分析。结果2009至2011年，常规监测系统首剂MVAEFI报告发生率为926．45／10万，主动监测240名8-10月龄儿童首剂MV接种后AEFI发生率30416．67／10万，差异有统计学意义（Y2：1767．41，P〈0．01）；2种监测方法所报告MVAEFI发生的时间在接种后3d内的构成比有明显差异，差异有统计学意义（f=179．44，P〈0．01）；MVAEFI多以发热、皮疹为主，常规监测反映的症状多出现在3d以内，主动监测则多在4d以后发生，≥8d的占近40％，2种监测反映的症状发生的时间间隔差异有统计学意义（f=143．82，P〈0．01）。结论提高MVAEFI监测的敏感性、科学性，有利于客观反映MV的安全性，有利于消除麻疹的目标实现。

Objective To analyze the sensitivity of adverse events following immunization （AEFI） and major clinical suffering after immunization of measles attenuated live vaccine （MV） in children of 8-10 months old. Metheds The information of AEFI MV cases of children of 8-10 months old of Danyang City routine monitoring data was collected from the China Immunization Information System （CIIS） and the Children Immunization Information Management System frcrn 2009 to 2011, and the implementation of the whole initiative surveillance within 30 days was performed. The data of 240 MV AEFI cases of children of 8-10 mcnths old were o3Uected and analyzed with the descriptive epidemiological methed. Results Frcrn 2009 to 2011, the report rate frcrn the routine monitorivg systen of the first dose of the MV AEF1 was 92.645 per million, and the MV AEFI incidence of the initiative surveillance of 240 cases of 8-10 month-old after the first dose of MV vaccination was 3041.667 per miUion, and there was a statistically significant difference （5（2 = 1 767.41,P〈0.01）. There was a significant difference between the two raethods for the constituent ratios of MV AEFI occurred time in the first 3 days after vaccination （X2= 179.44, P 〈 0.01）. The major MV AEFI was fever and rash, and the signs and symptoms appeared were reflected within 3 days by the routine surveillance, but after 4 days by the initiative surveillance systen, and nearly 40% of signs and symptoms occurrde after 8 days or more than 8 days. There was a significant difference between the two methods for the time interval of syrnptcms occurred（X2= 143.82, P 〈 0.01）. Conclusions It is necessary to improve the sensitivity and scientificity of the MV AEFI surveillance in order to objectivdy reflect the safety of the MV, which may be useful for achieving the goal of measles elimination.