2009至2012年江苏省扬州市广陵区疑似预防接种异常反应监测分析

Analysis of adverse events following immunization from 2009 to 2011 in Guangling District,Yangzhou City,Jiangsu Province

目的初步评价江苏省扬州市广陵区疑似预防接种异常反应(AEFI)监测质量。方法通过全国AEFI信息管理系统收集广陵区2009至2012年AEFI病例数据,采用描述性方法对相关指标进行流行病学分析。结果 2009至2012年广陵区共预防接种疫苗24种,累计接种732 005剂次,累计报告AEFI病例388例,AEFI报告发生率为53.7/10万。AEFI监测系统7项指标中,AEFI 48 h内报告率、48 h内调查率和分类率均为100%,2009年有4项指标,即3 d内调查表录入率、7 d内调查报告上传率、调查表关键项目完整率和AEFI报告乡镇覆盖率未达标;2010年3 d内调查表录入率和7 d内调查报告上传率均有较大幅度提高,但仍未达标;2011年以后,所有监测指标完成率均为100.0%。388例AEFI中,一般反应330例(85.0%),临床表现以发热、注射局部红肿和硬结为主;异常反应50例(12.9%),临床表现以过敏性皮疹居多(40例,80.0%),也可见血管性水肿(3例,6.0%)、卡介苗脓肿(2例,4.0%)、麻疹样皮疹(2例,4.0%)、过敏性紫癜(1例,2.0%)、热性惊厥(1例,2.0%)和腹泻(1例,2.0%);偶合症8例(2.1%)。AEFI报告发生率居前5位的疫苗为7价肺炎球菌结合疫苗(PCV-7,507.9/10万)、23价肺炎球菌多糖疫苗(343.2/10万)、脊髓灰质炎灭活疫苗(IPV,166.7/10万)、b型流感嗜血杆菌结合疫苗(163.8/10万)和麻疹风疹联合减毒活疫苗(MR,147.1/10万);异常反应报告发生率居前5位的疫苗为MR(88.3/10万)、PCV-7(63.5/10万)、流感病毒裂解疫苗(17.0/10万)、麻腮风联合减毒活疫苗(16.9/10万)和麻疹减毒活疫苗(13.7/10万)。结论扬州市广陵区2009至2012年AEFI监测系统运行质量逐年增高,完整性和敏感性较好。

Objective To evaluate the monitoring quality of adverse events following immunization （ AEFI ） from 2 0 0 9 to 2 0 1 1 in Guangling District , Yangzhou City, Jiangsu Province preliminarily. Methods The data of AEFI in Guangling District from 2009 to 2011 were collected through the AEFI information system of China and analyzed by descriptive epidemiological method. Results A total of 24 kinds of va- ccine were inoculated from 2009 to 2012 in Guangling District, the accumulative total inoculation doses were 732 005, the accumulative total AEFI cases were 388, the reporting rate was 53.7 per 100 000 doses. In seven state indicators of AEFI monitoring system, reporting rate within 48 hours, investigation rate within 48 hours, and classification rate were 100.0%. The input rate of questionnaire within 3 days, upload rate of investigation report within 7 days, integrity rate of key project in questionnaire, and report coverage rate in districts were not up to the standard of AEFI during 2009. The input rate of questionnaire within 3 days and upload rate of investigation report within 7 days were increased greatly during 2010, but were not up to the standard of AEFI yet. The completion rate of all indicators of AEFI monitoring system reached 100.0% ＊ince 2011. Of 388 cases of AEFI, the common adverse reactions were found in 330 cases （85.0%） , the main clinical manifestations were fever, red swelling and induration in injection area. The abnormal reactions were found in 50 cases （ 12.9% ） , the clinical manifestations were allergic skin rashes （40 cases, 80.0% ） , angioedema （3 cases, 6.0% ） , BCG abscess （2 cases, 4.0% ） , morbiUiform rash （2 cases, 4.0% ） , allergic purpura （ 1 ease, 2.0% ）, febrile convulsion （ 1 ease, 2.0% ）, and diarrhea （ 1 ease, 2. 0% ）. The coincidental events occurred in 8 cases （2.1% ）. The top five vaccines associated with reporting rate of AEFI were pneumococcal 7-valent conjugate vaccine （PCV-7, 507. 9/100 000 ）, 23-valent pneumococcal polysaccharide vaccine （343.2/100 000 ） , poliomyelitis vaccine （ monkey kidney cell） oral （166.7/100 000）, hemophilus influenzae type b conjugate vaccine （163.8/100 000）and measles and rubella combined vaccine, live （ MR, 147. 1/100 000 ）. The top five vaccines associated with abnormal reactions reporting rate were MR（88.3/100 000）, PCV-7（63.5/100 000）, influenza vaccine （split virion）, inactivated（ 17.0/100 000）, MR（ 16.9/100 000 ） and measles vaccine, live（ 13.7/100 000 ）. Conclusions The operation quality of AEFI surveillance system in Guangling District, Yangzhou City improves year by year from 2009 to 2012. The completeness and sensitiveness are well.