2009—2012年天津市北辰区疑似预防接种异常反应监测分析

Monitoring and analysis on suspected adverse events following immunization in Beichen District of Tianjin from 2009-2012

目的了解天津市北辰区疑似预防接种异常反应(AEFI)的发生特征,分析影响因素,提高监测的敏感性。方法利用Excel 2003对2009—2012年AEFI个案数据进行统计分析。结果天津市北辰区2009—2012年报告AEFI 84例,其中一般反应62例,异常反应21例,偶合症1例,总报告发生率104.80/100万剂;反应多发生在2岁以下儿童,占69.05%(58/84);其中0岁组所占比重最大,为51.72%(30/58)。反应时间主要集中在当日,占84.52%(71/84)。以一般反应为主,占73.81%(62/84);其中轻型发热、红肿者占62.90%(39/62)。引起AEFI的疫苗主要为第1类疫苗,占79.76%(67/84)。以百白破(无细胞)疫苗反应人数最多,占43.28%(29/67);其次是含麻制剂(MV、MMR)疫苗,占19.40%(13/67)。结论应继续加强该区医疗机构及接种单位的AEFI培训工作,强化各级、各部门职责,尤其是医疗机构的临床诊断、治疗和报告。报告例数较少的乡镇应该在监测敏感性上加强管理,可以结合日常咨询电话与接种单位报告相互评价来推动。而且要严格规范接种操作,加强疫苗保存运输,减少AEFI发生。

[ Objective] To understand the characteristics of suspected adverse events following immunization （AEFI） in Beichen District of Tianjin, analyze the influencing factors, and improve the sensitivity of monitoring. [ Methods] By using Excel 2003, the data of AEFI cases from 2009-2012 were statistically analyzed. [ Results] A total of 84 AEFI cases were reported in Beichen District of Tianjin from 2009-2012, which included 62 cases of general reaction, 21 cases of abnormal reaction and 1 accidental case, and the total reported incidence rate was 104.80/1 000 000 dose. 69.05% （58/84 } of cases were children under 2 years old, and 0-12 month-old age group accounted for 51.72% （30/58）. Most of AEFI occurred on the day of inoculation, accounting for 84. 52% （71/84）. 73.81% （ 62/84 ） of cases were general reaction, and reactions of mild fever, redness and swelling accounted for 62. 90% （39/62i. 79.76% （67/84） of AEFI cases were induced by type I vaccines. Most of AEFI cases were caused by DPT （cell-free） vaccine, which accounted for 43.28% （29/67）, followed by MV and MMR, which accounted for 19.40% （ 13/67 }. [ Conclusion] It is necessary to continuously strengthen the AEFI training in the medical institutions and inoculation hos- pitals, reinforce the responsibilities of departments in different levels, especially the clinical diagnosis, treatment and report of med- ical institutions. The towns that have few AEFI cases should strengthen the management in the sensitivity of monitoring, which can be promoted by the mutual evaluation of daily telephone consuhation and reports from inoculation institutions. Meanwhile, it is im- portant to carry out the strict operation of vaccination, pay attention to the reserve and transportation of vaccines, to reduce the AEFI.