2012年成都市疑似预防接种异常反应监测结果分析

Surveillance on Adverse Event Following Immunization in Chengdu,2012

目的了解成都市2012年疑似预防接种异常反应（AEFI）监测结果，评价AEFI监测系统的运行情况和预防接种安全性，为进一步完善AEFI监测工作提供依据。方法收集2012年成都市通过AEFI监测系统报告的AEFl个案数据，采用描述性方法对AEFI监测系统运行情况进行评价，对AEFI病例进行流行病学分析。结果2012年成都市20个区（市）县均有AEFI数据报告，48h报告率为97．02％，48h调查率为97．79％，3d内调查表报告率为93．01％，AEFl分类率为99．86％，AEFI调查表关键项目完整率为100％。全市AEFI监测系统共收到AEFI病例738例，报告发生率为14．59／10万，其中，病例分类一般反应65．18％、异常反应24．53％，年龄1岁以内48．24％、1岁组25．07％，男女性别比为1．48：1，接种疫苗后24h内发生者55．42％、24～48h内发生者33．60％，含百日咳、白喉、破伤风成份的疫苗占30．76％、含麻疹、腮腺炎、风疹成分疫苗占14。23％、Hib疫苗占13．14％，发生在第1剂疫苗占60．84％。结论成都市的AEFI监测系统健全运行正常但敏感性还有待提高，AEFI主要发生在小年龄组、首剂次和接种后48h内，百白破、麻腮风、Hib疫苗占较大比例，这是监测工作的重点。

Objective To analyze the surveillance results of adverse event following immunization （AEFI） in Chengdu in 2012, evaluate the operation of AEFI surveillance system and the safety of immunization services, and thus to provide the basis for further improvement of AEFI system. Methods The AEFI data of Chengdu in 2012 were collected through AEFI surveillance system. Descriptive epidemiology was adopted to evaluate the implementation of AEFI surveillance system and to analyze the AEFI cases. Results In 2012, 20 districts/ counties of Chengdu all had reported AEFI data. Of all the cases, 97.02% were reported in 48 h; 97.79% of the AEFI cases were investigated in 48 h ; 93.01% of the investigated cases were reported in 3 d. The rate of AEFI classification was 99.86% and the complete rate of AEFI investigate covering critical items was 100%. Altogether 738 AEFI cases occurring in 2012 were reported through the surveillance system and the reported in- cidence rate was 14. 59/105. General reaction cases accounted for 65.18% of all 738 AEFI cases; abnormal reaction cases accounted for 24.53% ; children ≤ 1 year accounted for 48.24% ; one - year - old group accounted for 25.07%. Male to female ratio was 1.48 ： 1. A proportion of 55.42% cases occurred within 24 h after vaccination, 33.60% of cases occurred within 24 -48 h after vaccination. Vaccines against whooping cough, diphtheria and tetanus altogether accounted for 30.76% of all adverse reactions; vaccines against mea-sles, mumps and rubella altogether accounted for 14. 23% ; HIB vaccine accounted for 13.14%. The adverse reactions which occurred after the first dose of vaccination accounted for 60. 84%. Conclusion The AEFI sur- veillance system of Chengdu is sound and operation normally, nevertheless, the sensitivity of this surveillance system need to be improved. AEFI majorly occurred in young children, first - dose vaccination and first 48 h after vaccination; DPT, MMR and HIB vaccines account for a large proportion of AEFI; thus, all the aforementioned aspect are recommended as the focus for the AEFI surveillance.