2009-2013年北京市海淀区预防接种异常反应监测

Analysis on surveillance of rare vaccine reaction following immunization in Haidian district of Beijing,2009-2013

目的分析北京市海淀区2009-2013年预防接种异常反应发生特征,评估该区预防接种异常反应(AEFI)监测系统运转情况。方法通过AEFI信息管理系统,收集2009-2013年报告中异常反应个案,采用描述性方法进行流行病学分析。结果 AEFI信息管理系统中,报告异常反应个案250例,报告发生率为3.16/10万。发生异常反应疫苗构成前3位的是:麻疹风疹联合减毒活疫苗、甲型H1N1流感裂解疫苗和麻疹减毒活疫苗,分别占报告数的27.6%、19.6%和9.2%;异常反应报告率前3位的疫苗是:麻疹风疹联合减毒活疫苗、7价肺炎球菌多糖结合疫苗、百白破IPV和Hib五联疫苗,报告发生率分别为44.14/10万、38.37/10万和12.02/10万;异常反应临床表现前3位的症状是过敏性皮疹、过敏性紫癜和速发型过敏反应,分别占91.2%、2.8%和1.4%,其中痊愈和好转占99.20%。异常反应58.8%发生在接种24 h内,无明显的季节聚集性。结论海淀区异常反应监测敏感性高,对异常反应的调查、诊断、鉴定、补偿流程畅通,严重异常反应报告发生率在预期发生范围内。

Objective The aims of this study were to analyze the occurrence features of rare vaccine reaction following immunization in Haidian District during 2009 - 2013 and to evaluate the implementation of adverse events following immunization （AEFI） surveillance system. Methods Case information was collected through the nation AEFI information management system during the period of 2009 -2013. The descriptive method was used in the study. Results 250 rare vaccine reaction cases were reported during period, and the incidence rate was 3. 16 per 100 000. Among the reported vaccines, the top 3 were MR （27.6%） ,InfV-Sp-H1N1 （19.6%） and MV （9.2%）. And the 3 highest incidences were MR （44. 14 per 100 000） ,PPCV7 （38.37 per 100 000） and DTaP-IPV-Hib （12.02 per 100 000）. In all rare vaccine reaction cases, the main diagnoses were anaphylactic rash, henoch-schonlein and acute anaphylaxis, which accounted for 91.2% , 2.8% and 1.4% respectively. Total 99.20% of cases recovered or got better. 58.8% vaccine reactions occurred within 24 hour after vaccination. There was no obvious clustering in seasonal distribution. Conclusion The sensitivity of rare vaccine reaction surveillance system was high in Haidian District. The procedures of case investigation, causality assessment, identification and compensation of rare vaccine reaction were performed smoothly. The estimated incidence rate of serious vaccine reaction was not higher than expected.