济南市2012—2013年疑似预防接种异常反应监测分析

Analysis on the Surveillance of Adverse Events Following Immunization in Jinan, from 2012 to 2013

目的分析济南市2012--2013年疑似预防接种异常反应（Adverse Events Following Immunization，AEFI）的发生特征，评价AEFI信息管理系统运转情况，国家免疫规划（National Immunization Program，NIP）疫苗的安全性和预防接种服务质量。方法通过中国疾病预防控制信息系统中的AEFI信息管理系统收集济南市2012-2013年AEFl个案数据，采用描述性方法对相关指标进行流行病学分析。结果济南市2012-2013年报告AEFl个案共1541例，全市10个县、区均有个案报告，48h内报告率为99．16％，48h内调查率为90．00％。≤1岁儿童占72．02％，≥7岁的占3．05％，男女性别比为1．25：1。发生AEFI前三位的疫苗为白喉-破伤风-无细胞百日咳联合疫苗、含麻疹成分疫苗和脑膜炎球菌多糖疫苗，首剂接种疫苗发生的占67．80％，接种后≤1d发生的占70．86％，治愈和好转的个案占99．03％。AEFI发生原因分类中，一般反应占96．63％，预防接种异常反应占2．99％，其他〈1．00％。报告的AEFI中，NIP疫苗占78．20％，全市NIP疫苗估算报告发生率在60．37／100万剂～1053．50／100万剂，其中最常见的预防接种异常反应为卡介苗淋巴结炎。结论济南市AEFI监测质量尚需提高。AEFI常发生在小年龄组儿童、NIP疫苗、首剂接种和接种后≤1d，此为监测重点。加强灭活脊髓灰质炎疫苗的推荐使用。

OBJECTIVE To analyze the occurrence features of Adverse Event Following Immunization（AEFI） in Jinan, and to evalu- ate the implementation of AEFI information system, the safety of National Immunization Program（NIP） Vaccines and the quality of the immunization services. METHODS The AEFI data were collected through AEFI information immunization of the China Informa- tion System for Diseases Control and Prevention from 2012 to 2013, which reported before January l, 2013. The descriptive method- ology was used in the study. RESULTS 1 541 AEFI cases were reported from 2012 to 2013, 10 counties reported to the AEFI surveil- lance system. The reported rate within 48h was 99.16%, and the investigated rate within 48 h was 90.00%. 72.02% cases were with- in 1 years old and 3.05% cases were beyong 7 years old. The ratio of male and female was 1.25 ： 1. The first three vaccines are DTaP, MCV, MPV. 67.80% happened after the 1st dose and 70.86% within ld after vaccination. 99.03% AEFIs were cured or get- ting better. In the classification of AEFI cases, 96.63% cases were common, minor reactions, 2.99% were Rare Adverse Reactions and others were within 1%. Among 1 541 AEFI cases, NIP vaccine accounted for 78.20%. The estimate reported ineidence of NIP vaccines were 60.37 - 1 053.50 per million doses. The most common Rare Adverse Reactions for NIP Vaccines is BCG Lymphadeni- tis. CONCLUSIONS The quality of AEFI surveillance was still low. AEFIs were often occurred in young children, NIP vaccines, the first dose and within 1 days after vaccination that were the main points of AEFI surveillance. The usage of IPV shoud be recom- mended.