哈尔滨市道里区2007-2013年疑似预防接种异常反应监测分析

Monitoring analysis on adverse effects following immunization in Daoli district of Harbin between 2007-2013

目的分析2007-2013年哈尔滨市道里区疑似预防接种异常反应(AEFI)发生、分布特征及AEFI监测系统运行情况,为评估疫苗安全性和服务质量提供依据。方法通过收集整理哈尔滨市道里区2007年1月1日-2013年12月31日AEFI监测报告的数据,应用Excel和SPSS软件,采用描述流行病学方法对AEFI分布特征和相关指标进行统计分析。结果 2007年1月1日-2013年12月31日哈尔滨市道里区报告AEFI 1 308例,累计报告发生率为137.01/10万剂。其中百白破疫苗引发的AEFI占报告总数的73.24%;其次是麻风疫苗,占报告总数的5.12%。临床诊断表现为发热和(或)红肿和(或)硬结的人数最多,占报告人数的69.95%;预防接种异常反应以过敏性皮疹和卡介苗接种淋巴结炎为主,分别占异常反应的50.00%和42.86%。1月报告AEFI最少,占2.60%。<2岁组儿童AEFI发生率较高,各年龄组间差异有统计学意义(χ2=28.058,P<0.01)。接种后24小时内发生AEFI 514例,占报告总数的54.74%。AEFI及时报告率为99.16%,及时调查率为98.77%。结论道里区AEFI监测质量和敏感性较高,但仍需进一步加强。

Objective To analyze the occurrence, distribution features of adverse events following immunization（AEFI） and the implementation of AEFI surveillance system in Daoli District of Harbin, and to provide the basis for evaluating the safety of vaccines and the quality of immunization services. Methods The data were collected from January 1, 2007 to December 31, 2013 though the AEFI surveillance system of Daoli District of Harbin. Descriptive methodology was used to analyze the distribution features and relative indexes of AEFI by using Excel and SPSS software. Results 1308 AEFI cases occurring from January 1, 2007 to December 31, 2013 in Daoli District of Harbin were reported, the incidence rate was137.01 per 100,000 doses. Among these, 958 DPT AEFI cases were reported, accounting for 73.24%, second were MR, 67 cases, accounting for 5.12%. Fever, red and swelling and indurations dominated the clinical diagnosis, accounting for69.95%. The main symptoms of adverse events following immunization were anaphylactic rashes and BCG lymphadenitis,the incidence accounted for 50.00% and 42.86% among the adverse events cases. The cases occurred in January were minimum,accounting for 2.6%. The incidence of AEFI was higher in the children 2 year group, the differences are statistically significant（χ2=28.058,P〈0.05）. 514 cases occurred within 24 hours after vaccination, accounting for54.747%. The percentage of AEFI reported promptly after identification reached 99.16% and the percentage of investigated in time after reporting reached 98.77%. Conclusion Monitoring quality and sensitivty of AEFI in Daoli district is high, but we still need to be further strengthened.