浙江省2008～2014年预防接种后死亡病例分析

Analysis of Infant Deaths after Immunization in Zhejiang Province,2008-2014

目的分析浙江省2008-2014年接种疫苗后发生的死亡病例特征,评价预防接种用疫苗的安全性。方法通过全国疑似预防接种异常反应（Adverse Events Following Immunization,AEFI）监测信息管理系统和中国免疫规划监测信息管理系统收集浙江省2008-2014年报告的预防接种后死亡个案信息及疫苗接种数据,采用描述性分析方法进行分析。结果 2008-2014年全省共报告预防接种后死亡个案32例,报告发生率为0.22/100万剂;其中偶合症23例（71.88%）、异常反应9例（28.12%）,报告发生率分别为0.16/100万剂、0.06/100万剂。在9例异常反应死亡病例中,8例存在先天性免疫功能不良且合并其他感染死亡;1例为过敏性休克死亡。结论 2008-2014年各年预防接种后死亡发生在预期范围内,主要是偶合症;尸检有助于查明死因。

Objective To analyze characteristic features of infant deaths following immunization in Zhejiang from 2008 to 2014,and to evaluate vaccine safety. Methods Reports of infant deaths following immunization were collected through the National Adverse Events Following Immunization（ AEFI） Surveillance System. Vaccine doses administered data were collected through the National Children Immunization Information System. Data were analyzed by descriptive methods. Results A total of 32 deaths after immunization were reported from 2008 to 2014 in Zhejiang,for an incidence rate of 0. 22 per million doses administered; 23（ 71. 88%） deaths were confirmed to be coincidental, and the other 9（ 28. 12%） were vaccine reactions,for incidence rates of 0. 16 and 0. 06 per million doses,respectively.Among the 9 vaccine-reaction deaths,8 had primary immunodeficiency along with other infections,and 1case was of allergic shock. Conclusions The incidence rates of deaths after immunization were not higher than the expected in Zhenjiang each year; most deaths were coincidental. Autopsy may help clarify causes of deaths following immunization.