芜湖县2014～2016年疑似预防接种异常反应监测分析

Analysis of suspected adverse event cases from immunization in Wuhu county from 2014 to 2016

目的了解芜湖县疑似预防接种异常反应(AEFI)的发生率和发生类别。方法通过中国免疫规划信息管理系统AEFI监测管理模块收集全县2014-2016年AEFI个案数据,对AEFI监测指标采用描述性方法进行分析。结果全县报告AEFI个案共74例,其中一般反应60例(81.08%),异常反应14例(18.92%),涉及13种疫苗。AEFI报告发生率29.80/10万,其中一般反应报告发生率为24.16/10万,异常反应报告发生率为5.64/10万。48h内报告率94.59%,48 h内调查率100%。95.95%的AEFI发生于疫苗接种后1 d内。AEFI主要发生于0~4岁儿童。临床诊断类型以一般反应如发热、红肿、硬结及过敏性反应为主。85.14%的AEFI发生于一类疫苗,主要是吸附无细胞百白破联合疫苗(DTa P)(22.97%)、A群C群脑膜炎球菌结合疫苗(MCV-A+C)(16.22%)和麻疹风疹联合减毒活疫苗(MR)(8.11%)等。结论芜湖县AEFI监测系统运行良好;加强AEFI规范处置,规范疫苗接种流程与接种操作,注重AEFI宣传教育与风险沟通等,减少AEFI发生。

Objective To study the occurrence situation of suspected adverse event cases of immunization（ AEFI） in Wuhu county and to study the security of conventional and intensification vaccination,so as to provide a scientific basis for immunization planning decisions. Methods AEFI data during the period of 2014-2016 were collected through the AEFI Monthly Routine Report System of Wuhu county and the China Information System for National Immunization Program（ NIP）. The descriptive methodology was used to conduct epidemiological analyses. Results 74 AEFI cases were reported from 2014 to 2016,there were 60（ 81. 08%） cases with general reactions and 14（ 18. 92%） cases with paradoxical reactions. There were 13 kinds of vaccines involved in AEFI cases. The reported incidence of AEFI was 29. 80/105,the general reactions incidence was 24. 16/105 and the paradise incidence was 5. 64/105. The reported and investigated rates within48 h were 94. 59% and 100%. 95. 95% AEFI cases occurred within 1 day after vaccination. Cases mainly happened in young who were 4 years old or less. The clinical diagnosis of AEFI cases were fever,flare,induration and anaphylaxis. 85.14% of AEFI cases occurred because of the first class vaccinations,these cases included DTa P vaccine（ 22. 97%）,MCV-A ＋ C vaccine（ 16. 22%） and MR vaccine（ 8. 11%） and so on. There were statistics significance between the general reactions of NIP vaccination and the second type of vaccine the abnormal reactions were no different. Conclusion The AEFI monitoring system was running in good condition in Wuhu county. It is necessary to strengthen the specification disposal,specify the technological process and operation of vaccination,and pay attention to the publicity and education and risk communication of AEFI. Then we can reduce the occurrence rate of AEFI.