2015—2016年武威市疑似预防接种异常反应监测数据分析

Surveillance of adverse events following immunization in Wuwei city from 2015 to 2016

目的分析2015—2016年甘肃省武威市疑似预防接种异常反应(AEFI)的发生情况和特征,评价监测系统的敏感性,为疫苗的安全性提供科学依据,以提高全市的预防接种服务质量。方法 2015—2016年武威市4个县(区)通过中国免疫规划信息管理系统报告的个案数据,按照《全国AEFI监测方案》,经调查诊断分析,AEFI按发生原因分为一般反应、异常反应、疫苗质量事故、接种事故、偶合症和心因性反应,运用描述流行病学方法分析病例数据。结果2015—2016年全市报告AEFI病例537例,其中一般反应536例、占99.81%,1岁及以下397例、占73.93%,AEFI病例发病季节集中在夏秋季,报告AEFI病例数居前五位的疫苗为"百白破"疫苗(无细胞)、乙脑疫苗(减毒)、"白破"疫苗(儿童)、A群流脑疫苗和麻疹/"麻风"疫苗,报告发生率排前五位的疫苗为"白破"疫苗(儿童)、麻疹/"麻风"疫苗、"百白破"疫苗(无细胞)、乙脑疫苗(减毒)和A群流脑疫苗。结论 2015年将AEFI监测指标纳入考核后,武威市疑似预防接种异常反应监测工作进一步提高,但监测系统的敏感性仍需加强;"百白破"疫苗和"白破"疫苗致异常反应发生率较高,需进行深入的调查分析。

Objective To analyze the occurrence and characteristics of adverse event following immunization（AEFI） in Wuwei city during 2005—2016, to evaluate the sensitivity of the surveillance system, and provide scientific basis for the safety of the vaccine and improvement of the quality of vaccination service in the city. Methods Data of the cases with AEFI（2015—2016） were collected from National AEFI Information Management System and classified as general reaction, abnormal reaction, vaccine quality event, inoculation accident, coincidental event and psychogenic reaction according to the symptoms and medical records. The descriptive epidemiology was used for the analysis. Results There were 537 AEFI cases reported in Wuwei city from 2015 to 2016, including 536 cases with general reactions accounting for 99.81%, and 397 infants at the age of one year and younger with AEFI occupying 73.93%. AEFI cases concentrated in summer and autumn. According to the case number of AEFI, the top five vaccines in turn was DTP（DTa P）, Japanese encephalitis（JE-Ⅰ）, DT（for children）,and MCV-A/MR. The top five vaccines were orderly DT, MR, DTa P, JE-Ⅰ and MCV-A in accordance with the AEFI incidence rate. Conclusions Since AEFI surveillance became one of the assessment indicators in 2015, the work of AEFI surveillance in Wuwei has been improved. The sensitivity of AEFI surveillance system needs enhancing. The incidences of DTa P and DT are still high and need to be investigated and analyzed further.