南昌市湾里区2014-2018年疑似预防接种异常反应监测分析

Surveillance of Adverse Events Following Immunization in Wanli District,Nanchang City,2014-2018

目的分析南昌市湾里区2014-2018年疑似预防接种异常反应(adverse events following immunization,AEFI)的监测情况。方法通过中国免疫规划信息管理系统收集南昌市湾里区2014-2018年AEFI个案,结合描述流行病学方法,从AEFI报告概况、三间分布、间隔分布、临床诊断分布、AEFI疫苗分布及病例转归等方面对AEFI的监测情况进行分析。结果南昌市湾里区2014-2018年共报告AEFI个案70例,AEFI年平均报告发生率为43.63/10万剂次。AEFI个案主要集中在幸福街办和罗亭镇,两地区共报告40例(57.14%);春夏季发生例数较多,共报告56例(80.00%);男女构成比为1.69∶1(44/26),各年龄组中以<1岁组报告例数最多,共报告38例(54.29%)。接种1 d内发生66例(94.29%),接种2 d发生3例(4.29%),接种15 d以上发生1例(1.42%)。一般反应62例(88.57%,其中发热45例、局部红肿/硬结17例),异常反应8例(11.43%,主要为过敏性反应);5年内未报告疫苗质量事故、接种事故、偶合症和心因性反应,无死亡病例发生,无群体性疑似预防接种异常反应报告。AEFI共涉及14种疫苗,包括一类疫苗11种,共67例(95.71%),报告发生率为53.78/10万剂次;二类疫苗3种,共3例(4.29%),报告发生率为8.36/10万剂次。报告前3位的疫苗分别是:麻风疫苗(10例,164.69/10万剂次)、乙脑疫苗(16例,130.56/10万剂次)、卡介苗(1例,92.34/10万剂次)。70例AEFI均痊愈或好转,无任何后遗症。结论总体来说,南昌市湾里区AEFI监测网络稳定,系统运行良好,监测工作灵敏性、完整性、及时性均达到较高水平。在今后的监测工作中需加强小年龄段儿童、春夏季节及二类疫苗的AEFI主动监测工作,加强AEFI监测工作的督导考核与人员培训,确保工作人员的稳定,增强其AEFI报告意识及责任感。

Objective To analyze the adverse events following immunization(AEFI) in Wanli District of Nanchang city from 2014 to 2018.Methods AEFI cases in Wanli District of Nanchang city(2014-2018) were collected by the China Immunization Planning Information Management System.The epidemiological methods were used to analyze the monitoring situations according to the report overview,time distribution,regional distribution,population distribution,interval distribution,diagnostic distribution,vaccine distribution and AEFI outcome.Results A total of 70 cases of AEFI were reported in Wanli District from 2014 to 2018.The average annual report rate of AEFI was 43.63/100,000 doses.Forty cases of AEFI(57.14%) were distributed in Xingfu street and Luoting town.Fifty-six cases(80.00%) were reported in spring and summer.The ratio of males to females was 1.69/1(44/26),and 38 cases(54.29%) were less than 1 year old.The AEFI occurred on the day of vaccination in 66 cases(94.29%),on day 2 after vaccination in 3 cases(4.29%),and more than 15 days after vaccination in 1 case(1.42%).General reactions were found in 62 cases(88.57%,45 cases of fever and 17 cases of local redness/induration),and abnormal reactions in 8 cases(11.43%,mainly anaphylaxis).There were no vaccination errors and vaccine quality accident reports within 5 years.No vaccine quality incidents,vaccination incidents,coincidences,psychogenic reactions,death and mass AEFI were reported within 5 years.AEFI was involved in 14 vaccines,including 11 first-class vaccines(67 cases,95.71%;reported incidence:53.78/100,000 doses) and 3 second-class vaccines(3 cases,4.29%;reported incidence:8.36/100,000 doses).The top three vaccines reported were leprosy vaccine(10 cases,164.69/100,000 doses),Japanese encephalitis vaccine(16 cases,130.56/100,000 doses),and bacillus Calmette-Guérin vaccine(1 case,92.34/100,000 doses).All the 70 cases of AEFI were cured or improved without any sequela.Conclusion The AEFI monitoring network is stable and the system runs well in Wanli District of Nanchang City.The sensitivity,integrity and timeliness of the monitoring work have reached a high level.In the future work,active AEFI monitoring should be strengthened in young children,spring and summer and secondary vaccines.Furthermore,the supervision and assessment of AEFI monitoring work and personnel training should be strengthened to ensure the stability of staff and to enhance their AEFI reporting awareness and responsibility.