上海市2015~2018年含脑膜炎球菌成分疫苗疑似预防接种异常反应监测分析

Surveillance and analysis of adverse events following immunization with meningococcus-containing vaccine in Shanghai,2015 ~ 2018

目的分析上海市2015~2018年含脑膜炎球菌成分疫苗(meningococcus-containing vaccine,MCV)疑似预防接种异常反应(adverse events following immunization,AEFI)发生特征和预防接种安全性。方法通过中国AEFI监测信息管理系统收集上海市2015~2017年报告的A群脑膜炎球菌多糖疫苗(group A meningocaccal polysa-ccharide vaccine,MPV-A)、A群C群脑膜炎球菌多糖疫苗(groups A+C meningococcal polysaccharide vaccine,MPV-AC)、A群C群脑膜炎球菌多糖结合疫苗(groups A+C meningococcal polysaccharide conjugate vaccine,MPCV-AC)、ACYW135群四价流脑多糖疫苗(groups A+C+Y+W135 meningococcal polysaccharide vaccine,MPV-ACYW135)和A群C群脑膜炎球菌(结合)b型流感嗜血杆菌(结合)联合疫苗(meningococcal groups A and C and Haemophilus influenzae b conjugate vaccine,MPV-AC/Hib)AEFI个案,采用描述流行病学方法进行分析。结果上海市2015~2018年共报告含流脑成分联合疫苗AEFI个案9174例,年平均报告发生率为243.60/10万剂。5种含流脑成分疫苗的AEFI报告发生率最高为363.85/10万剂,最低为145.13/10万剂,且5种疫苗的AEFI报告发生率差异有统计学意义(P<0.001)。在报告病例中,男女性别比为1.19∶1;0~1岁占69.42%;接种疫苗后0~1 d发生5518例(79.48%);一般反应8908例(236.23/10万剂);异常反应251例(3.40/10万剂),主要为过敏性皮疹(239例,6.49/10万剂)。结论上海市2015~2018年5种含流脑成分疫苗接种安全性均良好,不良反应均以发热和局部反应为主。

Objective To analyze the characteristics of adverse events following immunization(AEFI)with meningococcus-containing vaccine(MCV)and the safety of vaccination in Shanghai from 2015 to 2018.Methods The data on AEFI cases caused by group A meningocaccal polysaccharide vaccine(MPV-A),groups A+C meningococcal polysaccharide vaccine(MPV-AC),groups A+C meningococcal polysaccharide conjugate vaccine(MPV-AC),groups A+C+Y+W135 meningococcal polysaccharide vaccine(MPV-ACYW135)and meningococcal groups A and C and Haemophilus influenzae b conjugate vaccine(MPV-AC/Hib)in Shanghai during 2015~2018 were collected from National AEFI Surveillance System and analyzed by descriptively epidemiological method.Results A total of 9174 cases of AEFI caused by MCV were reported in Shanghai during 2015~2018,indicating an average incidence of 243.60 per 100000 doses.The incidences of AEFI caused by five kinds of MCVs showed significant difference(P<0.001),which was363.83/100000 doses at most and 145.13/100000 doses at least.The male to female ratio in the AEFI cases was1.19∶1.A portion of 69.42%of the cases occurred in the children at ages of 0~1 years.A total of 5518 cases(79.48%)occurred 0~1 d after vaccination,while 8908 cases(236.23 per 100000 doses)were general reactions and 251(3.40 per100000 doses were abnormal reactions which were mainly allergic rash(239 cases,6.49 per 100000 doses).Conclusion All the five kinds of MCVs used in Shanghai during 2015~2018 showed high safety,of which the adverse reactions were mainly fever and local reactions.