2016-2019年沈阳市疑似预防接种异常反应监测分析

Adverse events following immunization in Shenyang city,2016-2019:surveillance data analysis

目的分析沈阳市2016—2019年疑似预防接种异常反应(AEFI)特征,为评价沈阳市疫苗接种的安全性提供依据。方法通过中国免疫规划信息管理系统收集沈阳市2016—2019年AEFI数据,采用描述流行病学方法对监测数据进行统计分析。结果2016—2019年沈阳市共报告AEFI 1295例,AEFI报告发生率整体上呈上升趋势,由2016年的16.72/10万上升至2019年的32.51/10万,不同年份疫苗接种AEFI发生率差异有统计学意义(χ^(2)=74.46,P<0.05);其中一般反应发生率为91.64%、异常反应发生率为2.99%。接种后一般反应以发热、红肿、硬结等为主。病例主要集中在5—7月,<2岁占72.05%;AEFI报告发生率最高为辽中区(42.8/10万),最低为于洪区(2.52/10万);不同地区间AEFI发生率差异有统计学意义(χ^(2)=432.7,P<0.05)。一类疫苗AEFI发生率(19.88/10万剂)高于二类疫苗(3.46/10万剂),差异有统计学意义(χ^(2)=640.94,P<0.05)。结论沈阳市2016—2019年AEFI报告发生率逐年增加;全市监测工作发展不均衡,需对薄弱地区加强督导及培训,提高AEFI病例监测的敏感性。

Objective To analyze characteristics of adverse events following immunization(AEFI)in Shenyang city from 2016 to 2019 and to provide evidences for assessing vaccination safety in the city.Methods From National Immunization Program Information Management System,we extracted the data on all AEFI cases reported in Shenyang city during 2016–2019 and analyzed the data with descriptive epidemiology methods.Results Among 5548250 doses of vaccines inoculated during the 4-year period in the city,totally 1295 AEFI cases were reported and the reported annual incidence rate varied significantly(χ^(2)=74.46,P<0.05),with an increase from 16.72/100000 doses in 2016 to 32.51/100000 doses in 2019.The most(91.64%)of the reported AEFI cases were common reactions and only 2.99%of the reported cases were abnormal reactions.There were 72.05%of the reported AEFI cases occurred among the children less than 2 years old and more cases were reported between May and July in a year.The reported incidence of AEFI was significantly different among administrative districts(χ^(2)=432.7,P<0.05);the highest district-specific rate was 42.8/100000 and the lowest was 25.2/100000.The reported incidence of AEFI related to class A vaccines was significantly higher than that of AEFI related to class B vaccines(19.88/100000 doses vs.3.46/100000 doses,χ^(2)=640.94;P<0.05).Conclusion The reported incidence of AEFI increased yearly from 2016 to 2019 in Shenyang city and the district-specific incidence differed significantly suggesting that the surveillance on AEFI needs to be improved in some regions.