广东省特需人群接种门诊特殊健康状态儿童预防接种探索

Vaccination of children with medical conditions in a special vaccination clinic of Guangdong province

目的探索特殊健康状态儿童的预防接种。方法收集2020年12月至2021年5月广东省特需人群接种门诊就诊的特殊健康状态儿童,开展预防接种医学评估、提出疫苗接种建议和实施疫苗接种,观察接种后3个月内疑似预防接种异常反应(AEFI),描述性分析接种建议实施结果、接种依从性和AEFI发生率。结果共纳入596例研究对象,其中存在疫苗慎用证、输血史、过敏史、特殊药物使用史分别为334例(56.04%)、144例(24.16%)、72例(12.08%)、23例(3.86%);主要特殊健康状态包括神经系统疾病、新生儿疾病和心脏疾病,分别为174例(29.19%)、76例(12.75%)、70例(11.74%)。在221例研究对象中,免疫功能筛查正常、可疑异常、低下分别为176例(79.64%)、42例(19.00%)、3例(1.36%)。经医学评估,建议按免疫程序接种/补种疫苗、接种部分疫苗、暂缓接种疫苗的研究对象分别为431例(72.32%)、126例(21.14%)、39例(6.54%)。实际接种疫苗的研究对象542例(90.94%),接种平均延迟9.1个月,AEFI发生率为1.11%(6例),均为一般反应。结论特殊健康状态儿童经医学评估后大多数可接种疫苗,且接种依从性高,安全性良好;需进一步加强特需人群接种门诊对特殊健康状态儿童的预防接种服务工作。

Objective To explore the vaccination of children with certain medical conditions.Methods We enrolled children with medical conditions who visited a special vaccination clinic of Guangdong province between December 2020 and May 2021. We conducted medical evaluations of the children to assess appropriateness for vaccination, provided vaccination recommendations, vaccinated children who had no contraindications, and observed children for adverse events following immunization(AEFI) for 3 months after vaccination. We describe vaccination procedures and compliance and resulting AEFI incidence.Results A total of 596 children were enrolled, among which 334(56.04%), 144(24.16%), 72(12.08%), and 23(3.86%) had vaccine precautions, blood transfusion histories, allergy histories, and special drug use histories, respectively. The most common medical conditions were neurological(174 subjects, 29.19%), neonatal(76, 12.75%), and cardiac(70, 11.74%). Of 221 subjects screened for immune system status, the immune systems of 176(79.64%), 42(19.00%), and 3(1.36%) children were normal, possibly abnormal, and weak. According to the medical evaluations, 431(72.32%), 126(21.14%), and 39(6.54%) children were recommended for vaccination/revaccination using routine immunization schedules, partial vaccination, and postponement of vaccination. In total, 542 subjects(90.94%) were vaccinated, with an average delay of 9.1 months from the routine schedule. The overall incidence of AEFIs was 1.11%(6 cases), and all AEFIs were common reactions.Conclusions The majority of children with special medical conditions can be vaccinated after medical evaluation. Compliance with recommendations from the special clinic was very good;the safety profile showed only common reactions. We should further strengthen the vaccination service of special vaccination clinics for children with certain medical conditions.