陕西省特殊健康状态儿童预防接种评估门诊神经系统疾病儿童预防接种临床回顾

Clinical review of vaccination of children with neurological disorders in a vaccination evaluation clinic for children with special health status in Shaanxi province

目的探讨神经系统疾病儿童预防接种的临床研判和安全性。方法选取2020年12月-2021年10月在“陕西省特殊健康状态儿童预防接种评估门诊”咨询的神经系统疾病儿童,收集临床病史和实验室检查结果,提出预防接种评估建议,随访预防接种后不良反应。结果共纳入151例1月龄-17岁神经系统疾病儿童,其中癫痫48例(31.8%)、精神发育迟滞36例(23.8%)、脑血管病18例(11.9%)、热性惊厥11例(7.3%)、其他神经系统疾病38例(25.2%)。在所有神经系统疾病儿童中,建议接种灭活和减毒活疫苗、接种灭活疫苗但避免减毒活疫苗、暂缓接种所有疫苗分别为144例(95.4%)、2例(1.3%)、5例(3.3%);122例儿童共接种1392剂次疫苗,其中11例12剂次出现不良反应,发生率为8.6‰,均为一般反应。结论神经系统疾病儿童经医学评估后绝大多数可接种疫苗,接种后不良反应发生风险在预期范围内。

Objective To explore vaccination of children with neurological disorders(NDs)and the safety of vaccination.Methods We collected data on clinical history and laboratory testing of children with NDs who consulted the“Shaanxi Special Health Status Children’s Vaccination Assessment Clinic”from December 2020 to October 2021.We evaluated vaccinations and observed for adverse reactions after vaccination.Results A total of 151 children with NDs aged 1 month to 17 years were included,among which 48(31.8%),36(23.8%),18(11.9%),11(7.3%),and 38(25.2%)had epilepsy,mental retardation,cerebrovascular disease,febrile convulsions,or other ND.Among all children with NDs,144(95.4%)were recommended to receive inactivated and attenuated live vaccines,2(1.3%)were recommended to receive inactivated vaccines but not to receive attenuated live vaccines,and 5(3.3%)were recommended to suspend all vaccines.A total of 1392 vaccine doses were administered to 122 children,and adverse reactions occurred following 12 doses in 11 children,for an incidence of 8.6‰,with all reactions being common.Conclusions The majority of children with NDs can be vaccinated after medical evaluation;the risk of adverse reactions after vaccination is acceptable.