疑似预防接种异常反应监测与干预对策探讨

Discussion on Monitoring and Intervention Countermeasures of Suspected Abnormal Reaction of Vaccination

目的分析灌云县2020年疑似预防接种异常反应(adverse events following immunization,AEFI)情况,评估预防接种安全性并提出干预对策,为减少AEFI提供科学依据。方法通过“江苏省预防接种综合服务管理系统”收集灌云县2020年所有疫苗接种资料,通过“国家免疫规划信息系统”收集灌云县2020年报告的AEFI个案资料,统计分析疫苗接种剂次数和AEFI发生率及其特征。结果2020年累计接种26类疫苗237506剂次,报告154例AEFI,报告发生率为64.84/10万剂。其中一般反应150例,占97.40%,异常反应4例(过敏性皮疹和血管性水肿各2例),占2.60%,发生率分别为63.16/10万剂、1.68/10万剂。男性(87例)与女性(67例)发生例数之比为1.30∶1;年龄0~13岁,其中居前3位的为0岁组(59例,38.31%)、1岁组(60例,38.96%),2岁组(17例,11.04%)。每月均有AEFI事件报告,报告数居前3位的月份为7月(23例)、8月(22例)和11月(19例),占全年的41.56%。夏秋季报告数(100例)是冬春季报告数(54例)的1.85倍。86.36%的AEFI发生与接种时间间隔在0 d以内。共有20类疫苗报告发生AEFI,发生率居于前3位的是百白破疫苗(无细胞)(327.48/10万剂)、13价肺炎疫苗(181.49/10万剂)和Hib疫苗(170.07/10万剂)。全县13个镇街均有AEFI报告,发生率居前3位的为圩丰镇(130.87/10万剂)、南岗镇(101.30/10万剂)、小伊镇(89.02/10万剂),侍庄街道报告发生率最低,仅为5.77/10万剂。所有AEFI者均未住院,治愈率100%。结论灌云县2020年AEFI总报告发生率和各疫苗AEFI报告发生率均在正常监测范围内。今后应加大AEFI知识宣传和监测力度,进一步提高预防接种安全性。

Objective To analyze the situation of suspected adverse events following immunization(AEFI)in Guanyun County in 2020,evaluate the safety of vaccination and propose intervention measures,so as to provide scientific basis for reducing AEFI.Methods All vaccination data of Guanyun County in 2020 were collected through the"Jiangsu Provincial Comprehensive Service and Management System for Vaccination",and the AEFI case data reported in Guanyun County in 2020 were collected through the"National Immunization Planning Information System",and the number of vaccine vaccinations and the incidence and characteristics of AEFI were statistically analyzed.Results In 2020,a total of 237506 doses of 26 types of vaccines were administered,and 154 cases of AEFI were reported,with a reported incidence of 64.84/100000 doses.Among them,there were 150 cases of general reactions,accounting for 97.40%,and 4 cases of abnormal reactions(2 cases of allergic rash and 2 cases of vascular edema,respectively),accounting for 2.60%.The incidence rates were 63.16/100000 doses and 1.68/100000 doses,respectively.The ratio of male(87 cases)to female(67 cases)was 1.30∶1;the age ranged from 0 to 13 years,with the top three being the 0 year old group(59 cases,38.31%),the 1 year old group(60 cases,38.96%),and the 2 year old group(17 cases,11.04%).AEFI events were reported every month,with the top three reporting months being July(23 cases),August(22 cases),and November(19 cases),accounting for 41.56%of the year.The number of reports in summer and autumn(100 cases)was 1.85 times that of reports in winter and spring(54 cases).86.36%of AEFI occurred within 0 days of vaccination.A total of 20 types of vaccines had reported AEFI,with the top three rates being DPT vaccine(acellular)(327.48/100000 doses),13-valent pneumonia vaccine(181.49/100000 doses),and Hib vaccine(170.07/100000 doses).There were 13 towns and streets in the county with AEFI reports,with the top three reported incidence rates being Weifeng Town(130.87/100000 doses),Nangang Town(101.30/100000 doses),and Xiaoyi Town(89.02/100000 doses).Shizhuang Street had the lowest reported incidence rate,only 5.77/100000 doses.All AEFI patients were not hospitalized,and the cure rate was 100%.Conclusion The total reported incidence of AEFI and the reported incidence of AEFI of various vaccines in Guanyun County in 2020 are within the normal monitoring range.In the future,efforts should be made to promote and monitor AEFI knowledge to further improve the safety of vaccination.