2017—2021年北海市疑似预防接种异常反应监测分析

Monitors and analysis of adverse event following immunization in Beihai City from 2017-2021

目的分析2017—2021年北海市疑似预防接种异常反应(adverse event following immunization,AEFI)的报告发生率和分布特征。方法通过全国AEFI信息管理系统和广西免疫规划信息管理系统收集2017—2021年北海市AEFI个案信息和疫苗接种数据,进行描述流行病学分析。结果2017—2021年北海市报告各类疫苗AEFI个案232例,及时报告率和及时调查率分别为97.84%和100.00%。AEFI总报告发生率为5.49/10万剂,其中一般反应报告发生率为3.43/10万剂,异常反应为1.68/10万剂,不同类型反应报告发生率差异有统计学意义(P<0.05)。在报告的AEFI中,男性多于女性、年龄以<1岁、发生时间以4—9月、地区以海城区为主,性别、年龄、发生时间和地区构成差异均有统计学意义(均P<0.05)。报告发生率最高的免疫规划疫苗是无细胞百白破联合疫苗(DTaP),为17.12/10万剂;报告发生率最高的非免疫规划疫苗是无细胞百白破灭活脊髓灰质炎和b型流感嗜血杆菌联合疫苗(DTaP-IPV-Hib),为69.68/10万剂。87.93%的AEFI分布在接种疫苗的1天内,异常反应以过敏性皮疹、卡介苗淋巴结炎或血管性水肿报告发生率较多。结论2017—2021年北海市AEFI监测质量总体达国家监测要求,但监测敏感性有待加强。AEFI以一般反应为主,报告发生率在预期范围内。建议今后加强主动监测,进一步提高AEFI监测质量。

Objective To analyze the report incidence and distribution characteristics of the adverse events following immunization(AEFI)in Beihai City from 2017 to 2021.Methods Through the national AEFI information management system and Guangxi immunization planning information management system,the AEFI case information and vaccination data in Beihai City from 2017to 2021 were collected for descriptive epidemiological analysis.Results From 2017 to 2021,232 AEFI cases of various vaccines were reported in Beihai City,and the timely reporting rate and timely investigation rate were 97.84% and 100.00%,respectively.The total reported incidence of AEFI was 5.49/100000 doses,of which the reported incidence of general reactions was 3.43/100000doses and the reported incidence of abnormal reactions was 1.68/100000 doses.The difference in the reported incidence of different types of reactions was statistically significant(P<0.05).Among the reported AEFI cases,there were more males than females,the age was mainly<1 years old,the peak season was April to September,and the region was predominantly Haicheng District.The differences in gender,age,time of occurrence and regional distribution were statistically significant(all P<0.05).The national immunization program vaccine with the highest reported incidence was the Diphtheria,tetanus and acellular pertussis combinedvaccine(DTaP)with a rate of 17.12/100000 doses,and the non-national immunization program vaccine with the highest reported incidence was combined diphtheria-tetanus-acellular pertussis-inactivated poliovirus-Haemophilus influenza type b(Hib)conjugate vaccine(DTaP-IPV-Hib),with a rate of 69.68/100000 doses.87.93% of AEFI cases distributed within 1 day of vaccination,and the incidence of reported abnormal reactions was higher for allergic rash,BCG lymphadenitis and angioedema.Conclusions The overall monitoring quality of AEFI in Beihai City from 2017 to 2021 meets the national monitoring requirements,but the monitoring sensitivity needs to be strengthened.The AEFI cases are mainly general reactions,and the reported incidence is within the expected range.It is recommended that the active monitoring should be strengthened in the future to further improve the quality of AEFI monitoring.