丹阳市2011年无细胞百白破、流脑疫苗疑似预防接种异常反应主动监测结果分析  

Analysis of the results on active surveillance of suspected cases of adverse events following DTaP and meningitis immunization in 2011 in Danyang City

作　　者：袁卫建[1] 杭纪红[1] 徐建芳[1] 

机构地区：[1]丹阳市疾病预防控制中心,江苏丹阳212300

出　　处：《现代预防医学》2013年第18期3500-3503,共4页Modern Preventive Medicine

摘　　要：目的分析丹阳市2011年主动监测无细胞百白破、流脑疫苗疑似预防接种异常反应（Adverse Events Following Immunization,AEFI）的发生特征,评价AEFI监测系统运转情况及预防接种安全性。方法通过全国疑似预防接种异常反应信息管理系统,收集丹阳市截至2012年2月11日报告的2011年无细胞百白破、流脑疫苗AEFI个案数据,采用描述性方法进行流行病学分析。结果 2011年丹阳市AEFI监测系统共收到无细胞百白破、流脑疫苗2 408例个案,占所有疫苗报告个案的75.51%;2 408例个案中,其中﹤1岁1 451例占60.26%;男女性别比为1.09︰1;集中在7~12月份,共1 576例,占65.45%;发热1 488例,占61.79%,红肿797例,占33.10%,硬结331例,占13.75%;接种后﹤2 d内报告个案2 016例,占83.72%;无细胞百白破疫苗第一至第四针次反应报告发生率分别为：3 194.99/10万、2 876.42/10万、4 216.93/10万、5 773.20/10万,随着接种针次的增加反应报告发生率明现增加（χ2=117.71,P﹤0.01）,流脑A＋C疫苗第二针次反应发生率（1 147.51/10万）明显低于第一针次反应发生率（2 759.42/10万）（χ2=44.83,P﹤0.01）。结论丹阳市AEFI监测的敏感性尚可,主动监测疫苗反报告发生率明细高于被动监测疫苗,加强督导的频次和力度可以明显提高AEFI报告率和发现率,尤其可以提高轻、中度预防接种反应的发现报告率。AEFI常发生在小年龄儿童、接种后2 d内,为监测重点,国家免疫规划（National Immunization Programme,NIP）疫苗不良反应报告发生率均未超过预期发生范围。OBJECTIVE Features of active surveillance of adverse events following immunization （AEFI） of DTaP and meningitis vaccines in 2011 in Danyang City were analyzed to evaluate the implementation of AEFI surveillance system and the safety of vaccines under the National Immunization Program （NIP）. METHODS 2011 data on the cases of AEFI of DTaP and meningitis vaccines reported in Danyang City before Februray 11^th of 2012 were extracted from the National AEFI Information System, and the epidemiology was analyzed by using the descriptive methods. RESULTS The AEFI surveillance system in Danyang City received reporting of a total of 2 408 AEFI cases in 2011, accounting for 75.51% of all reported vaccination-related cases. Among the 2 408 cases, 1 451 cases （60.26%） were younger than 1 year of age, and the male/ female ratio was 1.09 ： 1. The majority of the cases （1 576 cases, 65.45%） were reported between July and December. The reported adverse reactions included fever （1 488 cases, 61.79% ）, redness and swelling （797 cases, 33.10% ） , and scleroma （331 cases, 13.75%）. 2 016 cases （83.72%） were reported in less than 2 days after vaccination, and reporting rates of the 1^th to 4^th dose of DTaP vaccination were 3 194.99, 2 876.42, 4 216.93, and 5 773.20 per 100 000, respectively. Reporting rate of AEFI significantly increased with the number of dosages received by the patients （X^2 = 117.71, P 〈 0.01）, and the rate for the second dose of meningitis A＋C vaccine （1 147.51 per 100 000） was significantly lower than that of the first dose （2 759.42 per 100 000） （X^2 = 44.83, P〈 0.01）. CONCLUSION Sensitivity of the AEEI：surveillance system in Danyang City is within an acceptable range. AEFI reporting rate under active surveillance of vaccination is significantly higher than that under passive surveillances. Enhancement of the frequency and intensity of supervision may significantly improve the reporting rate of AEFI cases, especially those with mild and moderate immunizat

关 键 词：疑似预防接种异常反应 主动监测 分析 

分 类 号：R186[医药卫生—流行病学]