2008—2020年南通市疫苗接种安全性分析与评估  

Analysis and evaluation of safety of vaccination in Nantong City from 2008-2020

作　　者：侯晓艳[1] 廉丽华[1] 倪杰 张之海[1] HOU Xiao-yan;LIAN Li-hua;NI Jie;ZHANG Zhi-hai(Epidemic Prevention Department,Development Area Center,Nantong Center for Disease Control and Prevention,Nantong Jiangsu,226007,China)

机构地区：[1]南通市疾病预防控制中心开发区分中心防疫科,江苏南通226007

出　　处：《职业与健康》2022年第19期2672-2677,2682,共7页Occupation and Health

基　　金：2019年度南通市卫生健康委员会科研立项课题(MA2019013)。

摘　　要：目的分析2008—2020年南通市疑似预防接种异常反应(adverse events following immunization,AEFI)监测系统报告案例的流行病学特征,评估南通市13年来AEFI监测系统运行质量以及疫苗预防接种的安全性。方法采用描述流行病学的方法,统计分析13年来南通市AEFI报告情况,比较分析不同群体AEFI报告发生率之间的差异,总结常见AEFI的发生规律。结果2008—2020年共报告11796例AEFI个案,平均报告发生率为59.93/10万,严重AEFI的报告发生率为2.79/10万,不良反应中一般反应10213例,报告发生率为51.89/10万,异常反应1519例,报告发生率为7.72/10万。13年间报告发生率呈“W型”波动,2013年起总体呈现逐年上升趋势。AEFI报告数男性多于女性,性别比为1.3∶1;2岁以下儿童报告占比最高,7岁以上儿童中发生严重AEFI占比较高(χ^(2)=23.84,P<0.01)。一年四季均有报告,AEFI合计在4—6月和7—9月占比较高,严重AEFI则在1—3月占比最高。报告的AEFI中不良反应主要发生于接种后1天以内(89.71%);从不良反应临床诊断分布来看,发热、红肿、硬结等一般反应占主要部分;异常反应中过敏性皮疹占比最高,发生率为5.83/10万。从疫苗分布来看,报告率排在前10位的疫苗有7种属于非全国免疫规划疫苗,另外3种全国免疫规划疫苗是麻风疫苗、百白破疫苗和麻疹疫苗。结论2008年以来南通市AEFI监测工作推进的较平稳,监测系统敏感性不断提高,且具备发现罕见严重AEFI的能力。但监测系统数据的准确性和及时性有待进一步提高,尚未达到预防接种及时安全预警的功效。Objective To evaluate the quality of adverse event following immunization(AEFI) monitoring system and the safety of vaccination in Nantong City in the past 13 years by analyzing the epidemiological characteristics of the report cases of AEFI in Nantong City from 2008 to 2020. Methods The descriptive epidemiological method was used to analyze the AEFI cases in Nantong City in the past 13 years,compare the incidence rate of AEFI reports in different groups,and summarize the occurrence rules of common AEFI. Results Totally 11 796 cases of AEFI were reported from 2008 to 2020,with an average reported incidence rate of 59.93/100 000,and the reported incidence rate of severe AEFI was 2.79/100 000. Among the adverse reactions,there were 10 213 cases of general reaction and 1 519 cases of abnormal reaction,with the reported incidence rate of 51.89/100 000and 7.72/100 000 respectively. The reported incidence rate fluctuated in "W-type" in the past 13 years,and the overall trend was increasing year by year since 2013. The number of males reported AEFI was more than that of females,and the sex ratio was 1.3 ∶ 1.The proportion of children under two years old was the highest,and the serious AEFI of children over seven years old was higher(χ^(2)=23.84,P <0.01). The AEFI cases were reported in the four seasons of the year,and the proportion of all AEFI types was higher in April to June and July to September,while the proportion of severe AEFI was the highest in January to March. The adverse reactions were mainly occurred within one day after inoculation(89.71%). For the distribution of adverse reactions,the general reactions such as fever,redness and swelling,and scleroma accounted the greatest proportion. The incidence of allergic rash was the highest in abnormal reaction,and the incidence was 5.83/100 000. For the distribution of vaccines,seven of the top10 vaccines with the report rate belonged to non NIP vaccines,and the other three were leprosy vaccine,DPT vaccine and measles vaccine. Conclusion Since 2008,the AEFI moni

关 键 词：疑似预防接种异常反应 疫苗安全性监测 预防接种信息系统 

分 类 号：R186[医药卫生—流行病学]