一起13价肺炎球菌多糖结合疫苗致血管神经性水肿伴感染事件调查分析  

Investigation on a case of angioneurotic edema with infection caused by 13-valent pneumococcal polysaccharide conjugate vaccine

作　　者：孙中环 SUN Zhong-huan(Department of Immunization Program,Center for Disease Control and Prevention of Xuecheng District,Zaozhuang,Shandong 277000,China)

机构地区：[1]山东枣庄市薛城区疾病预防控制中心免疫规划科,山东枣庄277000

出　　处：《疾病预防控制通报》2024年第3期13-16,共4页Bulletin of Disease Control & Prevention(China)

基　　金：枣庄市科技发展计划项目(2023NS33)。

摘　　要：目的了解一例接种13价肺炎球菌多糖结合疫苗(PPCV13)后发生血管神经性水肿伴感染事件起因,明确事件性质,为疫苗安全性观察和规范处置类似事件提供参考。方法调查患儿接种PPCV13后疾病发生、发展及转归情况、疾病诊疗过程、疫苗冷链流通、接种实施、预防接种门诊以及人员接种资质等,收集相关资料,组织专家开展预防接种异常反应诊断。结果患儿接种第3剂PPCV13后发生的疑似预防接种异常反应(AEFI),经薛城区预防接种异常反应调查诊断专家组诊断为血管神经性水肿,与PPCV13存在因果关联,属于预防接种异常反应。结论该患儿发生血管神经性水肿与自身过敏体质有关,感染症状可能为血管神经性水肿炎性介质释放引起,也可能偶合呼吸道病毒感染导致;应加强新疫苗、特殊体质儿童、同种疫苗多次接种者AEFI监测,加强临床医生AEFI诊断及处置能力培训,对儿童家长开展预防接种知识宣传教育,减少不良反应危害。Objective To understand the cause of an event of a case with angioneurotic edema and concurrent infection after inoculation of 13-valent pneumococcal polysaccharide conjugate vaccine(PPCV13),clarify the event property,and provide reference for vaccine safety observation and standardized processing of similar events.Methods The occurrence,development and outcome of the disease,diagnosis and treatment process of disease,cold chain operation of vaccine,vaccination,the vaccination clinic and the qualification of the vaccination staff were investigated after the vaccination of PPCV13 in the child.Relevant data were collected,and experts were organized to carry out the diagnosis of abnormal vaccination reactions.Results The suspected adverse event following immunization(AEFI)after the child received third dose of PPCV13 vaccination was diagnosed as angoneurotic edema by the experts of the investigation and diagnosis expert group of abnormal reaction to vaccination in Xueccheng district,which has a causal association with PPCV13 and belongs to the abnormal reaction to vaccination.Conclusions The occurrence of angioneurotic edema of this child is related to selfallergic constitution.The symptoms of infection may be caused by the release of inflammatory mediators of angioneurotic edema,or it may be combined with respiratory virus infection.The AEFI monitoring of new vaccines,children with special constitution,and people who received multiple doses of the same vaccine should be strengthened.The training of AEFI diagnosis and treatment ability of clinicians should be enhanced,and the publicity and education of vaccination knowledge should be carried out in parents of children for reducing the harm of adverse reactions.

关 键 词：13价肺炎球菌多糖结合疫苗 预防接种 疑似预防接种异常反应 血管神经性水肿 

分 类 号：R186[医药卫生—流行病学]