河南省2010~2011年疑似预防接种异常反应监测分析

Surveillance of adverse events following immunization in Henan Province, China between 2010-2011

摘要:

目的：分析河南省疑似预防接种异常反应（AEFI）的发生特征，评价河南省目前使用疫苗的安全性。方法：通过中国免疫规划监测信息管理系统收集河南省2010年1月1日至2011年12月31日报告的AEFI个案数据，采用描述性方法对相关指标进行流行病学分析。结果：河南省2010~2011年共报告AEFI个案2415例，主要集中在郑州市、洛阳市和焦作市（1238例，51.26%）。男女比为1.32∶1，报告AEFI病例年龄以小于1岁为主（799例，33.08％）。发生AEFI的疫苗主要是麻疹疫苗和百白破疫苗，共占61.24%，发生率分别为30.3/10万和5.0/10万，接种剂次以第1剂次为主（1528例，63.27%）。发生AEFI最多的前5种疫苗临床损害以炎症反应和过敏性症状为主，不同疫苗引起的AEFI临床表现不同（χ2=304.5，P<0.001）。2415例AEFI个案中一般反应1946例（80.58%），异常反应348例（14.41%），偶合症98例（4.06%），心因性反应13例（0.51%），不明原因反应10例（0.41%）。AEFI预后良好，治愈率为90.64%。结论：小年龄儿童和首剂接种应得到预防接种服务人员和儿童家长的密切关注。

Abstract:

OBJECTIVE: To analyze the epidemiological features of adverse events following immunization (AEFI) in Henan Province, China and to evaluate the safety of vaccines currently used in Henan. METHODS: The AEFI cases reported in Henan from January 1, 2010 to December 31, 2011 were collected through the China Surveillance System of Information on National Immunization Program. The descriptive method was used for epidemiological analysis. RESULTS: A total of 2415 cases of AEFI were reported in Henan from January 1, 2010 to December 31, 2011, and 1238 (51.26%) of them were found in Zhengzhou, Luoyang, and Jiaozuo cities. The male-to-female ratio was 1.32:1. Seven hundred and ninety-nine (33.08%) of these cases were less than one year old. Measles vaccine and DPT vaccine (against diphtheria, pertussis, and tetanus) were the main causes of AEFI, contributing to 61.24% of cases; the incidence rates of AEFI among people receiving measles and DPT vaccines were 30.3/105 and 5.0/105, respectively. 1528 cases (63.27%) developed AEFI after the first dose of vaccination. Inflammation and allergic symptoms were the predominant adverse effects caused by the top 5 vaccines AEFI-causing vaccines, and the clinical manifestations were significantly different among AEFI cases caused by different vaccines (χ2=304.5, P<0.001). Among the 2415 AEFI cases, 1946 (80.58%) had common adverse reaction, 348 (14.41%) had rare adverse reaction, 98 (4.06%) had coupling disease, 13 (0.51%) had psychogenic reaction, and 10 (0.41%) had reaction for unknown reasons. The prognosis of most AEFI cases was good, with a cure rate as high as 90.64%. CONCLUSIONS: AEFI occurs mostly in young children and after the first dose of vaccination. This should be brought to the attention of vaccination service personnel and the children′s parents.