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目的分析芜湖市疑似预防接种异常反应(AEFI)的发生特征,评价AEFI监测系统运转情况、预防接种质量和疫苗安全性,探讨AEFI防范措施。方法通过疑似预防接种异常反应信息管理系统收集全市2010-2012年AEFI个案数据,采用描述性方法对AEFI监测的相关指标进行流行病学分析。结果 2010~2012年全市共报告AEFI 308例,其中一般反应257例(83.44%),异常反应49例(15.91%),偶合症2例(0.65%)。各县均有AEFI报告县与预防接种门诊AEFI报告覆盖率分别为100.00%、93.55%;48h内报告率为97.40%,48h内调查率为100.00%。81.82%的AEFI发生于疫苗接种后1d内。89.94%的AEFI发生于0~2岁及6岁儿童。临床诊断以发热、红肿、硬结及过敏性反应为主。AEFI报告发生率为12.10/10万,其中一般反应为10.10/10万,异常反应为1.93/10万。85.06%的AEFI发生于国家免疫规划(NIP)疫苗,69.81%的AEFI发生于第一剂次疫苗接种;不良反应发生较多的疫苗分别为无细胞百白破疫苗(39.29%)、白破疫苗(15.26%)、A+C群流脑结合疫苗(7.79%)、23价肺炎疫苗(5.19%)、麻风疫苗(4.87%)。NIP疫苗与第二类疫苗的一般反应与异常反应发生率差异无统计学意义(χ2一般反应=2.29,P>0.05;χ2异常反应=0.46,P>0.05)。结论目前芜湖市AEFI监测系统运行状况良好,AEFI监测较为敏感。
Objective To analyze the occurrence characteristics of suspected AEFI in Wuhu City, evaluate the operation of AEFI monitoring system, prevent the vaccination quality and vaccine safety, and discuss the preventive measures against AEFI. Methods AEFI data collection system was used to collect the data of AEFI cases in the city from 2010 to 2012 and the descriptive method was used to carry out epidemiological analysis on the related indicators of AEFI monitoring. Results A total of 308 AEFI cases were reported in the city from 2010 to 2012, including 257 cases (83.44%) of which were general reactions, 49 cases (15.91%) of abnormal reactions and 2 cases (0.65%) of complications. The coverage of AEFI reports in both counties and vaccination clinics in counties was 100.00% and 93.55% respectively; the report rate was 97.40% in 48h and 100.00% in 48h. 81.82% of AEFI occurred within 1 day after vaccination. 89.94% of AEFI occurred in children aged 0 ~ 2 and 6 years old. Clinical diagnosis of fever, swelling, induration and allergic reactions based. The incidence of AEFI was 12.10 / 100,000, with a general response of 10.10 / 100,000 and an anomalous response of 1.93 / 100,000. 85.06% of AEFI occurred in the national immunization program (NIP) vaccine, 69.81% of AEFI occurred in the first dose of vaccination; the more adverse reactions occurred in the vaccine were acellular diphtheriae vaccine (39.29%), (15.26%), A + C group ECM vaccine (7.79%), 23 pneumococcal vaccine (5.19%) and leprosy vaccine (4.87%). There was no significant difference in the incidences of general and abnormal reactions between the NIP vaccine and the second type of vaccine (χ 2 general response = 2.29, P> 0.05; χ 2 abnormal response = 0.46, P> 0.05). Conclusion At present, the AEFI monitoring system in Wuhu City is in good condition and the AEFI monitoring is more sensitive.