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目的分析2005-2010年常州市疑似预防接种异常反应(AEFI)的发生特征,评价AEFI监测系统运转情况和疫苗的安全性。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。结果全市累计报告AEFI个案1 997例,涉及疫苗32种,其中报告最多的是无细胞百白破(DPT)疫苗(24.79%)。各年报告发生率在预期发生率范围之内。接种第一剂疫苗后发生的AEFI占57.84%。反应发生在接种后0~1 d的占89.23%。一般反应最多占81.62%;其次为异常反应占15.77%。临床诊断发热/红肿/硬结最多,占74.06%;其次为过敏性皮疹占13.52%。结论常州市AEFI监测敏感性虽逐年提高但仍然较低,全市监测系统运转正常,社会上所使用的疫苗安全性和预防接种服务质量良好。要加强对临床医生的相关知识培训,政府应进一步完善AEFI补偿机制。
Objective To analyze the occurrence characteristics of suspected immunization anomalous response (AEFI) in Changzhou from 2005 to 2010 and evaluate the operation of AEFI monitoring system and the safety of the vaccine. Methods The data of AEFI cases were collected through the China Immune Program Monitoring Information Management System and the descriptive method was used to carry out epidemiological analysis of related indicators. Results A total of 1 997 AEFI cases were reported in the city, involving 32 kinds of vaccines. The most reported cases were DPT (24.79%). The annual incidence of the report is within the expected rate of occurrence. AEFI occurred after vaccination with the first dose of 57.84%. The reaction took place at 0 to 1 day after inoculation, accounting for 89.23%. The most common reactions accounted for 81.62%; followed by abnormal reactions accounted for 15.77%. Clinical diagnosis of fever / swelling / induration most, accounting for 74.06%; followed by allergic skin rash 13.52%. Conclusion Although the sensitivity of AEFI monitoring in Changzhou City has been increasing year by year, it is still low. The surveillance system in the city is in normal operation. The safety of vaccines used in the community and the quality of vaccination services are good. To strengthen the training of clinicians, the government should further improve the AEFI compensation mechanism.