天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (11): 1330-1333.doi: 10.11958/j.issn.0253-9896.2015.11.029

• 流行病学调查 • 上一篇    下一篇

天津市 2011—2013 年疑似预防接种异常反应主动监测分析与被动监测评价

李永成 1， 张颖 1△， 高志刚 1， 刘红英 2， 胡强 3， 韩永刚 4， 常利民 5#br#   

  1. 1天津市疾病预防控制中心传染病控制所 （邮编300011）； 2天津市河北区疾病预防控制中心； 3天津市津南区疾病预防控制中心； 4天津市滨海新区大港疾病预防控制中心； 5天津市宁河县疾病预防控制中心
  • 收稿日期:2015-01-04 修回日期:2015-05-19 出版日期:2015-11-15 发布日期:2015-11-15
  • 通讯作者: 张颖 E-mail： tjcdcaefi@163.com E-mail:tjcdcaefi@163.com
  • 作者简介:李永成 （1971）， 男， 硕士， 副主任医师， 主要从事传染病控制、 免疫规划方面的研究

Analysis of adverse events following immunization in Tianjin (2011-2013) evaluated by active surveillance and passive surveillance#br#

LI Yongcheng1， ZHANG Ying1△， GAO Zhigang1， LIU Hongying2， HU Qiang3， HAN Yonggang4, CHANG Limin5   

  1. 1 Tianjin Center for Disease Control and Prevention, Tianjin 300011, China; 2 Tianjin Hebei District Center for Disease Control and Prevention; 3 Tianjin Jinnan District Center for Disease Control and Prevention; 4 Tianjin Binhai District Dagang Center for Disease Control and Prevention;5 Tianjin Ninghe Country Center for Disease Control and Prevention
  • Received:2015-01-04 Revised:2015-05-19 Published:2015-11-15 Online:2015-11-15
  • Contact: ZHANG Ying E-mail： tjcdcaefi@163.com E-mail:tjcdcaefi@163.com

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摘要： 目的 分析天津市疑似预防接种异常反应 （AEFI） 主动监测数据的发生特征， 评价同期被动监测系统的敏感性。方法 2011—2013 年， 分层选择 4 个区县的 8 家接种门诊作为主动监测点， 通过主动回访收集到的 AEFI 为主动监测 AEFI 数据， 通过全国信息系统收集全市范围自愿就医的被动监测数据。组织 AEFI 调查诊断专家组对除明确诊断为一般反应以外的 AEFI 开展调查诊断分类。结果 共有效主动监测 32 698 例， AEFI 病例 235 例， 发生率为
 718.70/10 万剂。3 年间 AEFI 主动监测发生率差异无统计学意义（849.01/10 万剂 vs 599.32/10 万剂 vs 686.72/10万剂， χ2=5.07）； 被动监测 AEFI 4 164 例， 发生率为 34.09/10 万剂； 3 年间 AEFI 被动监测发生率逐年上升（20.05/10万剂 vs 31.35/10 万剂 vs 50.51/10 万剂， χ2=572.02， P < 0.05）； 各年度主动监测 AEFI 发生率均高于被动监测（均 P <0.05）。主动监测 AEFI 的一般反应所占比例（95.32%）高于被动监测（85.09%）， 异常反应低于被动监测（3.83% vs13.32%， 均 P < 0.05）， 偶合症、 心因性反应差异均无统计学意义。二者均未监测到疫苗质量事故和接种事故， AEFI发生率居前 5 位的疫苗中均有 7 价肺炎、 麻疹、 进口百白破疫苗。结论 AEFI 主动监测可发现更多的轻微一般反应， 天津市被动监测系统的敏感性逐年上升， 能够满足工作需求。应建立针对严重 AEFI 病例的统一分类诊断标准。

关键词: 疫苗, 疑似预防接种异常反应, 主动监测, 被动监测, 天津

Abstract: Objective To analyze the occurrence features of the active surveillance of adverse events following immunization (AEFI) in Tianjin, and evaluate the sensitivity of passive surveillance systems over the same period. Methods The layered eight vaccination clinics of four counties were selected as active surveillance points. The data of active surveillance AEFI were collected through telephone investigation in 2011-2013. The data of passive surveillance was collected through the national AEFI information management system. The descriptive methodology and chi square test were used. Results A total of 235 cases were collected through active surveillance in 2011-2013. The AEFI incidence rate was 718.70 per 100 000 doses， no difference in the incidence between three years（χ2=5.07). A total of 4164 cases were collected through passive surveillance. The incidence rate was 34.09 per 100 000 doses， the incidence increased year by year（χ2=572.02， P < 0.05). In active surveillance cases, 95.32% was the common vaccine reaction, 3.83% was the rare vaccine reaction, no serious vaccine reaction. In passive surveillance cases, the common vaccine reaction, the rare vaccine reaction were 85.09% and 13.32%. The serious vaccine reaction was found in 44 cases. Conclusion The more slightly common vaccine reaction can be found by active surveillance. The sensitivity of Tianjin passive surveillance system is increasing year by year, which can meet the requirements for job. The classification and diagnostic criteria of the serious vaccine reaction need to be established.

Key words: vaccines, adverse events following immunization, active surveillance, passive surveillance, Tianjin