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目的分析8～10月龄儿童麻疹减毒活疫苗(measles attenuated live vaccine,MV)接种后疑似预防接种异常反应(adverse events following immunization,AEFI)监测的敏感性和MV主要AEFI临床危害。方法通过中国免疫规划监测信息管理系统和儿童预防接种信息管理系统,收集2009—2011年丹阳市8~10月龄儿童MV AEFI常规监测个案数据;实施30 d内全程主动监测,收集240例8～10月龄MV AEFI个案数据。采用描述性方法进行流行病学分析。结果 2009至2011年,常规监测系统首剂MV AEFI报告发生率为926.45/10万,主动监测240名8～10月龄儿童首剂MV接种后AEFI发生率30 416.67/10万,差异有统计学意义(χ2=1 767.41,P<0.01);2种监测方法所报告MV AEFI发生的时间在接种后3 d内的构成比有明显差异,差异有统计学意义(χ2=179.44,P<0.01);MVAEFI多以发热、皮疹为主,常规监测反映的症状多出现在3 d以内,主动监测则多在4 d以后发生,≥8 d的占近40%,2种监测反映的症状发生的时间间隔差异有统计学意义(χ2=143.82,P<0.01)。结论提高MV AEFI监测的敏感性、科学性有利于客观反映的安全性有利于消除麻疹的目标实现。
Objective To analyze the sensitivity of suspected AEFI surveillance after measles attenuated live vaccine (MV) vaccination in children aged 8-10 months and the clinical risk of MV primary AEFI. Methods The data of routine monitoring of MV AEFI in children aged 8 ~ 10 months in Danyang from 2009 to 2011 were collected through the information system of China immunization program monitoring and information system of vaccination of children. The data of 240 cases of 8 ~ 10-month MV AEFI case data. Descriptive methods were used for epidemiological analysis. Results From 2009 to 2011, the MVAEFI report of the first dose of routine monitoring system was 926.45 / 100000, and the incidence of AEFI was 30 416.67 / 100 000 in 240 children aged 8-10 months who were vaccinated with the first dose of MV AEFI. The difference was statistically significant (Χ2 = 1767.41, P <0.01). There was a significant difference in the constituent ratios of MV AEFI reported by the two monitoring methods within 3 days after inoculation (χ2 = 179.44, P <0.01) ; MVAEFI mostly fever, skin rash, conventional monitoring reflect the symptoms appear more than 3 d, take the initiative to monitor the more occurred after 4 d, ≥ 8 d accounted for nearly 40%, 2 kinds of monitoring reflect the time of onset of symptoms The difference was statistically significant (χ2 = 143.82, P <0.01). CONCLUSIONS To improve the sensitivity of MV AEFI monitoring, the scientificity that is objective to reflect the safety is conducive to eliminating the target of measles.