百白破疫苗接种不良反应的观察及护理

目的 分析百白破疫苗接种不良反应发生的原因并提出预防措施.方法 回顾2009年1～12月共接种百白破疫苗1980人次,其中基础免疫1470人次,加强免疫510人次.对接种过百白破疫苗的儿童进行不良反应的护理观察.结果 接种1980人次中,共发生不良反应149例,主要以发热和局部硬结为主,未见潜在生命威胁的不良反应.结论 预防接种不良反应与受种者的个体差异、接种人员操作技术等有密切关系.增强责任心,规范操作流程,可减少和避免不良反应.     

无细胞百自破疫苗接种安全性观察

目的观察无细胞百白破疫苗不良反应发生率。方法2007年5～8月共接种无细胞百白破疫苗717人次，对接种者进行不良反应观察。结果接种717人次中，共发生不良反应40例，主要以低热为主，无严重不良反应。结论无细胞百白破疫苗安全可靠。     

无细胞百白破疫苗接种安全性观察

目的 观察无细胞百白破疫苗不良反应发生率.方法 2007年5～8月共接种无细胞百白破疫苗717人次,对接种者进行不良反应观察.结果 接种717人次中,共发生不良反应40例,主要以低热为主,无严重不良反应.结论 无细胞百白破疫苗安全可靠.     

百白破疫苗接种不良反应的观察及护理体会

疫苗接种是预防和控制相应传染病最有效、最经济、最简便的公共卫生预防措施。在临床工作中,随着疫苗的广泛应用,预防接种不良反应事件越来越受到关注。为此本院计划免疫门诊2009年1月-2011年12月中,共接种吸附无细胞百白破三联疫苗6920人次,其中基础免疫6035人次、加强免疫885人次,对接种过百白破疫苗者进行预防不良反应的护理观察,分析百白破疫苗不良反应的原因并提出预防措施。     

百白破疫苗接种不良反应的观察及护理干预

目的分析百白破疫苗接种副反应的发生及护理.方法2012年1~12月中,共接种吸附无细胞百白破疫苗3098人,其中基础免疫845人,加强免疫2253人,对接种过百白破疫苗者进行预防不良反应的护理观察.结果接种3098人中,共发生不良反应为52例,主要为低热和中等热为主,有11例儿童发生局部硬结,经及时处理得以恢复.结论预防接种不良反应与受种者的个体差异、接种人员操作技术等有密切关系.加强责任心,规范操作流程,可减少和避免不良反应.     

不同部位接种百白破疫苗不良反应观察体会

目的:观察不同部位接种百白破疫苗后不良反应发生情况,探讨预防及护理对策。方法:将2012年1-6月在本中心接种百白破疫苗的470名儿童随机分为两组,每组235名,其中A组儿童在上臂三角肌肌内注射百白破疫苗,共接种516剂次;B组儿童在臀部外上1/4处肌内注射百白破疫苗,共接种508剂次;观察两组儿童不良反应发生情况。结果:A组儿童发生不良反应38例,发生率为7.36%;B组儿童发生不良反应19例,发生率为3.74%,由此得出臀部接种百白破疫苗的不良反应发生率显著低于上臂三角肌接种疫苗者。结论:臀部接种百白破疫苗的不良反应发生率低、安全性好。     

接种百白破疫苗不良反应监测分析

目的：探讨减少接种百白破疫苗不良反应的有效措施。方法：对2009年1至12月出生的满3个月到2周岁的儿童在汕头市下蓬医院接种百白破疫苗出现的不良反应资料进行统计分析。结果：2009年1至12月共接种百白破疫苗10551人次,发生不良反应1300例,发生率12.32%,其中接种吸附全细胞百白破疫苗疫苗（DTwP）9411人,发生不良反应1255例,占13.36%。接种吸附无细胞百白破疫苗疫苗（DTaP）1140人,发生不良反应45例,发生率3.95%,DTaP明显低于DTwP,差异有统计学意义（Х^2=97.29 P〈0.005）。结论：接种百白破疫苗不良反应发生率较高,因此要改进接种要求,严格掌握禁忌证,接种前疫苗要充分摇匀,做到深部肌肉注射,最好选择不良反应率较低的无细胞百白破疫苗,从而降低接种后不良反应的发生。     

无细胞百白破疫苗接种不良反应的观察及护理

目的：对无细胞百白破疫苗接种者所出现的不良反应发生进行观察,分析发生原因,并提出有效的护理措施。方法：对7750例3个月以上足月健康儿进行预防接种无细胞百白破疫苗的临床资料进行分析。并对接种过无细胞百白破疫苗幼儿进行观察及预防护理工作。结果：7750例预防接种无细胞百白破疫苗幼儿中,有240例出现不良反应,不良反应发生率3.1%。主要症状以低热、情绪烦躁,疲倦为主,未见潜在生命威胁和较为重要的不良反应。结论：在进行无细胞百白破疫苗接种时,接种不良反应多与接种人员操作技术、疫苗的冷链管理,健康教育指导,受种者个体差异等因素有着密切的关系。因此,加强规范操作流程管理,增强责任心,可最大程度地避免或减少无细胞百白破疫苗接种时的不良反应发生。     

儿童接种百白破疫苗发生不良反应护理体会

百白破疫苗是我国现行的计划免疫程序规定的针次最多,使用最广泛的疫苗.回顾2009年1～12月中,对980名幼儿按计划免疫程序进行吸附百白破三联疫苗基础免疫的接种者,接种前后护理体会,现报告如下. 临床资料 一般资料:资料来自我院社区2009年1～12月,接种吸附无细胞百白破疫苗者,共接种980人次,其中基础免疫780人次,加强免疫200人次.     

百白破三联疫苗接种不良反应的观察分析

目的:通过对百白破三联疫苗接种不良反应的观察与分析,掌握其反应特点,为接种前干预和接种后的诊疗过程提供客观依据.方法:对记录在案的220例发生百白破三联疫苗接种不良反应的病例进行归纳总结,并进行描述性分析.结果:共接种百白破三联疫苗5 684人次,发生不良反应220例,占3.87%,并且绝大多数(95%)为一般反应,而加强免疫明显高于基础免疫.结论:加强疫苗规范化接种,可有效减少预防接种不良反应的发生,促进计划免疫的有效实施.     

Adverse reactions to the preschool (fifth) dose of adsorbed diphtheria-pertussis-tetanus vaccine in Canadian children.

OBJECTIVE: To quantify accurately the rate of adverse reactions after the preschool (fifth) dose of adsorbed diphtheria toxoid-pertussis vaccine-tetanus toxoid (DPT) vaccine and to test the hypothesis that large local reactions are attributable to the diphtheria toxoid. DESIGN: Double-blind randomized controlled trial. SETTING: Suburban community public health unit. PARTICIPANTS: Healthy children 4 to 5 years of age with a history of having received four doses of adsorbed DPT vaccine. INTERVENTIONS: Subjects were given either the standard DPT vaccine (with 25 Lf units of diphtheria toxoid) or a modified DPT vaccine (with 10 Lf units of diphtheria toxoid). They were assessed 24 hours later by a nurse. Serum samples obtained before vaccination were tested for diphtheria and tetanus antitoxin levels by means of neutralization assay and enzyme-linked immunosorbent assay. MAIN OUTCOME MEASURES: Rates of large local reactions (an area of redness or swelling or both of 5 cm or greater) 24 hours after vaccination in the two groups. Relation between serum antitoxin levels before vaccination and the rate of large local reactions in each group. RESULTS: Of the 250 subjects enrolled 124 received the standard vaccine and 126 the modified one. Large local reactions occurred in 71% of the subjects receiving the standard vaccine and 52% of those receiving the modified one (p less than 0.01). In the former group large erythematous reactions occurred significantly more often in those with an elevated prevaccination diphtheria antitoxin level than in those without an elevated level; no relation was found between such reactions and the prevaccination tetanus antitoxin level. Reduced arm movement was evident in 45% of the children in the two groups. Few had systemic adverse reactions. CONCLUSIONS: Large local reactions occur frequently after the preschool administration of the DPT vaccine. These reactions are uncomfortable but not serious. They result in part from the large amount of diphtheria toxoid in the standard DPT vaccine.     

Role of whole-cell pertussis vaccine in severe local reactions to the preschool (fifth) dose of diphtheria-pertussis-tetanus vaccine.

OBJECTIVE: To estimate the contribution of whole-cell pertussis vaccine to severe local reactions after the preschool (fifth) dose of adsorbed diphtheria toxoid-pertussis vaccine-tetanus toxoid (DPT) vaccine. DESIGN: Double-blind randomized controlled trial. SETTING: Urban community. PARTICIPANTS: Volunteer sample of 200 healthy children 4 to 6 years old who were eligible for the fifth dose of DPT vaccine. INTERVENTIONS: Children received, in both arms, either diphtheria toxoid-tetanus toxoid (DT) and monovalent pertussis vaccines (group A, 99 children) or DPT and meningococcal vaccines (group B, 101 children). All were licensed products from single lots. The children were assessed 24 hours later by a trained observer. Serum samples obtained before vaccination were tested for antibodies to tetanus and diphtheria toxins and five pertussis antigens by means of enzyme-linked immunosorbent assay. MAIN OUTCOME MEASURES: Rates of severe local reactions (an area of redness or swelling or both of 50 mm or greater) 24 hours after vaccination. Relation between serum antibody levels before vaccination and rates of severe local reactions to corresponding vaccines. RESULTS: All of the subjects were followed up 24 hours after vaccination. Severe redness was present in 38% given DPT vaccine, 29% given intramuscular pertussis vaccine and 9% given DT vaccine (p < or = 0.002, three-way comparison). Severe swelling was common after vaccination with all three products. After intramuscular pertussis vaccination a relation was evident between the prevaccination levels of antibody to whole-cell pertussis bacteria and the rates of redness (p < 0.02) but not between the prevaccination subcellular antibody levels and the rates of redness. CONCLUSION: That pertussis vaccine resembled the DPT vaccine in causing severe redness suggests that it is the principal cause of such reactions after DPT vaccination. The DT vaccine was also reactogenic; thus, cumulative sensitization to one or more of its constituents may be a factor.     

护理干预对儿童免疫接种百白破疫苗不良反应的影响分析

目的探讨护理干预对儿童免疫接种百白破疫苗不良反应的影响。方法选择我院免疫接种百白破疫苗的健康儿童320例,将其平均分为研究组与对照组。对照组儿童采取常规护理措施,研究组儿童在接种前及接种后采取针对性的护理干预,并于接种后6h给予热水湿热敷。结果通过相应的护理干预后,研究组14 d内百白破疫苗免疫接种的不良反应率为1.88%,明显低于对照组的9.38%（P〈0.05）。结论采取针对性的护理干预,可以有效降低百白破疫苗接种的不良反应,保障儿童的健康质量,适于临床广泛开展应用。     

Reactogenicity of fluid compared with adsorbed diphtheria-pertussis-tetanus vaccine

Shortly after the introduction of adsorbed diphtheria-pertussis-tetanus (DPT) vaccine in British Columbia the frequency of reports of reactions to the vaccine increased. As the reasons for the increase were not clear a study was carried out in five health units to compare the reactions to adsorbed DPT vaccine manufactured by Wyeth Ltd. and Connaught Laboratories Ltd. and fluid DPT vaccines manufactured by Connaught, all the vaccines being injected in the anterolateral thigh. From the responses on 1619 questionnaires that the parents of vaccinated children had completed it was found that the relative risk of a reaction was higher with the fluid than with the adsorbed Connaught vaccine (1.7 for redness and 1.8 for swelling on the day of vaccination but 1.0 for drowsiness and 1.3 for persistent crying). The size and duration of local redness and swelling were also greater with the fluid than with the adsorbed Connaught vaccines. The results with the Wyeth and Connaught vaccine were very similar. Only 10% of the parents said that there had been no reaction; 9% said that the reaction was severe, and 6% said that it was completely unacceptable. The overall frequency of local reactions was 86.1%.     

Comparison of adverse reactions to whole-virion and split-virion influenza vaccines in hospital personnel.

OBJECTIVE: To compare the adverse effects, particularly generalized aching, of a trivalent, inactivated whole-virion vaccine (WVV) and split-virion vaccine (SVV) for influenza in hospital personnel. DESIGN: Recipient-blinded study; first-time vaccinees were randomly assigned to receive either of the vaccines from one manufacturer in the 1989-90 influenza season. Subjects were asked to complete a symptom questionnaire during the 48 hours after immunization. SETTING: Annual influenza program for staff of a tertiary care children's hospital. PARTICIPANTS: Volunteers were sought among approximately 2200 members of the hospital staff. Of the 358 vaccinated for the first time, 333 (93%) returned the questionnaire. RESULTS: During the 48 hours after vaccination 13% of the SVV recipients reported generalized aching, as compared with 26% of the WVV recipients (p less than 0.01). Also, the SVV group reported fewer visible local reactions and more transient arm soreness, but the actual differences between the two groups were small. The occurrence of mild symptoms was equally common in the two groups (local reactions in at least 70% of cases, systemic reactions in at least 33%). In each group 1% of the subjects reported missing work because of the vaccination. CONCLUSIONS: The use of SVV reduces the rate of the most objectionable of the common adverse effects of influenza vaccination. Therefore, as with children, it might be more acceptable to health care workers than the current use of WVV.     

Local reactions after the fourth dose of acellular pertussis vaccine in South Australia

OBJECTIVE: To assess the reported rate of local reactions after administration of acellular pertussis vaccine (DTPa) according to dose number and type of pertussis vaccine (whole-cell or acellular) used for the primary course, and to document the severity and outcome of fourth-dose local reactions. DESIGN AND SETTING: Retrospective review. Reports of adverse events after vaccination in South Australia between 1 January 1997 and 31 December 2000 were reviewed, and a questionnaire administered to all parents who reported a local reaction after the fourth dose of DTPa. MAIN OUTCOME MEASURES: The number, and rate per 100 000 administered doses, of local reactions following the primary and booster doses of DTPa, and of local reactions after the fourth-dose in cohorts of children whose primary vaccinations were with either DTPw or DTPa. Redness and/or swelling at the injection site as reported by parents. RESULTS: Of 581 reported adverse events after vaccination, 138 were local reactions after a pertussis-containing vaccine. Primary vaccinations with DTPa was a significant risk factor for a fourth-dose local reaction (relative risk, 6.7; 95% CI, 2.4-18.5). Parental questionnaires were completed for 45 of the 71 children (63%) with reported local reactions after the fourth dose of DTPa; extensive limb swelling was reported in 8 children (18%) and all except one child had recovered by the time of review. CONCLUSIONS: Parents should be informed that children receiving booster doses of DTPa vaccine, after primary doses with DTPa, are at increased risk of local reactions (which tend to resolve spontaneously) but not of systemic effects. Studies should be initiated to investigate the pathogenesis and the risk of recurrence of local reactions to further improve vaccination schedules.     

佛山市三水区2016—2019年疑似预防接种异常反应监测分析

  目的  分析佛山市三水区疑似预防接种异常反应(AEFI)发生率,掌握接种疫苗的安全性,为免疫规划管理提供依据。  方法  通过中国免疫规划信息系统收集2016—2019年佛山市三水区报告的疑似预防接种异常反应个案,采用Excel和SPSS 17.0统计学软件进行描述性分析。  结果  2016—2019年三水区共报告AEFI个案437例,年均报告发生率为30.29/10万剂次,一般反应332例(占73.68%),异常反应76例(占17.39%),未报告过疫苗质量事故、接种事故和心因性反应,报告个案的性别比为1.5 9∶ 1,以1岁以下年龄组报告数最多,≥7岁组最少,1岁以下AEFI报告病例中,8月龄儿童占比最高,达22.78%;接种疫苗到发生疑似预防接种异常反应间隔时间以接种后12 h内占比最高(64.76%);所有报告AEFI共涉及27种疫苗,报告发生率居前3位的疫苗为:23价肺炎疫苗、麻风疫苗、无细胞百白破疫苗;其中异常反应发生率居前3位的疫苗为:麻风疫苗、四价HPV疫苗、23价肺炎疫苗;发生的异常反应前3位分别为过敏反应-荨麻疹26例(34.21%);过敏性皮疹17例(22.37%);过敏反应-斑丘疹12例(15.79%)。  结论  2016—2019年佛山市三水区AEFI监测各项指标均达到监测方案要求,系统运转正常,AEFI监测结果在一定程度上反映了疫苗的安全性,尤其需关注报告发生率居前的疫苗,有必要持续加强AEFI监测,进一步提高监测系统的敏感性和上报及时性。      

辽宁省葫芦岛市2013~2016年疑似预防接种异常反应监测分析

目的:分析葫芦岛市2013~2016年疑似预防接种异常反应(AEFI)发生特点,对AEFI监测系统的运行情况及预防接种疫苗安全性进行评估.方法:采用描述性方法对AEFI监测系统收集的2013-2016年AEFI病例进行流行病学分析.结果:2013年1月~2016年12月葫芦岛市共接种疫苗(包括一类及二类疫苗)1845803剂次,AEFI上报198例,报告发生率10.73/10万.其中一般反应197例占99.5%,在各种接种疫苗中AEFI发生率以狂犬病(Vero冻干)(52.04/10万)、白破(41.85/10万)、百白破(无细胞)(33.32/10万)及流脑A群(26.53/10万)分居前四位;AEFI病例报告数量构成比百白破(无细胞)(46.19%)、流脑A群(12.18%)乙脑(减毒)(9.14%)以及麻风(7.61%)分居前4位;葫芦岛市共辖6个县区,6个县区均通过AEFI信息管理系统报告了病例,其中建昌县报告最多占38.89%,兴城市最少占2.53%.以县区为单位报告覆盖率100%,达到国家要求的100%指标;以乡镇级为单位报告覆盖率28.07%;葫芦岛市198例AEFI病例以红肿87例(43.94%)、发热58例(29.29%)及硬节46例(23.23%)多见,男性(56.57%)高于女性(43.43%),以0~1岁幼儿为主(68.69%),夏季为高发期(41.41%),多在48h内出现不良反应(85.86%).结论:AEFI监测对保障预防接种的安全性有重要的意义.     

德庆县2009～2011年疑似预防接种异常反应监测数据分析

目的了解德庆县疑似预防接种异常反应报告情况,分析预防接种的安全性及工作质量。方法采用描述性流行病学方法对德庆县2009～2011年报告的疑似预防接种异常反应资料进行分析。结果2009－2011年德庆县报告疑似预防接种异常反应病例170例,AEFI报告发生率为20．99／10万剂次。反应分类构成为一般反应占72．94％（15．31／10万剂次）、异常反应占24．12％（5．06／10万剂次）、偶合反应占2．94％（0．62／10万剂次）。全县接种单位报告覆盖率为61．54％（8／13）,病例报告男女比例为1．13：1,年龄分布以1岁以下年龄组较多（47．06％）,主要报告月份为3～8月份,报告反应时间较多发生在1d内（67．06％）;AEFI涉及25种疫苗,第一类疫苗AEFI报告发生率以全细胞百白破疫苗（212．12／10万剂次）、无细胞百白破疫苗（43．11／10万剂次）、麻风疫苗（29．07／10万剂次）居前3位;第二类疫苗AEFI报告发生率以甲乙肝联合疫苗（225．56／10万剂次）、23价肺炎疫苗（164．38／10万剂次）、甲肝灭活疫苗（115．42／10万剂次）居前3位。一类疫苗的报告发生率17．57／10万剂次,二类疫苗为37．58／10万剂次,两者比较差异无统计学意义（χ^2=2．75,P=0．10）。一般反应中以发热（53．23％）、局部红肿硬结（30．65％）为主;异常反应中以过敏性皮疹（56．10％）为主;偶合反应以上呼吸道感染较多。结论德庆县预防接种的安全性和工作质量较好,规范实施预防接种,减少预防接种异常反应的发生及其负面影响。促进提高预防接种工作质量。