接种白破二联疫苗后发生过敏性紫癜1例报告

近年来,随着预防接种的普及,接种后引起或偶合过敏性紫癜的现象时有发生.现将我市2004年接种"白破"二联疫苗(以下简称白破疫苗)后发生的1例过敏性紫癜的事件报道分析如下.     

宜兴市白破二联苗免疫成功率监测结果分析

白破二联苗是国家免疫程序规划的疫苗，由于白破二联苗接种0．5ml剂量的不良反应较多，故江苏省将白破二联苗的接种剂量调整为0．25ml，为了解接种2种不同剂量白破二联苗后的免疫效果，我们在宜兴市市丁蜀镇开展此项监测，现将结果报告如下。     

护理干预对吸附白喉破伤风联合疫苗接种后不良反应发生率的影响

目的护理干预对吸附白喉破伤风联合疫苗(白破二联疫苗)接种后不良反应发生率的影响。方法 2010年1月淄博市张店区中埠镇卫生院接种门诊对辖区内6-12岁无接种禁忌的460名在校小学生进行白破二联疫苗的强化免疫接种,随机分为对照组和观察组各230名,对照组接种前后进行常规护理,观察组在对照组基础上给予针对性护理干预。比较两组接种不良反应发生率。计数资料采用χ2检验,P<0.05为差异有统计学意义。结果不良反应对照组轻度7例,中度3例,重度1例,不良反应发生率4.78%;观察组轻度2例,中度1例,重度0例,不良反应发生率1.30%。两组比较差异有统计学意义(χ2=4.71,P<0.05)。结论儿童在接种白破二联疫苗前后给予针对性护理干预,可有效降低预防接种不良反应的发生率。     

一起白破二联制剂与A群流脑多糖体疫苗混合接种引起反应的处理

20 0 0年 12月 ,某幼儿园进行适龄儿童Ａ群流脑多糖体疫苗 (流脑疫苗 )加强免疫 ,误用白喉、破伤风类毒素二联制剂 (白破二联制剂 )作稀释液使用 ,皮下接种 0 5ｍｌ/人 ,7人接种 ,5人发生反应 ,经及时对症处理均恢复正常。1　事件经过2 0 0 0年 12月进行流脑疫苗免疫时 ,某乡镇医院将9月份剩余的几支白破二联制剂与流脑疫苗稀释液混放退回防疫站 ,后被某幼儿园领取 ,幼儿园医生接种时没有认真核对 ,将白破二联制剂误作流脑疫苗稀释液使用。本次所用疫苗及制剂均为上海生物制品研究所生产 ,批号 990 30 4 1的流脑疫苗 ,有效期为 2 0 0 1 3,…     

接种白破二联疫苗致血管性水肿一例报告

某镇卫生院预防接种门诊在一次对辖区内6岁组儿童进行白破二联疫苗加强免疫后,发生1例血管性水肿病例,现报告如下。1病例资料患儿,男,2000年2月23日出生,既往无药物过敏史,近期未患病,无服药史。2006年9月16日在当地卫生院预防接种门诊由专业人员肌内注射白破二联疫苗(武汉生物     

接种精白,白破二联疫苗诱发集体精神性反应的调查

1997年9月24日上午，江苏省邳州市徐塘乡二庙小学一、四年级分别接种精制白喉类毒素疫苗（以下简称精白疫苗）、精制白喉、破伤风二联疫苗（以下简称白破二联疫苗）后，诱发一起集体性精神性反应，现将调查结果报道如下。l流行病学调查结果l．且发病经过与强度lop年9月四日上午，该乡防保站组织接种组对二庙小学一、四年级学生分别接种精白、白破二联疫苗，接种前未向班主任及学生作宣传解释、体检及了解病史，一（2）班男生耿某（8岁）在接种精白疫苗半小时后自诉头晕、恶心、腹部不适，10余分钟后有10余名学生出现类似症状，下课后其它班…     

江苏省健康学生人群白破二联疫苗血清学效果监测

目的了解江苏省健康学生人群白喉、破伤风免疫状况,评价江苏省吸附精制白破二联制剂疫苗(DT)的全量和半量免疫效果。方法用白喉、破伤风间接血凝方法,进行白喉、破伤风免疫成功率监测。结果2006年全省426份健康学生人群白喉全量和半量免疫成功率分别为99.01%和98.21%、破伤风全量和半量免疫成功率分别为100.0%、99.09%,全量和半量免疫差异无显著性(P>0.05)。结论江苏省健康学生人群对白喉、破伤风已经形成了较好的免疫屏障,使用吸附白破二联疫苗半量0.25ml注射可以减少预防接种的不良反应发生。     

塔什库尔干县接种麻疹、白喉破伤风类毒素引起副反应的调查报告

塔什库尔干县2002年5月对171名儿童接种麻疹、白喉破伤风类毒素(以下简称白破二联)疫苗后，有34名学生发生副反应，现将结果报告如下。     

2009～2010年潍坊市6～12岁儿童吸附白喉破伤风联合疫苗漏种补种情况调查

[目的]了解潍坊市吸附白喉破伤风联合疫苗(白破二联疫苗)漏种与补种情况,为降低白喉、破伤风发病提供科学依据。[方法]2009～2010年,对潍坊市1997年1月1日至2002年12月31日出生的儿童进行调查,对未接种者进行补种。[结果]调查目标儿童510 990人,查出漏种白破二联疫苗的240 255人,漏种率为47.02%,补种229 209人,补种率为95.40%。其中常住儿童漏种232 630人,补种221 874人,补种率为95.38%;流动儿童漏种7 625人,补种7 335人,补种率为96.20%。[结论]潍坊市6～12岁儿童白破二联疫苗漏种率较高,本次补种率达到95%以上。     

一起小学生接种麻疹疫苗后的群体性癔病反应报告

2004年4月2日,济宁市某县某镇某小学发生了一起小学生接种麻疹疫苗后的群体性癔病反应,现将有关情况报告如下:一、接种情况和反应发生经过为进一步做好在校小学生麻疹疫苗和白破二联疫苗的接种工作,保护儿童身体健康,根据省市有关     

Spontaneously reported adverse reactions after diphtheria-tetanus revaccination at 4-6 years of age--a comparison of two vaccines with different amounts of diphtheria toxoid

On 1 January 1996, diphtheria-tetanus revaccination at the age of 5 years was implemented in the Danish Childhood Vaccination Programme. Initially, a combined DT vaccine containing 25 Lf diphtheria toxoid was used. Due to a high frequency of spontaneously reported adverse reactions, however, concerns were raised that the diphtheria dose was too high, and it was reduced to 6.25 Lf. This survey presents the rates of spontaneously reported adverse reactions following diphtheria-tetanus revaccinations of 4-6-year-old from 1996 to 2002. The change to the lower dose of diphtheria toxoid resulted in a remarkable reduction in the yearly rates of injection site reactions: in 1996, the rate was 180 injection site reactions per 100,000 vaccinations; from 1998 to 2002, this changed to between 12 and 24 reactions per 100,000 vaccinations. Furthermore, the rates of systemic reactions such as fever were reduced.     

Dermal testing of vaccines for children at high risk of allergies

Vaccinations for children with allergic diseases often need to be postponed or terminated because of the presumed risk of an immediate-type allergic reaction such as anaphylaxis. A new skin test protocol for predicting allergic reactions using the vaccine itself and the following stepwise vaccination method were developed and tested. Intradermal tests using 1:10 and 1:100 diluted measles vaccine indicated that the former was superior to the latter because a positive reaction against 1:10 diluted vaccine was found in 28.6% of 49 patients with severe allergic diseases including bronchial asthma, atopic dermatitis, food allergies and allergies to two or more allergens with high levels of IgE, as compared with the reaction against 1:100 diluted vaccine in 10.2% of the patients. Patients negative for 1:10 skin tests were safe from the following full-dose vaccine shots. Three patients showed very strong local reactions against measles vaccine, and avoided receiving the following full-dose shot. Positive reactions to skin tests of 1:10 diluted vaccine were found in 11 patients, who were given stepwise vaccinations. Three patients had adverse reactions, and two of them had been negative for 1:100 skin tests. In the case of influenza vaccine, skin tests were again more sensitive to 1:10 than to 1:100 diluted vaccine, because 3 out of 14 patients with positive reactions showed immediate-type adverse reactions against the following stepwise vaccinations, and 1 of them was negative for the 1:100 skin test. Moreover, the results of the skin prick test (undiluted vaccine) and the intradermal skin test (1:10 diluted vaccine) indicated that the latter was more useful in both cases of measles (54 patients) and influenza vaccine (69 patients). Overall, the skin test using 1:10 diluted vaccine was the more suitable for predicting an immediate-type reaction to measles and influenza vaccinations. Patients having negative 1:10 skin tests can be expected to show no adverse reactions to the remaining injections and even the positive subjects will complete the course of vaccine doses by the stepwise method.     

儿童麻疹疫苗初免后不良反应回顾性调查

目的了解常熟市儿童初次免疫麻疹疫苗后的不良反应,进一步做好接种前告知工作,提高麻疹疫苗接种率。方法对麻疹疫苗注射儿童监护人进行回顾性问卷调查。结果共调查567名儿童,有136人发生不良反应,发生率为23．99％;接种后第5—8天发生者最多,占73．53％;出现发热兼皮疹症状最多,占57．35％。结论儿童初免麻疹疫苗后有一定的不良反应,发现较严重的反应及时对症处理;期待开发研制新型免疫原性好、免疫持久性好而不良反应少的麻疹疫苗。     

2008-2014年江苏省b型流感嗜血杆菌疫苗预防接种不良反应监测分析

摘要:目的　分析江苏省2008-2014年b型流感嗜血杆菌（Hib）疫苗预防接种不良反应的发生特征,评价Hib疫苗预防接种的安全性。方法　通过疑似预防接种异常反应信息管理系统和江苏省预防接种个案信息管理系统,收集江苏省2008-2014年报告的Hib疫苗不良反应个案数据和Hib疫苗接种数据,采用描述流行病学方法对相关指标进行分析。结果　2008-2014年江苏省共报告Hib疫苗不良反应5352例,平均报告发生率为77.98/10万剂,其中严重异常报告发生率为0.13/10万剂。所有不良反应中,一般反应4979例,占93.03%;异常反应373例,占6.97%。男、女性别比为1.51∶1,主要集中在≤1岁儿童和首剂接种后。一般反应的主要症状为发热、局部红肿和局部硬结,异常反应的诊断主要为过敏性皮疹。不良反应集中在接种后≤1d。结论　Hib疫苗不良反应以发热、红肿、硬结和过敏性皮疹为主,发生时间主要集中在接种后≤1 d。Hib疫苗具有较好的预防接种安全性,但仍需关注预防接种后急性过敏反应的发生信号。     

国产冻干水痘减毒活疫苗的安全性及免疫原性观察

目的观察国产冻干水痘减毒活疫苗（Varicella Attenuated Live Vaccine,Freeze-dried;VarV）的安全性及免疫原性。方法对未感染水痘-带状疱疹病毒、1～13岁健康儿童,接种国产VarV进行安全性观察,应用膜免疫荧光抗体方法检测水痘抗体。结果观察对象接种后30min和4h、24h、48h、72h的不良反应发生率,分别为2.29%、3.69%、3.82%、1.78%、0.25%,6周后无不良反应报告。总发热反应率为3.82%,注射部位红肿反应发生率为3.69%,局部硬结发生率为0.64%。VarV免疫后,免疫成功率为98.3%,免疫前、后抗体几何平均滴度增长明显。结论国产VarV临床反应轻微,安全性和免疫原性良好。     

2015 - 2017年无锡市含无细胞百白破成分疫苗预防接种安全性评价

目的 评价无锡市无细胞百白破疫苗（DTaP）和无细胞百白破-灭活脊髓灰质炎- b型流感嗜血杆菌联合疫苗（DTaP - IPV - Hib）的预防接种安全性。方法 分别通过中国AEFI监测信息管理系统和无锡市免疫规划信息管理系统收集AEFI监测数据和疫苗接种数据，采用描述性流行病学方法对2015 - 2017年无锡市的DTaP和DTaP - IPV - Hib接种后的不良反应进行分析。结果 2015 - 2017年无锡市接种DTaP 、DTaP - IPV - Hib一般反应报告发生率分别为327.67/10万、268.23/10万，异常反应报告发生率分别为19.79/10万、15.58/10万。DTaP和DTaP - IPV - Hib 的一般反应和异常反应均以加强免疫为主，集中在接种后0～1 d。一般反应均主要表现为红肿（80.73%，65.31%）、硬结（45.14%，33.33%）和发热（22.69%，44.22%），异常反应主要表现均以过敏性皮疹为主（58.11%，50%）。结论 DTaP和DTaP - IPV - Hib的不良反应报告发生率无差别，均主要发生在加强免疫期间，具有良好的预防接种安全性。     

After vaccination adverse effects in the city of Campo Grande (MS, Brazil)

The implantation of Vaccination Adverse Effects System enabled the formation of critical professionals with knowledge that could offer more security to the patients and avoid false contraindication. The aim of the study was to know the main incidents of the adverse reactions in Campo Grande (MS, Brazil). Data were conducted by notifications cards of After Vaccinations Adverse Effects located at the Reference Center of Special Immunobiological from January to July-2006. Most of the people who did the notification were patients aging up to 10 years old (53.6%), and 63.4% from female sex. The vaccine who caused more reactions was the adult diphtheria-tetanus (26.8%) comparing to the tetravalent (19.5%) and 63.4% happened in the first 24 hours. The adverse events more notificated were ache, blush and heat (22.4%), followed by enduration (18.4%) and in 75.6% of the cases it was used a conduct to the vaccination process. There is a need for capacitating human resources upon the importancy of notifications for the after vaccinations adverse effects, contributing in this way for the perfection of our immunobiologics.     

2015 - 2017年湖北省口服轮状病毒减毒活疫苗安全性监测分析

目的 分析湖北省2015 - 2017年口服轮状病毒减毒活疫苗（oral live attenuated rotavirus vaccine,ORV）疑似预防接种异常反应（adverse Events following Immunization, AEFI）的发生特征,评价ORV预防接种的安全性。方法 通过中国AEFI信息管理系统,收集湖北省2015 - 2017年接种ORV发生的AEFI个案数据,采用描述流行病学方法进行分析。结果 湖北省2015 - 2017年接种ORV发生AEFI 223例（33.82/10万剂）,未报告肠套叠等严重AEFI病例,其中一般反应、异常反应分别为197例（29.88/10万剂）和20例（3.03/10万剂次）。一般反应主要表现为发热（25.63/10万剂）和胃肠道反应（9.71/10万剂）,异常反应主要为过敏性皮疹（2.12/10万剂）和荨麻疹（0.91/10万剂）。发病年龄集中在2岁以下,其中51.57%发生在＜1岁,35.43%发生在1~2岁;各剂次中,首剂接种后发生186例（83.41%）、第2剂30例（13.45%）、第3剂7例(3.14%);66.37%的病例发生在接种当天;17.04%发生在接种后1 d;4.48%发生在接种后2 d,0.45%发生在接种后3 d及以上;联合接种时92.04%为一般反应;98.21%病例治愈或好转,无后遗症和死亡病例报告。结论 口服轮状病毒减毒活疫苗具有良好的安全性。     

Case-control study of allergic reactions to Japanese encephalitis vaccine

Japanese encephalitis (JE) vaccine is widely used in Asia for childhood immunizations, but the vaccine is also used for travellers to Asia from other parts of the world. In Denmark, more than 400,000 doses have been distributed from Statens Serum Institut since 1982. In 1989, the first allergic mucocutaneous reactions after JE vaccination were registered in Denmark and, although the number of reactions have decreased since 1992, reactions are still observed. No explanation of these reactions have been found. The present case-control study, including 49 travellers with allergic reactions and 148 travellers without similar reactions after JE vaccination was performed in order to clarify any possible risk factors. About one third of the adverse reactions to the vaccine could be attributed to an allergic predisposition in the vaccinees. The main risk factors were young age, female gender and previous allergic skin reactions or hayfever. The study also indicated that cases more often reacted to nickel and more often had severe edema after mosquito or other insect bites. Hormone intake was more often spontaneously reported by females in the case group. Accordingly, information on any history of allergy in young adults should be given before JE vaccination, the vaccination should be carried out more than a week before departure and antihistamine treatment should be available if a reaction occurs.     

Surveillance of Vaccine Safety: Comparison of parental reports with routine surveillance and a clinical trial

One way to maintain confidence in vaccination programmes is to improve monitoring of immunisation safety. We studied active parental reporting of adverse events after a booster dose of diphtheria-tetanus toxoid (DT). 7193 children received the vaccine. Questionnaires were submitted by 84.2% of the parents, who reported reactions for 9.2% of the children. Four percent of events were classified as moderate/severe by interviews. Relative risk of redness and swelling reported was 0.24 (95% CI, 0.13–0.42) compared to a clinical trial, while it was 71.0 (44–114) compared to passive surveillance. Active surveillance by parental reports is a useful complement to passive surveillance of childhood immunisations to generate hypotheses for evaluation in controlled studies.