75起群体性疑似预防接种异常反应文献分析

目的了解群体性疑似预防接种异常反应(Adverse Events Following Immunization,AEFI)发生的特征和规律,为预防和处理群体性AEFI提供参考。方法检索中国医院知识数据库和万方数据库1999～2009年4月发表的群体性AEFI相关文献,提取相关信息进行流行病学特征分析。结果从41种杂志中检索到相关文献83篇,75起群体性AEFI,发生在乡村占64%;发生在学校占62.67%。共涉及疫苗10种,其中流行性乙型脑炎疫苗(Japanese EncephalitisVaccine,JEV)13起,卡介苗(Bacillus Calmette Guerin,BCG)12起,脑膜炎球菌多糖疫苗(Meningococcal PolysaccharideVaccine,MPV)、麻疹减毒活疫苗(Measles Attenuated Live Vaccine,MV)各10起,共占60%。一般反应占5.33%,异常反应占17.33%,偶合症占12.00%,心因性反应占46.67%,实施差错占18.67%。总反应人数4465人,其中95.52%为中、小学生;82.22%为心因性反应,9.14%为偶合症。群体性一般反应均为发热;异常反应主要为过敏反应,占57.14%;心因性反应主要为癔症,占97.14%,多发生于接种JEV、MPV、MV后,共占57.58%;实施差错事故主要表现为红肿、硬结、发热、脓肿、破溃,且主要发生于接种BCG,占71.43%。结论群体性AEFI主要发生在乡村接种、学校集中接种活动中。一般反应和异常反应发生率较低;心因性反应和实施差错(尤其是BCG的实施差错)发生率较高,AEFI总数和平均每起AEFI发生人数均较多,预防控制群体性AEFI的关键在于提高预防接种服务质量。

Literature Review of 75 Clusters of Adverse Events Following Immunization

Objective To know the characteristic of AEFI clusters,and provide reference for preventing and handling of AEFI clusters.Methods The literature were collected from CNKD and WAN FANG datebases 1999-2009.4.The related information were analysed from the qualified literatures.Results 75 clusters from 83 literatures of 41 kinds of journal were identified.Among them,64%occurred in rural area,62.67%occurred at school.10 kinds of vaccines were identified.13 clusters of Japanese encephalitis vaccine(JEV),12 of Bacil...