淄博市两种含麻疹成分疫苗免疫策略调整前后疑似预防接种异常反应监测分析

Surveillance data of adverse events following immunization with measles containing vaccines after adjusting the immunization strategy in Zibo City，Shandong Province

摘要:

目的 对淄博市2018-2022年含麻疹成分疫疫苗（measles-containing vaccine，MCV）的疑似预防接种异常反应(adverse events following immunization , AEFI)监测情况进行比较分析，为免疫策略调整安全性提供数据参考。方法 通过中国疾病预防控制信息系统免疫规划系统和山东省预防接种管理信息系统收集淄博市2018-2022年免疫策略调整前后第一剂次MCV接种及AEFI数据，比较其报告及流行特征。结果 淄博市MCV免疫策略调整前（2018年1月1日-2020年5月31日）第一剂次麻风联合减毒活疫苗（measles and rubella combined attenuated live vaccine，MR）报告AEFI个案114例，报告发生率131.50/10万；免疫策略调整后（2020年6月1日-2022年12月31日）第一剂次麻腮风联合减毒活疫苗（measles, mumps and rubella combined attenuated live vaccine，MMR）报告AEFI个案156例，报告发生率162.97/10万，免疫策略调整前后AEFI报告发生率无统计学差异（c2=3.049，P=0.081）。AEFI个案均以一般反应为主，MR报告发生率（88.82/10万）低于MMR（137.90/10万）（c2=9.576，P=0.002），临床表现以发热最多，分别报告71例（报告发生率81.90/10万）、114例（报告发生率119.10/10万）；MR的异常反应报告发生率（42.68/10万）高于MMR（22.98/10万）（c2=5.458，P=0.019），以过敏性皮疹居多，分别报告16例、11例，报告发生率分别为18.46/10万、11.49/10万。MMR在≥1岁组报告个案占比高于MR（c2=41.089，P＜0.001）；MR第一季度报告个案比例高于MMR（29.82%、17.95%），而MMR在第三季度报告个案比例高于MR（34.64%、17.54%）（c2=14.197，P=0.003）。结论 淄博市MCV免疫策略调整后AEFI报告在预期范围内，未发现MCV相关AEFI流行特征的不良变化。

关键词:疑似预防接种异常反应;含麻疹成分疫苗;监测

Abstract:

Objective To compare and analyze the epidemiological characteristics of the adverse events following immunization (AEFI) with measles containing vaccine (MCV) in Zibo City from 2018-2022, and to provide reference data for evaluating the safety of the immunization strategy adjustment. Methods AEFI surveillance data related to MCV in Zibo City from 2018 to 2022 were collected from the China Disease Prevention and Control Information System Immunization Planning System and Shandong Provincial Vaccination Information System. The AEFI reports and epidemic characteristics after adjusting the immunization strategy about MCV were compared. Results Before adjusting immunization strategy of MCV in Zibo City (January 1, 2018 to May 31, 2020), 114 cases of AEFI were reported in the first dose of measles and rubella combined attenuated live vaccine (MR), with a reported incidence rate of 131.50/100 000. After adjusting the immunization strategy (June 1, 2020- December 31, 2022), 156 cases of AEFI were reported in the first dose of MMR, with a reported incidence of 162.97/100,000. There was no statistically significant difference in the reported incidence of AEFI (c2=3.049, P=0.081). AEFI cases were mainly characterized by general reactions, and the reported incidence rate of MR (88.82/100,000) was lower than that of MMR (137.90/100,000) (c2=9.576, P=0.002). Their most common clinical manifestation was fever, with 71 cases reported (81.90/100 000) and 114 cases reported (119.10/100 000), respectively. The reported incidence of abnormal reactions in MR (42.68/100 000) was higher than that in MMR (22.98/100,000) (c2=5.458, P=0.019). Among them, allergic rash was the most common, with 16 and 11 cases reported, respectively, and the reported incidence rates were 18.46/100 000 and 11.49/100 000, respectively. The proportion of reported cases in the age group ≥ 1 year old was higher in MMR than in MR (c2=41.089, P<0.001). The proportion of reported cases in the first quarter was higher in MR than in MMR (29.82%, 17.95%), while the proportion in the third quarter was higher in MMR than in MR (34.64%, 17.54%) (c2=14.197, P=0.003). Conclusion After adjusting the MCV immunization strategy in Zibo City, the report on AEFI is within the expected range, and no adverse changes have been found in the epidemic characteristics of MCV related AEFI.

Key words:Adverse events following immunization (AEFI); Measles-containing vaccine (MCV); Surveillance