D'Souza R M, Campbell-Lloyd S, Isaacs D, Gold M, Burgess M, Turnbull F, O'Brien E
National Centre for Disease Control, Commonwealth Department of Health and Aged Care, Canberra.
Commun Dis Intell. 2000 Feb 17;24(2):27-33.
The Measles Control Campaign (MCC) conducted in Australia from August to November 1998 resulted in a total of 1.7 million school children being vaccinated. This article reports on the Adverse Events Following Immunisation (AEFI) associated with measles-mumps-rubella vaccine (MMR) administered as part of the MCC. Reports of adverse events that occurred within 30 days of administration of the MMR vaccine were assessed by an expert panel that assigned a causality rating to each AEFI. Reports with missing onset dates or uncertain causality were excluded. Eighty-nine AEFI were classified as associated with MMR vaccine and the overall rate of adverse events was 5.24 per 100,000 doses of vaccine administered. Of these 46 were thought to be certainly caused by MMR vaccine, 23 were probably and 20 were possibly associated with the vaccine. Although 46 reactions were categorised to be certainly caused by the MMR vaccine, the majority of these were syncopal fits, syncope, local reactions, and allergic reactions that were short-lived, and all of these children recovered. The most commonly occurring adverse reaction was syncopal fit with a rate of 1.24 per 100,000. There was only one anaphylactic reaction, giving a rate of 0.06 per 100,000. The combined rate for anaphylaxis, anaphylactoid and allergic reactions was 1.06 per 100,000 administered doses. The rate of seizures (febrile and afebrile) was 0.30 and encephalopathy was 0.06 per 100,000 doses administered. Of the 89 children who had an AEFI, 43 did not require hospitalisation or medical attention while 13 were seen in an emergency room, 14 were hospitalised and 19 were seen by a doctor. There were no deaths reported resulting from the administration of the MMR vaccine during the period of the campaign. All children who had an AEFI have recovered although 9 children could not be followed up for reasons of confidentiality. The overall rate of adverse events was lower than that observed in the 1994 measles campaign conducted in the United Kingdom. On comparing the risks and benefits of MMR vaccine, the benefits of this MCC far outweigh the incidence of serious adverse events associated with immunisation.
1998年8月至11月在澳大利亚开展的麻疹控制运动（MCC）使总计170万名学童接种了疫苗。本文报告了作为MCC一部分接种的麻疹-腮腺炎-风疹疫苗（MMR）相关的免疫接种后不良事件（AEFI）。一个专家小组对在接种MMR疫苗30天内发生的不良事件报告进行了评估，并为每个AEFI确定了因果关系等级。发病日期缺失或因果关系不确定的报告被排除。89例AEFI被归类为与MMR疫苗相关，不良事件的总体发生率为每10万剂疫苗接种5.24例。其中46例被认为肯定是由MMR疫苗引起的，23例可能相关，20例可能相关。虽然46例反应被归类为肯定由MMR疫苗引起，但其中大多数是短暂的晕厥发作、晕厥、局部反应和过敏反应，所有这些儿童均已康复。最常见的不良反应是晕厥发作，发生率为每10万例1.24例。只有1例过敏反应，发生率为每10万例0.06例。过敏反应、类过敏反应和过敏反应的综合发生率为每10万剂接种量1.06例。癫痫发作（发热性和非发热性）的发生率为每10万剂0.30例，脑病的发生率为每10万剂0.06例。在89例发生AEFI的儿童中，43例不需要住院或医疗护理，13例在急诊室就诊，14例住院，19例看过医生。在运动期间，没有报告因接种MMR疫苗导致死亡。所有发生AEFI的儿童均已康复，不过有9名儿童因保密原因无法进行随访。不良事件的总体发生率低于1994年在英国开展的麻疹运动中观察到的发生率。在比较MMR疫苗的风险和益处时，本次MCC的益处远远超过与免疫接种相关的严重不良事件的发生率。
