Scheifele David W, Halperin Scott A
Immunization Monitoring Program, Active (IMPACT), Ottawa, Ontario, Canada.
Semin Pediatr Infect Dis. 2003 Jul;14(3):213-9. doi: 10.1016/s1045-1870(03)00036-0.
In Canada since 1993 the nation's passive system for reporting postimmunization adverse events has been supplemented by the active surveillance of inpatients at 10 to 12 pediatric referral centers, a system referred to as the Immunization Monitoring Program, Active. Participating centers are located from coast-to-coast and receive referrals from every province and territory. Approximately 20 percent of the population aged 0 to 12 years lives in the immediate vicinity of these centers. Nurse monitors at each center search for numerous target conditions, including postimmunization adverse events and vaccine-preventable infections. Vaccine safety observations have included (1) a substantial decrease in the risk of the development of febrile seizures and hypotonic-hyporesponsive episodes since the country switched from whole-cell to acellular pertussis-containing vaccines, (2) no evidence for encephalopathy resulting from the latter vaccines, (3) a generally benign outcome with postimmunization thrombocytopenia cases, and (4) an unexpectedly high rate of disseminated bacille Calmette-Guérin infections among aboriginal infants. Concomitant disease surveillance has been important for sustaining the surveillance system because few postimmunization adverse events require hospital admission.
自1993年以来，加拿大全国性的免疫接种后不良事件被动报告系统得到了10至12个儿科转诊中心对住院患者进行主动监测的补充，该系统被称为主动免疫监测项目。参与的中心遍布全国，接收来自每个省和地区的转诊患者。0至12岁的人口中约有20%居住在这些中心的附近。每个中心的护士监测员会查找多种目标病症，包括免疫接种后不良事件和疫苗可预防感染。疫苗安全性观察结果包括：（1）自该国从全细胞百日咳疫苗改用含无细胞百日咳疫苗以来，热性惊厥和低张性低反应性发作的发生风险大幅降低；（2）没有证据表明后一种疫苗会导致脑病；（3）免疫接种后血小板减少症病例的总体预后良好；（4）原住民婴儿中播散性卡介苗感染率意外偏高。伴随疾病监测对于维持监测系统很重要，因为很少有免疫接种后不良事件需要住院治疗。
