Meyer C, Rasch G, Keller-Stanislawski B, Schnitzler N
Robert Koch-Institut, Berlin, Germany.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2002 Apr;45(4):364-70. doi: 10.1007/s00103-002-0391-6.
The decrease in infectious diseases preventable by immunisation and the absence of complications caused by these diseases leads to an increased awareness of vaccine-associated adverse events. The analysis of a survey of the vaccine injury compensation data from the German Bundesländer shows the decrease in accepted and demanded compensation from 1991 to 1999. From 1976 to 1990 1139 of 4569 demands were accepted, whereas from 1991 to 1999, acceptance of only 389 of 2543 demands was reported. In all, 38% of the accepted compensations refer to the smallpox vaccine which is not longer recommended by the STIKO (Permanent Vaccination Commission in Germany) since immunisation against smallpox was stopped in the 1980s. Regional differences show that process elements of the German healthcare system as well as political and social reasons express most of the differences in rates and prevalence of vaccine associated adverse events. Epidemiological questions and questions of causality cannot be answered by the analysis of data collected in vaccine injury programs. Valid analysis needs a register of individual documented cases of vaccine adverse events. The surveillance of adverse events following immunisation will make progress by the analysis of data reported according to the Protection against Infection Act (IfSG) and by further surveillance systems that should be implemented in the near future. A centralised commission with expert opinion concerning causality could increase transparency and homogeneity within judgement and documentation of vaccine associated adverse events.
可通过免疫预防的传染病减少，且这些疾病未引发并发症，这导致人们对疫苗相关不良事件的关注度增加。对德国联邦州疫苗伤害补偿数据的一项调查分析显示，1991年至1999年期间，获得认可和提出的补偿都有所减少。1976年至1990年，4569项索赔中有1139项获得认可，而1991年至1999年，据报告2543项索赔中只有389项获得认可。总体而言，38%的已获认可补偿涉及天花疫苗，自20世纪80年代停止天花免疫接种以来，德国常设疫苗委员会（STIKO）已不再推荐使用该疫苗。地区差异表明，德国医疗保健系统的流程因素以及政治和社会原因在很大程度上体现了疫苗相关不良事件发生率和流行率的差异。疫苗伤害项目收集的数据分析无法回答流行病学问题和因果关系问题。有效的分析需要一份记录在案的疫苗不良事件个体病例登记册。通过对根据《感染防护法》（IfSG）报告的数据进行分析，以及通过在不久的将来应实施的进一步监测系统，免疫接种后不良事件的监测将取得进展。一个具有因果关系专家意见的中央委员会可以提高疫苗相关不良事件判断和记录的透明度和一致性。
