Shimabukuro Tom T, Nguyen Michael, Martin David, DeStefano Frank
Immunization Safety Office, Division of Health care Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.
Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States.
Vaccine. 2015 Aug 26;33(36):4398-405. doi: 10.1016/j.vaccine.2015.07.035. Epub 2015 Jul 22.
The Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) conduct post-licensure vaccine safety monitoring using the Vaccine Adverse Event Reporting System (VAERS), a spontaneous (or passive) reporting system. This means that after a vaccine is approved, CDC and FDA continue to monitor safety while it is distributed in the marketplace for use by collecting and analyzing spontaneous reports of adverse events that occur in persons following vaccination. Various methods and statistical techniques are used to analyze VAERS data, which CDC and FDA use to guide further safety evaluations and inform decisions around vaccine recommendations and regulatory action. VAERS data must be interpreted with caution due to the inherent limitations of passive surveillance. VAERS is primarily a safety signal detection and hypothesis generating system. Generally, VAERS data cannot be used to determine if a vaccine caused an adverse event. VAERS data interpreted alone or out of context can lead to erroneous conclusions about cause and effect as well as the risk of adverse events occurring following vaccination. CDC makes VAERS data available to the public and readily accessible online. We describe fundamental vaccine safety concepts, provide an overview of VAERS for healthcare professionals who provide vaccinations and might want to report or better understand a vaccine adverse event, and explain how CDC and FDA analyze VAERS data. We also describe strengths and limitations, and address common misconceptions about VAERS. Information in this review will be helpful for healthcare professionals counseling patients, parents, and others on vaccine safety and benefit-risk balance of vaccination.
美国疾病控制与预防中心(CDC)和美国食品药品监督管理局(FDA)利用疫苗不良事件报告系统(VAERS)开展上市后疫苗安全性监测,这是一个自发(或被动)报告系统。这意味着在疫苗获批后,CDC和FDA在其投放市场供人使用的过程中,通过收集和分析接种疫苗后发生的不良事件的自发报告来持续监测安全性。使用了各种方法和统计技术来分析VAERS数据,CDC和FDA利用这些数据来指导进一步的安全性评估,并为围绕疫苗建议和监管行动的决策提供信息。由于被动监测存在固有限制,VAERS数据的解读必须谨慎。VAERS主要是一个安全信号检测和假设生成系统。一般来说,VAERS数据不能用于确定疫苗是否导致了不良事件。单独或脱离背景解读VAERS数据可能会导致关于因果关系以及接种疫苗后发生不良事件风险的错误结论。CDC向公众提供VAERS数据,且可在网上轻松获取。我们阐述了基本的疫苗安全概念,为提供疫苗接种服务、可能想要报告或更好地理解疫苗不良事件的医护人员概述了VAERS,并解释了CDC和FDA如何分析VAERS数据。我们还描述了其优势和局限性,并解决关于VAERS的常见误解。本综述中的信息将有助于医护人员就疫苗安全性以及接种疫苗的获益风险平衡向患者、家长和其他人提供咨询。