Danova Jana, Kocourkova Aneta, Celko Alexander M
Department of Epidemiology, Third Faculty of Medicine Charles University, Prague, Czech Republic.
BMC Public Health. 2017 Feb 6;17(1):167. doi: 10.1186/s12889-017-4083-4.
Despite the undisputed public health benefits of routine vaccination, adverse events following immunisation (AEFI) remain a concern. As most adverse events are mild, they may be under-reported; this may underlie the wide range of AEFI rates reported in the literature. We investigated the rates of AEFI related to routine vaccination of children 0-10 years old in the Czech Republic.
The study reviewed patients' records in a sample of 49 paediatric GP practices covering all 12 administrative regions of the Czech Republic between 2011 and 2013. Adverse events following routine immunisation of children aged 0-10 years were identified and recorded.
The overall rate of AEFI was 209/100,000 doses; this was 6 times higher than the rate reported to the Czech State Institute for Drug Control (34/100,000 doses). Over two fifths (44%) of all AEFI occurred after the booster dose of the combined diphteria, tetanus and pertussis vaccine in 5-year old children. The vast majority of AEFI were non-serious local events (e.g. redness) and fever. Most AEFI occurred the second day after the immunisation, lasted 4 days on average, and were treated by cold therapy, antipyretics and analgesics.
The rate of AEFI identified in this study was considerably higher than the officially reported rate. Although the vast majority of AEFI were non-serious, health care providers and the public should be educated and encouraged to report AEFI to address the issue of underreporting, to increase the safety profile of vaccines, and to improve public confidence in immunisation programmes.
尽管常规疫苗接种对公众健康的益处无可争议,但免疫接种后的不良事件(AEFI)仍然令人担忧。由于大多数不良事件较为轻微,可能存在报告不足的情况;这可能是文献中报道的AEFI发生率差异较大的原因。我们调查了捷克共和国0至10岁儿童常规疫苗接种相关的AEFI发生率。
本研究回顾了2011年至2013年间捷克共和国12个行政区49家儿科全科医疗诊所样本中的患者记录。识别并记录了0至10岁儿童常规免疫接种后的不良事件。
AEFI的总体发生率为209/100,000剂;这比向捷克国家药物控制研究所报告的发生率(34/100,000剂)高出6倍。超过五分之二(44%)的AEFI发生在5岁儿童接种白喉、破伤风和百日咳联合疫苗加强针之后。绝大多数AEFI为非严重的局部事件(如发红)和发热。大多数AEFI发生在免疫接种后的第二天,平均持续4天,并采用冷疗法、退烧药和镇痛药进行治疗。
本研究中确定的AEFI发生率远高于官方报告的发生率。尽管绝大多数AEFI并不严重,但应教育并鼓励医疗保健提供者和公众报告AEFI,以解决报告不足的问题,提高疫苗的安全性,并增强公众对免疫规划的信心。