Zhang Y J
Division of Expanded Programme on Immunization, Shandong Center for Disease Control and Prevention, Jinan 250014, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2017 Aug 6;51(8):723-727. doi: 10.3760/cma.j.issn.0253-9624.2017.08.012.
To analyze the occurrence and death of Adverse Event Following Immunization (AEFI) in Shandong province. Collecting the information of AEFI cases from 2011 to 2016, which were reported through the National AEFI Management System in Shandong province up to January 15, 2017. The autopsy reports of death following immunization were issued by the qualified institutions. The inoculation data from 2011 to 2016 was obtained through Immunization Information Management System of Shandong province. Chi-square test was used to compare the incidence rate of AEFI and mortality related to immunization among different time and age groups. A total of 189 864 512 doses of vaccine were administered in Shandong province during 2011-2016, the total number of AEFI cases was 89 973 and the incidence rate of AEFI was 473.88/1 000 000. The number of death cases was 52 and the mortality rate was 0.27/1 000 000. The incidence rate of AEFI from 2011 to 2016 respectively was 273.63/1 000 000, 405.22/1 000 000, 479.88/1 000 000, 545.13/1 000 000, 500.66/1 000 000, and 627.09/1 000 000 (0.001), respectively. The mortality rate from 2011 to 2016 was 0.17/1 000 000, 0.16/1 000 000, 0.25/1 000 000, 0.39/1 000 000, 0.26/1 000 000, and 0.40/1 000 000 (0.285), respectively.The mortality rates of HepB, BCG and IPV were the top three. There was statistical significance of the mortality rate among different month-old children (0.001). The highest mortality rate was<2 month-old (1.09/1 000 000), and the next was 4-5 month-old (0.54/1 000 000), and the lowest was ≥10 month-old (0.06/1 000 000). The mortality rate of spring (from February to April), summer (from May to July), autumn (from August to October) and winter (from November to January of next year) was 0.41/1 000 000, 0.16/1 000 000, 0.08/1 000 000 and 0.48/1 000 000 (0.001), respectively. Among 52 death cases, 26 cases were anatomized, including 3 rare vaccine reaction following immunization and 23 coincidental events; 26 cases were not anatomized, including 17 coincidental events and 9 unknown causes. The AEFI mortality rate of<2 month-old, spring and winter, and the second dose was higher than else, which was similar to normal child mortality. Immunization did not increase the risk of death, and the most deaths following immunization were coincidental events.
分析山东省免疫规划疫苗接种后疑似预防接种异常反应(AEFI)的发生及死亡情况。收集2011年至2016年通过山东省国家AEFI管理系统上报的AEFI病例信息,截至2017年1月15日。免疫接种后死亡的尸检报告由具备资质的机构出具。2011年至2016年的接种数据通过山东省免疫规划信息管理系统获取。采用卡方检验比较不同时间和年龄组的AEFI发病率及免疫接种相关死亡率。2011 - 2016年山东省共接种疫苗189864512剂次,AEFI病例总数为89973例,AEFI发病率为473.88/100万。死亡病例数为52例,死亡率为0.27/100万。2011年至2016年AEFI发病率分别为273.63/100万、405.22/100万、479.88/100万、545.13/100万、500.66/100万和627.09/100万(P<0.001)。2011年至2016年死亡率分别为0.17/100万、0.16/100万、0.25/100万、0.39/100万、0.26/100万和0.40/100万(P = 0.285)。乙肝疫苗、卡介苗和脊灰灭活疫苗的死亡率位列前三。不同月龄儿童的死亡率差异有统计学意义(P<0.001)。死亡率最高的是<2月龄(1.09/100万),其次是4 - 5月龄(0.54/100万),最低的是≥10月龄(0.06/100万)。春季(2月至4月)、夏季(5月至7月)、秋季(8月至10月)和冬季(11月至次年1月)的死亡率分别为0.41/100万、0.16/100万、0.08/100万和0.48/100万(P<0.001)。52例死亡病例中,26例进行了尸检,其中3例为罕见的免疫接种后疫苗反应,23例为偶合症;26例未进行尸检,其中17例为偶合症,9例死因不明。<2月龄、春季和冬季以及第二剂次的AEFI死亡率高于其他情况,与正常儿童死亡率相似。免疫接种并未增加死亡风险,免疫接种后死亡大多为偶合症。