MacDonald L, Naus M
Immunization Programs and Vaccine Preventable Diseases Service, British Columbia Centre for Disease Control, Vancouver, BC.
School of Population and Public Health, University of British Columbia, Vancouver, BC.
Can Commun Dis Rep. 2014 Dec 4;40(Suppl 3):24-30. doi: 10.14745/ccdr.v40is3a03.
In British Columbia, vaccine safety is monitored through a passive surveillance system with voluntary reporting of adverse events following immunization (AEFIs) from immunizers to five regional health authorities and onward to the British Columbia Centre for Disease Control (BCCDC).
To review and summarize all documented AEFI cluster or signal investigations carried out by BCCDC between November 2007 and July 2014.
Documented cluster or signal investigations were reviewed to summarize year, alerting mechanism, event type and vaccine, investigative analysis approach, results, and public health actions. The findings and public health actions of two cluster investigations are described in detail.
There were two fatality investigations and thirteen cluster investigations. The two fatalities were found to be due to sudden infant death syndrome and were not vaccine-related. Clusters were predominantly identified through notification from regional medical health officers or public health nurses, and the majority were local injection site reactions (54%), or allergic events (39%). Most investigations did not identify a specific association to a vaccine or a lot of vaccine, and no public health actions were taken. Two recent investigations-reports of hypotonic-hyporesponsive episodes with or without severe vomiting and diarrhea following receipt of a single lot of DPT-IPV/Hib/hepatitis B vaccine, and reports of severe pain past nearest joint following administration of a single lot of influenza vaccine-were thought to be vaccine-related. The former investigation did not find an association to vaccine, while the severe local reactions post-influenza immunization were determined to be a result of improper injection technique. Public health actions included communication to federal/provincial/territorial vaccine safety partners and additional injection technique training.
This investigative aspect of public health immunization programs is often not in the public eye but is an important component of behind the scenes activities that serve to protect public safety.
在不列颠哥伦比亚省，通过一个被动监测系统对疫苗安全性进行监测，免疫接种人员将免疫接种后出现的不良事件（AEFI）自愿报告给五个地区卫生当局，再上报至不列颠哥伦比亚疾病控制中心（BCCDC）。
回顾并总结BCCDC在2007年11月至2014年7月期间开展的所有已记录的AEFI聚集性事件或信号调查。
对已记录的聚集性事件或信号调查进行回顾，以总结年份、警报机制、事件类型和疫苗、调查分析方法、结果及公共卫生行动。详细描述了两次聚集性事件调查的结果和公共卫生行动。
有两次死亡调查和十三次聚集性事件调查。发现这两起死亡事件是由婴儿猝死综合征导致的，与疫苗无关。聚集性事件主要通过地区医疗卫生官员或公共卫生护士的通报确定，大多数是局部注射部位反应（54%）或过敏事件（39%）。大多数调查未发现与某种疫苗或某一批次疫苗有特定关联，未采取公共卫生行动。最近的两项调查——关于接种一批白百破-脊灰- Hib/乙肝疫苗后出现或未出现严重呕吐和腹泻的低张低反应发作报告，以及接种一批流感疫苗后最近关节处出现严重疼痛的报告——被认为与疫苗有关。前一项调查未发现与疫苗有关联，而流感免疫接种后的严重局部反应被确定是注射技术不当所致。公共卫生行动包括与联邦/省/地区疫苗安全合作伙伴沟通以及提供额外的注射技术培训。
公共卫生免疫计划的这一调查方面通常不为公众所见，但却是保障公众安全的幕后重要活动组成部分。
