澳大利亚两家专家免疫门诊低张低反应发作的复发风险。

Recurrence risk of a hypotonic hyporesponsive episode in two Australian specialist immunisation clinics.

机构信息

SAEFVIC, MCRI, Melbourne, Australia; Immunisation Service, General Medicine, RCH, Melbourne, Australia; Department Paediatrics, University of Melbourne, Australia.

SAEFVIC, MCRI, Melbourne, Australia.

出版信息

Vaccine. 2018 Oct 1;36(41):6152-6157. doi: 10.1016/j.vaccine.2018.08.062. Epub 2018 Sep 6.

DOI:10.1016/j.vaccine.2018.08.062

PMID:30197281

Abstract

BACKGROUND

A hypotonic hyporesponsive episode (HHE) is a well-described adverse event following immunisation (AEFI) in young children. There is limited data regarding recurrence post re-vaccination.

METHOD

A retrospective analysis of HHEs reported to two tertiary paediatric hospitals in Australia: The Royal Children's Hospital, Melbourne [2006-11] and the Children's Hospital Westmead, Sydney [1997-2014]. HHE definition level of confidence was allocated according to Brighton Collaboration (BC) criteria and defined immediate if within 30 min post vaccination. The Australian Immunisation Register (AIR) was utilised to document current immunisation status.

RESULTS

235 HHE cases (135 Melbourne, 100 Sydney) were identified: 47% were female and 67% (157/235) occurred following the routine dose one vaccines at 6-8 weeks of age. Median time following immunisation was 120 min (range 1 min to 14 days) An immediate HHE occurred in 43% (102/235) and by BC criteria, 74% (173/235) were level 1 (definite). Subsequent vaccines were administered under supervision in hospital in 37% overall (86/235); 43% (58/135) in Melbourne and 28% (28/100) in Sydney. HHE recurrence rate was 3% (7/235) [95% confidence interval 1-6%]. AIR records were available in 94% (221/235). At a median age of 3.1 years, 84% (186/221) were up-to-date with recommended vaccines.

CONCLUSION

This study highlights the importance of specialist immunization clinics in supporting the National Immunisation Program, through follow-up and management of serious adverse events following immunization.

摘要

背景

低张性低反应发作（HHE）是幼儿接种疫苗后（AEFI）的一种描述良好的不良事件。关于再接种后的复发，数据有限。

方法

对澳大利亚两家三级儿科医院（墨尔本皇家儿童医院[2006-11]和西悉尼儿童医院[1997-2014]）报告的 HHE 进行回顾性分析。根据 Brighton 合作组织（BC）标准分配 HHE 定义的置信水平，并将 30 分钟内发生的情况定义为立即发生。利用澳大利亚免疫登记处（AIR）记录当前免疫状况。

结果

共确定了 235 例 HHE 病例（135 例来自墨尔本，100 例来自悉尼）：47%为女性，67%（157/235）发生在常规剂量疫苗接种后 6-8 周龄。接种疫苗后中位数时间为 120 分钟（范围为 1 分钟至 14 天），43%（102/235）立即发生 HHE，根据 BC 标准，74%（173/235）为 1 级（明确）。总体而言，37%（86/235）的后续疫苗在医院监督下进行，其中 43%（58/135）在墨尔本，28%（28/100）在悉尼。HHE 复发率为 3%（7/235）[95%置信区间为 1-6%]。235 例中有 94%（221/235）的 AIR 记录可用。在中位数年龄为 3.1 岁时，84%（186/221）的儿童已按建议接种疫苗。