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流感疫苗接种后不良事件信号检测的及时性:一项模拟案例研究。

Timeliness of signal detection for adverse events following influenza vaccination in young children: a simulation case study.

机构信息

Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia

National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.

出版信息

BMJ Open. 2020 Mar 1;10(2):e031851. doi: 10.1136/bmjopen-2019-031851.

Abstract

OBJECTIVES

To determine how soon after commencement of the seasonal influenza vaccination programme, the AusVaxSafety active vaccine safety surveillance system, currently in use across Australia, would have detected a safety signal had it been operating in 2010 when there was an unprecedented number of febrile seizures in young children associated with one specific influenza vaccine brand, Fluvax (CSL Biotherapies).

DESIGN

Simulation study.

SETTING

Western Australian vaccine influenza coverage and adverse event surveillance data.

OUTCOME MEASURES

Simulated solicited responses from caregivers who would have received an SMS survey about adverse events experienced following seasonal influenza vaccination of their children aged 6 months to <5 years.

PARTICIPANTS

None.

RESULTS

We estimated a >90% probability of a safety signal being detected by AusVaxSafety based on solicited reports for either fever or medical attendance at or before the week ending 28 March 2010, 3 weeks after the start of vaccine distribution. Suspension of the national paediatric influenza vaccination programme as a result of the passive adverse events surveillance operating at the time did not occur until 23 April 2010.

CONCLUSIONS

Active vaccine safety surveillance leading to rapid detection of a safety signal would likely have resulted in earlier suspension of Fluvax from the vaccination programme, prevention of many febrile convulsions and maintenance of public confidence in influenza vaccination for young children.

摘要

目的

确定如果 AusVaxSafety 主动疫苗安全监测系统在 2010 年(当时有一种特定的流感疫苗品牌 Fluvax[CSL 生物治疗公司]与幼儿发生大量热性惊厥有关)运行,该系统将在季节性流感疫苗接种计划开始后多快时间检测到安全信号。

设计

模拟研究。

地点

西澳大利亚州疫苗流感覆盖率和不良事件监测数据。

结果测量

模拟接受过 SMS 调查的照顾者的应答,了解他们的孩子在 6 个月至<5 岁时接种季节性流感疫苗后经历的不良事件。

参与者

无。

结果

我们估计,根据 2010 年 3 月 28 日结束的那一周之前或之前因发烧或因医疗就诊而进行的主动报告,AusVaxSafety 基于主动报告检测到安全信号的可能性超过 90%,疫苗分发开始后 3 周。由于当时被动不良事件监测而暂停全国儿科流感疫苗接种计划直到 2010 年 4 月 23 日才发生。

结论

主动疫苗安全性监测可快速检测到安全信号,这可能会更早地暂停 Fluvax 疫苗接种计划,预防许多热性惊厥,并维护公众对幼儿接种流感疫苗的信心。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d13/7050305/967fc10cbfab/bmjopen-2019-031851f01.jpg

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