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[新冠病毒疫苗安全性:阿根廷一个哨点的主动监测结果 新冠病毒疫苗安全性:阿根廷一个哨点的主动监测结果]

[COVID-19 vaccine safety: results of active surveillance at a sentinel site in ArgentinaSegurança das vacinas contra COVID-19: resultados da vigilância ativa em uma unidade sentinela da Argentina].

作者信息

Lescura Nerina Ivana, Selent Carolina, Guerci Mariana Noel, Bertachini Octavia María, López María Victoria, de Prada Ana Martina, Del Valle Fernández María, Barboza Nancy Vivian, Juárez María Del Valle, Cáceres Analía Florencia, Falla Carlos, Solarte Ivonne Natalia, Bruggesser Florencia, Stecher Daniel

机构信息

Departamento de Epidemiología Hospital Provincial Neuquén Dr. Castro Rendón Neuquén Argentina Departamento de Epidemiología, Hospital Provincial Neuquén, Dr. Castro Rendón, Neuquén, Argentina.

Dirección de Control de Enfermedades Inmunoprevenibles Ministerio de Salud de la Nación Ciudad Autónoma de Buenos Aires Argentina Dirección de Control de Enfermedades Inmunoprevenibles, Ministerio de Salud de la Nación, Ciudad Autónoma de Buenos Aires, Argentina.

出版信息

Rev Panam Salud Publica. 2024 Dec 16;48:e94. doi: 10.26633/RPSP.2024.94. eCollection 2024.

DOI:10.26633/RPSP.2024.94
PMID:39687241
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11648208/
Abstract

OBJECTIVE

To analyze the results of surveillance of adverse events of special interest (AESI) within the context of the COVID-19 vaccination campaign at a sentinel site in Argentina. The retrospective (pre-vaccination) period was compared with the prospective (vaccination) period to identify safety signals.

METHODS

Retrospective and prospective search for AESI based on ICD-10 hospital discharge codes. A descriptive analysis, moving-averages trend smoothing, and control charts were used to detect changes in AESI behavior.

RESULTS

A total of 1,586 AESI were identified. Analysis of the proportion of AESI codes at hospital discharge revealed an increase during the pandemic period (2020) and a progressive decrease during the vaccination period (2021-2022), accounted for by the incidence of acute respiratory distress syndrome (ARDS). Moving-average smoothing and control charts were compared to identify time points at which the proportion of AESI exceeded the upper limits of control. During the vaccination period, this occurred for ARDS, thrombosis, myocarditis, meningoencephalitis, multisystem inflammatory syndrome, and anaphylaxis. No differences were observed for Guillain-Barré syndrome, thrombocytopenia, or pericarditis. Acute disseminated encephalomyelitis, meningoencephalitis, and pericarditis events during the vaccination period all occurred in subjects with no history of vaccination.

CONCLUSION

Active sentinel-site surveillance allowed identification of AESI occurring at a higher frequency during the vaccination period compared to the pre-vaccination baseline. The protective effect of the vaccine against COVID -19 was clearly observed, as manifested especially by a reduction of ARDS cases in the post-vaccination period. This strategy is useful for assessing vaccine safety by identification of safety signals.

摘要

目的

分析阿根廷一个哨点在新冠疫苗接种活动背景下特殊关注不良事件(AESI)的监测结果。将回顾性(接种前)时期与前瞻性(接种)时期进行比较,以识别安全信号。

方法

基于国际疾病分类第十版(ICD - 10)医院出院编码对AESI进行回顾性和前瞻性搜索。采用描述性分析、移动平均趋势平滑法和控制图来检测AESI行为的变化。

结果

共识别出1586例AESI。对医院出院时AESI编码比例的分析显示,大流行期间(2020年)有所增加,而在接种期间(2021 - 2022年)逐渐下降,这是由急性呼吸窘迫综合征(ARDS)的发病率所致。比较移动平均平滑法和控制图,以确定AESI比例超过控制上限的时间点。在接种期间,ARDS、血栓形成、心肌炎、脑膜脑炎、多系统炎症综合征和过敏反应出现了这种情况。吉兰 - 巴雷综合征、血小板减少症或心包炎未观察到差异。接种期间的急性播散性脑脊髓炎、脑膜脑炎和心包炎事件均发生在无疫苗接种史的受试者中。

结论

主动哨点监测能够识别出与接种前基线相比在接种期间发生频率更高的AESI。疫苗对新冠病毒的保护作用清晰可见,尤其表现为接种后ARDS病例的减少。该策略通过识别安全信号,对评估疫苗安全性很有用。

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本文引用的文献

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成年人接种 COVID-19 疫苗后吉兰-巴雷综合征并无显著增加:一项疫苗不良事件报告系统研究。
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