Chen Fuxing, Chen Yaping, Liang Hui, Pan Xuejiao, Wang Ying, Shen Lingzhi, Hu Yu
Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, No. 3399 Binsheng Road, Binjiang District, Hangzhou, P.R. China.
BMC Infect Dis. 2024 Dec 23;24(1):1457. doi: 10.1186/s12879-024-10385-1.
Previous evidence had suggested age and sex affect the reporting rate of adverse events following immunization (AEFI), but with little exploration of potential their non-linear and interaction effects on AEFIs. Examining these non-linear effects could be beneficial for identifying high-risk populations.
Using AEFI records and vaccination data from national passive surveillance system of adverse event following immunization and Zhejiang provincial immunization information system in the 2021-2022 influenza season, respectively. The effects of age and sex on AEFIs were analyzed through the generalized additive model (logistic regression with a smooth term) to estimate non-linear characteristics after adjusting for other co-variables (adopted significance level p < 0.05).
There were 1,259,975 influenza vaccine doses administered and 1304 AEFI records reported during the 2021-2022 influenza season, with a reporting rate of 10.35/10,000 doses. The odds of reporting an AEFI increased from 6 months of age, peaking at about 54 years of age, then gradually declined. The odds of females experiencing AEFIs are higher than that of males. The data model indicated clear effects of age, sex, and their interaction (p < 0.01) on reporting rate of AEFI. Concomitant vaccination and vaccine type were also the impact factors for reporting rate of AEFI.
This study revealed a non-linear property in age and the AEFI odds, with a significant interaction and higher reporting rate in females. In addition, the odds of AEFI increased with co-administration compared to separate vaccination.
先前的证据表明年龄和性别会影响免疫接种后不良事件（AEFI）的报告率，但对其对AEFI的潜在非线性和交互作用的探索较少。研究这些非线性效应可能有助于识别高危人群。
分别使用国家免疫接种后不良事件被动监测系统和浙江省免疫信息系统在2021-2022流感季节的AEFI记录和疫苗接种数据。通过广义相加模型（带有平滑项的逻辑回归）分析年龄和性别对AEFI的影响，在调整其他协变量后估计非线性特征（采用显著性水平p<0.05）。
在2021-2022流感季节，共接种1,259,975剂流感疫苗，报告AEFI记录1304条，报告率为10.35/10,000剂。报告AEFI的几率从6个月龄开始增加，在约54岁时达到峰值，然后逐渐下降。女性发生AEFI的几率高于男性。数据模型表明年龄、性别及其交互作用对AEFI报告率有明显影响（p<0.01）。同时接种疫苗和疫苗类型也是AEFI报告率的影响因素。
本研究揭示了年龄与AEFI几率之间的非线性特征，女性存在显著交互作用且报告率更高。此外，与单独接种相比，同时接种时AEFI的几率增加。
