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目的评价2011年北京市疑似预防接种异常反应(AEFI)监测系统运行情况,分析AEFI报告的病例,为进一步改善AEFI监测工作提供依据。方法通过全国AEFI信息管理系统收集2011年北京市AEFI个案数据,应用描述流行病学方法进行分析,用AEFI的监测指标进行评价。采用定量问卷调查和定性小组访谈方法,调查AEFI病例诊断质量。结果 2011年北京市共报告AEFI 860例,报告发生率9.60/10万剂次;国家规定的7项监测指标中有6项(AEFI区县报告覆盖率、48 h内报告率、调查率、3 d内调查表录入率,7 d内调查报告上传率,分类率)达标,1项(调查表关键项目完整率)未达标。市、区两级疾病预防控制中心(CDC)共组织AEFI专家会议27次,讨论病例95例,诊断异常反应55例、其中严重异常反应8例;排除异常反应7例。不同区县AEFI调查诊断专家组活动情况差异较大。860例AEFI中一般反应526例(61.2%),异常反应209例(24.3%),偶合症117例(13.6%),心因性反应8例(0.9%)。导致AEFI的生物制品主要为吸附无细胞百白破联合疫苗和麻疹风疹联合减毒活疫苗。AEFI的临床表现以过敏性皮疹(79.5%)和血管神经性水肿(9.1%)为主。过敏性皮疹主要因接种麻疹风疹联合减毒活疫苗所致,占37.7%。无疫苗质量事故和接种事故。结论 2011年北京市AEFI监测系统运行质量达较高水平,但应进一步完善AEFI专家组的规范化管理。麻疹风疹联合减毒活疫苗所致异常反应发生率较高,需要进行深入的调查分析。
Objective To evaluate the operation status of suspected AEFI surveillance system in Beijing in 2011 and analyze the cases reported by AEFI in order to provide evidence for further improvement of AEFI monitoring. Methods The data of AEFI cases in Beijing in 2011 were collected through the National AEFI Information Management System. Epidemiological methods were used to analyze the data and the AEFI monitoring indicators were used to evaluate the data. Quantitative questionnaires and qualitative panel interviews were used to investigate the diagnostic quality of AEFI cases. Results A total of 860 cases of AEFI were reported in Beijing in 2011, with a reported incidence of 9.60 / 10 000 doses. Six of the 7 monitoring indicators prescribed by the state (coverage of AEFI counties and districts, reporting rate within 48 h, investigation rate, 3 d in the questionnaire entry rate, 7 d survey report upload rate, classification rate) standard, 1 (questionnaire key project complete rate) did not meet the standards. CDC organized a total of 27 AEFI expert meetings to discuss 95 cases, 55 cases of abnormal diagnosis, including 8 cases of serious abnormal reaction and 7 cases of abnormal reaction. Different districts and counties AEFI survey diagnostic expert group activities vary greatly. There were 526 cases (61.2%) of the 860 cases of AEFI, 209 cases (24.3%) of the abnormal reaction, 117 cases (13.6%) of coupling and 8 cases of psychogenic reaction (0.9%). The resulting AEFI’s biologics are primarily adsorbed cell-free baibutai combination vaccine and measles rubella live attenuated vaccine. The clinical manifestations of AEFI with allergic rash (79.5%) and angioedema (9.1%) dominated. Allergic rash mainly due to inoculation of measles and rubella joint live attenuated vaccine, accounting for 37.7%. No vaccine quality accident and vaccination accident. Conclusion The quality of AEFI monitoring system in Beijing reached a high level in 2011, but the standardized management of the AEFI expert group should be further improved. Measles rubella joint live attenuated vaccine caused by a higher incidence of abnormal reactions, the need for in-depth investigation and analysis.