目的探索疑似预防接种死亡的死因排查原则及其应用。方法收集4起疑似接种疫苗后死亡报告、调查处理、尸检鉴定资料,根据接种疫苗急性变态反应和疫苗质量以及实施差错的规律,结合流行病学病因推理,探索死因排查原则和分析可能死因,并与尸检结果对比印证。结果用发病超过接种后2h者排除过敏性休克;无同批号疫苗的多人发病,以及接种疫苗后不符合相应种类疫苗针对传染病的潜伏期和临床症状而突然死亡者,排除疫苗质量隐患;使用疫苗过程中没有由于启封后的安瓿较长时间裸露,以及无同支疫苗的多人致死,排除疫苗受到相关细菌及其毒素污染;无常规药物与疫苗一起摆放引起将药物误作疫苗注射,排除实施差错等四大原则,对疑似接种疫苗后死亡的死因进行排查,并经尸检证实4起疑似接种疫苗后死亡均与接种疫苗无关,表明四大原则可行。结论疑似预防接种死亡死因排查四大原则,对疑似接种疫苗后死亡的死因排查有参考意义。 Objective To explore the principle of investigation of the cause of death caused by suspected vaccination and its application. Methods Four cases of suspected death after vaccination, investigation and treatment, and autopsy data were collected. According to the rules of vaccine acute allergic reaction and vaccine quality and the implementation of the error, combined with the etiological reasoning of epidemiology, the principle of cause of death investigation was explored and the possible causes of death were analyzed. Contrast with autopsy results confirmed. Results The incidence of anaphylactic shock was ruled out more than 2 hours after inoculation. Many people without the same batch of vaccine developed the vaccine, and the vaccine would not be hidden if the vaccine did not meet the latent period and clinical symptoms of the corresponding vaccine. Vaccines were not exposed for a long time due to unsealed ampoules, and many people without syngeneic vaccine died from the vaccine and were contaminated with the bacteria and their toxins. No conventional drugs and vaccines were placed together to cause the drug to be mistaken for a vaccine injection, Rule out the implementation of the four major principles of error, the death of the suspected vaccination after the cause of death were investigated and confirmed by autopsy 4 suspected deaths after vaccination and vaccination have nothing to do, indicating that the four principles are feasible. Conclusions The four principles of investigation of the cause of death from suspected vaccination have reference value for the investigation of the cause of death after the suspected vaccination.