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疫苗相关麻痹型脊髓灰质炎(脊灰)(Vaccine-associated Paralytic Poliomyelitis,VAPP)是口服脊灰减毒活疫苗(Oral Poliomyelitis Attenuated Live Vaccine,OPV)使用过程中出现的罕见不良反应。世界卫生组织2001年对全球VAPP造成的疾病负担进行了估算,估计全球使用OPV的国家每年发生250~500例VAPP,或每年每100万出生人口发生2~4例VAPP。由于VAPP诊断和分类很复杂,不同国家VAPP纳入标准和估算方法不同,导致VAPP发生率差异很大。国内关于VAPP的文献也仅局限于个别省(自治区、直辖市),由于数据来源、病例诊断、估算方法不同,导致不同地区VAPP的发生情况缺乏可比性。现对国内外VAPP发生率的估算方法及VAPP的流行病学特征进行综述,目的在于探寻、建立一个能准确、合理估算VAPP发生率的方法,总结VAPP流行病学特征,为我国实施新的疫苗免疫策略,有效预防VAPP的发生提供参考。
Vaccine-associated Paralytic Poliomyelitis (VAPP) is a rare adverse reaction that occurs during the oral administration of Oral Poliomyelitis Attenuated Live Vaccine (OPV). WHO estimated the global burden of disease (VAPP) in 2001 and estimates that 250 to 500 VAPP occur annually in countries that use OPV worldwide or 2 to 4 VAPP per 1 million births annually. Due to the complexity of VAPP diagnosis and classification, different countries have different VAPP inclusion criteria and estimation methods, resulting in very different VAPP incidence. The domestic literature on VAPP is also confined to only individual provinces (autonomous regions and municipalities). Due to the different sources of data, the diagnosis of cases and the different estimation methods, the incidence of VAPP in different regions is not comparable. The methods of estimating the incidence of VAPP at home and abroad and the epidemiological characteristics of VAPP are summarized in order to explore and establish a method that can accurately and reasonably estimate the incidence of VAPP and summarize the epidemiological characteristics of VAPP for the implementation of new vaccines Immune strategy, effectively prevent the occurrence of VAPP provide a reference.