摘要
目的:了解上海市0~6岁儿童免疫规划疫苗延迟接种发生情况,并评价疫苗补种的安全性。方法:采用分层随机抽样方式,选取上海市徐汇区6个预防接种门诊,通过上海市免疫规划信息管理系统采集这6个接种门诊2019—2021年0~6岁儿童免疫规划疫苗的接种记录,并通过中国疾病预防控制信息系统疑似预防接种异常反应(adverse event following immunization,AEFI)监测模块收集上述6个接种门诊同期AEFI个案,进行描述流行病学分析。按照受种者是否出现延迟接种(0~12月龄儿童超出免疫规划疫苗接种月龄≥1个月;1岁以上儿童超出接种月龄≥3个月)分为及时接种和疫苗补种两组,比较两组接种方式的安全性。进一步分层比较单独接种、同时接种、常规免疫接种和替代联苗接种四种接种方式的安全性。采用χ^(2)检验比较不同组之间的差异。结果:2019—2021年上海市徐汇区6个接种门诊共接种124031剂次0~6岁免疫规划疫苗,延迟接种剂次占25.99%(32234/124031)。2020年上海市因新型冠状病毒肺炎(简称“新冠肺炎”)疫情启动重大突发公共卫生事件一级响应期间延迟接种率高于2019年同期(34.70%vs.24.19%,χ^(2)=136.23,P<0.05),2021年新冠肺炎疫苗群体接种活动期间延迟接种率高于2019年(25.27%vs.22.55%,χ^(2)=82.80,P<0.05)。2019—2021年期间,6个接种门诊共监测到AEFI个案475例,AEFI报告发生率为382.97/10万剂次,其中一般反应421例(88.63%,339.43/10万剂次)、异常反应51例(10.74%,41.12/10万剂次)、偶合症3例(0.63%,2.42/10万剂次)。疫苗补种AEFI报告发生率低于及时接种(291.62/10万剂次vs.415.05/10万剂次,χ^(2)=9.53,P<0.05)。采用单独接种、2种及以上疫苗同时接种、常规免疫接种和替代联苗接种四种方式进行补种监测到的AEFI报告发生率均低于及时接种,除常规免疫接种组外其余各组间相比差异均有统计学意义(χ^(2)=9.82,P<0.05;χ^(2)=5.46,P<0.05;χ^(2)=2.97,P>0.05;χ^(2)=11.89,P<0.05)。结论:上海市徐汇区0~6岁儿童所接种的免疫规划疫苗中有25.99%的剂次存在延迟接种。与及时接种相比,疫苗补种未增加发生AEFI的风险。
Objective To understand the incidence of delayed vaccination with the national immunization program vaccines among children aged 0-6 years in Xuhui District,Shanghai,and to evaluate the safety of delayed vaccination.Methods A stratified random sampling was used to obtain six vaccination clinics in Xuhui District,Shanghai.The vaccination records of children 0-6 years from these six vaccination clinics were collected from the Shanghai Immunization Program Information Management System.Adverse events following immunization(AEFI)data were collected from the China Information System for Disease Control and Prevention.Descriptive epidemiology was used to analyze the data.Children were divided into the timely vaccination group and delayed vaccination group according whether they were delayed in vaccination(received one month or more after the recommended age among children aged≤1 year;received three months or more after the recommended age among children aged>1 year).The safety of four vaccination methods—individual vaccination,simultaneous vaccination,routine vaccination and combined vaccination—were further compared.Differences between groups were compared using chi-square test.Results From 2019 to 2021,six vaccination clinics in Xuhui District administered 124031 doses of the national immunization program vaccines among children aged 0-6 years,and delayed vaccinations accounted for 25.99%(32234/124031)of these doses.In 2020,the delayed vaccination rate during the first-level COVID-19 public health emergency response period in Shanghai was significantly higher than that in the same period in 2019(34.70%vs.24.19%,χ^(2)=136.23,P<0.05).The delayed vaccination rate during the COVID-19 vaccination campaign in 2021 was significantly higher than that in the same period in 2019(25.27%vs.22.55%,χ^(2)=82.80,P<0.05).From 2019 to 2021,a total of 475 cases of AEFI were reported in six vaccination clinics,with a reported incidence of 382.97 per 100000 doses,including 421 cases of common adverse reaction(88.63%,339.43 per 100000 doses),51 cases of rare adverse reaction(10.74%,41.12 per 100000 doses)and 3 cases of coincidences(0.63%,2.42 per 100000 doses).The reported incidence of AEFI among delayed vaccinations was significantly lower than that among timely vaccinations(291.62 per 100000 doses vs.415.05 per 100000 doses).The incidence of AEFI for the four delayed vaccination methods(individual vaccination,simultaneous vaccination,routine vaccination and combined vaccination)was lower than that for timely vaccination.There were significant differences between the groups except for the routine vaccination group(χ^(2)=9.82,P<0.05;χ^(2)=5.46,P<0.05;χ^(2)=2.97,P>0.05;χ^(2)=11.89,P<0.05).Conclusions In Xuhui District of Shanghai,25.99%of doses of the national immunization program vaccines administered to children 0-6 years were delayed.Delayed vaccination does not increase the risk of AEFI compared with timely vaccination.
作者
吴强松
茅淑倩
徐延
龚睿婕
周祺
刘敏
刘景壹
朱丹红
郭翔
Wu Qiangsong;Mao Shuqian;Xu Yan;Gong Ruijie;Zhou Qi;Liu Min;Liu Jingyi;Zhu Danhong;Guo Xiang(Department of Immunization,Xuhui District Center for Disease Control and Prevention,Shanghai 200237,China;Clinic of Vaccination,Xujiahui Community Health Service Centre in Xuhui District,Shanghai 200030,China;Department of Immunization Program,Shanghai Municipal Center for Disease Controland Prevention,Shanghai 200336,China)
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2023年第7期983-991,共9页
Chinese Journal of Preventive Medicine
关键词
免疫规划
疫苗
接种
安全性
延迟接种
Immunization programs
Vaccines
Vaccination
Safety
Delayed vaccination
