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Article(id=1240651446983651561, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240651438955754377, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202401463, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1706457600000, receivedDateStr=2024-01-29, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773723955150, onlineDateStr=2026-03-17, pubDate=1719244800000, pubDateStr=2024-06-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773723955150, onlineIssueDateStr=2026-03-17, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773723955150, creator=13701087609, updateTime=1773723955150, updator=13701087609, issue=Issue{id=1240651438955754377, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='12', pageStart='2113', pageEnd='2912', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773723953236, creator=13701087609, updateTime=1773723953236, updator=13701087609, preIssue=null, nextIssue=null, ext=null, issueFiles=null}, startPage=2282, endPage=2286, ext={EN=ArticleExt(id=1240651448061587716, articleId=1240651446983651561, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Monitoring and analyses of adverse events following immunization in Guiyang City, 2014-2023, columnId=1228016571713520579, journalTitle=Modern Preventive Medicine, columnName=Health Supervison, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the characteristics of suspected adverse events following immunization (AEFI) in Guiyang City from 2014 to 2023, to evaluate the safety of immunization in Guiyang City, and to provide guidance for improving AEFI monitoring.

Methods

Collect AEFI data and vaccine immunization data in Guiyang City from 2014 to 2023 through the “National Immunization Planning Information System” and “Guizhou Province Immunization Planning Information Management System.” Use descriptive epidemiological methods to statistically analyze the epidemiological characteristics and reported incidence rates of AEFI in Guiyang City.

Results

From 2014 to 2023, Guiyang City reported a total of 4 498 cases of AEFI, with an average annual reported incidence rate of 14.63 per 100 000. The incidence rate was the highest in 2023 (1 358 cases, 42.43/100 000) and the lowest in 2015 (23 cases, 1.85/100 000). The reported incidence rate had a statistically significant difference among different years (χ2=3 638.04,P<0.001). Yunyan District reported the most cases (1 539 cases, 25.86/100 000), while Xifeng County reported the least cases (86 cases, 6.67/100 000), and the difference among different regions was statistically significant (χ2=890.10,P<0.001). The most cases were reported in November (588 cases, 24.7/100 000) and the least in February (136 cases, 8.37/100 000), and there was a statistically significant difference among different months (χ2=277.31,P<0.001). The male-to-female ratio was 1.10：1.00, with the highest reports in the age group ≤1 year (2 697 cases, 59.96%). The outcome was recovery or improvement in 96.47% of cases.

Conclusion

2014-2023 AEFI in Guiyang is mainly a general response and the vaccination safety is good. However, the work carried out in different places varies and the monitoring sensitivity needs to be further enhanced.

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目的

分析2014—2023年贵阳市疑似预防接种异常反应（Adverse Events Following Immunization，AEFI）的发生特征，评价贵阳市预防接种安全性，为提高AEFI监测及处置工作提供依据。

方法

通过“国家免疫规划信息系统”和“贵州省免疫规划信息管理系统”，收集2014—2023年贵阳市AEFI数据和疫苗接种数据，采用描述性流行病学方法对贵阳市AEFI流行病学特征和报告发生率进行统计分析。

结果

2014—2023年贵阳市共报告AEFI个案4 498例，年均报告发生率为14.63/10万，2023年最高（1 358例，42.43/10万），2015年最少（23例，1.85/10万），报告发生率不同年度差异有统计学意义（χ2=3 638.04，P<0.001）。云岩区报告最多（1 539例，25.86/10万），息烽县报告最少（86例，6.67/10万），不同地区差异有统计学意义（χ2=890.10，P<0.001）。11月报告最多（588例，24.7/10万），2月最少（136例，8.37/10万），不同月份差异有统计学意义（χ2=277.31，P<0.001）。男女比为1.10：1.00，≤1岁年龄组报告最多（2 697例，59.96%），96.47%转归为治愈和好转。

结论

2014—2023年贵阳市AEFI主要以一般反应为主，疫苗接种安全性良好，但各地工作开展有差异，仍需进一步提高监测敏感性。

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程菲，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=cSa8lB8CSkV4Rt5OuTAKdw==, magXml=mLr4pu/DJQCOhgR7K4r/hQ==, pdfUrl=null, pdf=FZvce/TqU9LIQQaoqefsKA==, pdfFileSize=507959, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=hLZZnhedSWyrLntSAwtdvA==, mapNumber=null, authorCompany=null, fund=null, authors=

程菲（1986—），女，本科，主管医师，研究方向：免疫规划及传染病防控相关工作

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程菲（1986—），女，本科，主管医师，研究方向：免疫规划及传染病防控相关工作

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程菲（1986—），女，本科，主管医师，研究方向：免疫规划及传染病防控相关工作

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language=CN, orderNo=3, keyword=疫苗)], refs=[Reference(id=1240651454332072577, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240651446983651561, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[1], rfOrder=0, authorNames=国家卫生健康委员会办公厅, journalName=null, refType=null, unstructuredReference=国家卫生健康委员会办公厅．全国疑似预防接种异常反应监测方案（2022版）[EB/OL]．[2024-05-13]．https://wjw.jiangsu.gov.cn/art/2022/12/15/art_7312_10707582.html．, articleTitle=全国疑似预防接种异常反应监测方案（2022版）, refAbstract=null), Reference(id=1240651454411764358, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240651446983651561, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[1], rfOrder=1, authorNames=The General Office of the National Health Commission, journalName=null, refType=null, unstructuredReference=The General Office of the 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Modern Preventive Medicine, 2019, 46(5): 921-924, 933., articleTitle=Surveillance of adverse events following immunization,Anyang, 2015-2017, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1240651448854311247, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240651446983651561, xref=1., ext=[AuthorCompanyExt(id=1240651448858505552, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240651446983651561, companyId=1240651448854311247, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Guiyang Center for Disease Prevention and Control, Guiyang, Guizhou 561000, China), AuthorCompanyExt(id=1240651448866894161, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240651446983651561, companyId=1240651448854311247, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.贵阳市疾病预防控制中心，贵州 贵阳 561000)]), AuthorCompany(id=1240651448971751771, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240651446983651561, xref=2., ext=[AuthorCompanyExt(id=1240651448975946076, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240651446983651561, companyId=1240651448971751771, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.贵州医科大学)])], figs=[ArticleFig(id=1240651452973118001, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240651446983651561, language=EN, label=Table 1, caption=

Classification of AEFI incidence agents in Guiyang from 2014 to 2023 [n(/100 000)]

, figureFileSmall=null, figureFileBig=null, tableContent=
年份疫苗接种剂次一般反应异常反应偶合症心因性反应接种事故总计
20141 195 56922(1.84)1(0.08)5(0.42)0(0.00)0(0.00)28(2.34)
20151 246 55821(1.68)1(0.08)0(0.00)0(0.00)1(0.08)23(1.85)
20161 331 35353(3.98)3(0.23)2(0.15)0(0.00)0(0.00)58(4.36)
20171 740 14977(4.42)8(0.46)1(0.06)0(0.00)0(0.00)86(4.94)
20182 253 367118(5.24)6（0.27）11(0.49)0(0.00)0(0.00)135(5.99)
20192 193 275249(11.35)12（0.55）16(0.73)0(0.00)0(0.00)277(12.63)
20202 880 395994(34.51)9（0.31）14(0.49)0(0.00)1(0.08)1 018(35.34)
202110 404 971585(5.62)39(0.37)67(0.64)2(0.02)0(0.00)693(6.66)
20224 296 942789(18.36)5(0.12)28(0.65)0(0.00)0(0.00)822(19.13)
20233 200 7021 339(41.83)4(0.12)15(0.47)0(0.00)0(0.00)1 358(42.43)
合计30 743 2814 247(13.50)88(0.29)159(0.52)2(0.01)2(0.01)4 498(14.63)
), ArticleFig(id=1240651453057004091, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240651446983651561, language=CN, label=表1, caption=

2014—2023年贵阳市AEFI报告发生率剂分类情况[n（/10万剂）]

, figureFileSmall=null, figureFileBig=null, tableContent=
年份疫苗接种剂次一般反应异常反应偶合症心因性反应接种事故总计
20141 195 56922(1.84)1(0.08)5(0.42)0(0.00)0(0.00)28(2.34)
20151 246 55821(1.68)1(0.08)0(0.00)0(0.00)1(0.08)23(1.85)
20161 331 35353(3.98)3(0.23)2(0.15)0(0.00)0(0.00)58(4.36)
20171 740 14977(4.42)8(0.46)1(0.06)0(0.00)0(0.00)86(4.94)
20182 253 367118(5.24)6（0.27）11(0.49)0(0.00)0(0.00)135(5.99)
20192 193 275249(11.35)12（0.55）16(0.73)0(0.00)0(0.00)277(12.63)
20202 880 395994(34.51)9（0.31）14(0.49)0(0.00)1(0.08)1 018(35.34)
202110 404 971585(5.62)39(0.37)67(0.64)2(0.02)0(0.00)693(6.66)
20224 296 942789(18.36)5(0.12)28(0.65)0(0.00)0(0.00)822(19.13)
20233 200 7021 339(41.83)4(0.12)15(0.47)0(0.00)0(0.00)1 358(42.43)
合计30 743 2814 247(13.50)88(0.29)159(0.52)2(0.01)2(0.01)4 498(14.63)
), ArticleFig(id=1240651453170250307, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240651446983651561, language=EN, label=Table 2, caption=

Gender and age distribution of AEFI in Guiyang from 2014 to 2023 [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量非严重AEFI严重AEFI总计
性别
男2 299（52.52）73(60.33)2 372(52.73）
女2 078（47.48）48(39.67)2 126（47.27）
年龄（岁）
<22 658（60.73）39(32.23)2 697（59.96）
2～<71 102（25.18）18(14.88)1 120（24.90）
7～<18131（2.99）6(4.96)137（3.05）
≥18486（11.10）58(47.93)544（12.09）
合计4 377（100.00）121(100.00)4 498（100.00）
), ArticleFig(id=1240651453291885129, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240651446983651561, language=CN, label=表2, caption=

2014—2023年贵阳市AEFI性别与年龄分布[n（%）]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量非严重AEFI严重AEFI总计
性别
男2 299（52.52）73(60.33)2 372(52.73）
女2 078（47.48）48(39.67)2 126（47.27）
年龄（岁）
<22 658（60.73）39(32.23)2 697（59.96）
2～<71 102（25.18）18(14.88)1 120（24.90）
7～<18131（2.99）6(4.96)137（3.05）
≥18486（11.10）58(47.93)544（12.09）
合计4 377（100.00）121(100.00)4 498（100.00）
), ArticleFig(id=1240651453400937039, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240651446983651561, language=EN, label=Table 3, caption=

2014-2023 Guiyang AEFI reporting time distribution

, figureFileSmall=null, figureFileBig=null, tableContent=
月份报告例数（例）接种剂次报告发生率（/10万）
11671 790 8469.33
21361 625 1978.37
34052 444 01516.57
43572 086 80317.11
53843 035 74512.65
64823 214 85014.99
74893 336 04014.66
84603 649 79912.6
93232 297 55214.06
103282 282 94014.37
115882 380 85524.7
123792 598 63914.58
合计4 49830 743 28114.63
), ArticleFig(id=1240651453518377560, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240651446983651561, language=CN, label=表3, caption=

2014—2023年贵阳市AEFI报告时间分布情况

, figureFileSmall=null, figureFileBig=null, tableContent=
月份报告例数（例）接种剂次报告发生率（/10万）
11671 790 8469.33
21361 625 1978.37
34052 444 01516.57
43572 086 80317.11
53843 035 74512.65
64823 214 85014.99
74893 336 04014.66
84603 649 79912.6
93232 297 55214.06
103282 282 94014.37
115882 380 85524.7
123792 598 63914.58
合计4 49830 743 28114.63
), ArticleFig(id=1240651453673566822, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240651446983651561, language=EN, label=Table 4, caption=

Regional distribution of AEFI cases reported in Guiyang from 2014 to 2023 [n(/100 000)]

, figureFileSmall=null, figureFileBig=null, tableContent=
地区接种剂次一般反应异常反应偶合症心因性反应接种事故总计
南明区5 407 744806（14.90）10（0.18）34(0.63)1(0.02)1(0.02)852(15.76)
云岩区5 950 3031 492（25.07）20（0.34）26(0.44)0(0.00)1(0.02)1 539(25.86)
花溪区4 343 022524（12.07）9（0.21）26(0.60)0(0.00)0(0.00)559(12.87)
乌当区1 525 59483（5.44）8（0.52）11(0.72)0(0.00)0(0.00)102(6.69)
白云区2 672 560278（10.40）4（0.15）9(0.34)0(0.00)0(0.00)291(10.89)
观山湖区2 327 437393（16.89）23（0.99）28(1.20)1(0.04)0(0.00)445(19.12)
开阳县1 804 292179（9.92）3（0.17）6(0.33)0(0.00)0(0.00)188(10.42)
息烽县1 289 35683（6.44）1（0.08）2(0.16)0(0.00)0(0.00)86(6.67)
修文县1 887 451152（8.05）4（0.21）7(0.37)0(0.00)0(0.00)163(8.64)
清镇市3 535 522257（7.27）6(0.17)10(0.28)0(0.00)0(0.00)273(7.72)
合计30 743 2814 247（13.81）88(0.29)159(0.52)2(0.01)2(0.01)4 498(14.63)
), ArticleFig(id=1240651453799395951, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240651446983651561, language=CN, label=表4, caption=

2014—2023年贵阳市报告AEFI个案地区分布[n（/10万）]

, figureFileSmall=null, figureFileBig=null, tableContent=
地区接种剂次一般反应异常反应偶合症心因性反应接种事故总计
南明区5 407 744806（14.90）10（0.18）34(0.63)1(0.02)1(0.02)852(15.76)
云岩区5 950 3031 492（25.07）20（0.34）26(0.44)0(0.00)1(0.02)1 539(25.86)
花溪区4 343 022524（12.07）9（0.21）26(0.60)0(0.00)0(0.00)559(12.87)
乌当区1 525 59483（5.44）8（0.52）11(0.72)0(0.00)0(0.00)102(6.69)
白云区2 672 560278（10.40）4（0.15）9(0.34)0(0.00)0(0.00)291(10.89)
观山湖区2 327 437393（16.89）23（0.99）28(1.20)1(0.04)0(0.00)445(19.12)
开阳县1 804 292179（9.92）3（0.17）6(0.33)0(0.00)0(0.00)188(10.42)
息烽县1 289 35683（6.44）1（0.08）2(0.16)0(0.00)0(0.00)86(6.67)
修文县1 887 451152（8.05）4（0.21）7(0.37)0(0.00)0(0.00)163(8.64)
清镇市3 535 522257（7.27）6(0.17)10(0.28)0(0.00)0(0.00)273(7.72)
合计30 743 2814 247（13.81）88(0.29)159(0.52)2(0.01)2(0.01)4 498(14.63)
), ArticleFig(id=1240651454038471285, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240651446983651561, language=EN, label=Table 5, caption=

Incidence of vaccine AEFI in Guiyang from 2014 to 2023 [n(/100 000)]

, figureFileSmall=null, figureFileBig=null, tableContent=
疫苗名称接种剂次一般反应异常反应接种事故偶合症心因性反应合计
卡介苗（BCG）769 60510（1.30）6（0.78）2（0.26）3（0.39）0（0.00）21（2.73）
乙肝疫苗（HepB）2 018 073216（10.70）1（0.05）0（0.00）6（0.30）0（0.00）223（11.05）
脊灰减毒活疫苗（OPV）1 277 65344（3.44）2（0.16）0（0.00）5（0.39）0（0.00）51(3.99)
脊灰灭活疫苗（IPV）891 606210（23.55）1（0.11）0（0.00）5（0.56）0（0.00）216(24.23)
百白破疫苗（DTaP）1 953 815504（25.80）0（0.00）0（0.00）7（0.36）0（0.00）511(26.15)
白破疫苗（DT）625 757191（30.52）2（0.32）0（0.00）0（0.00）0（0.00）193(30.84)
腮腺炎疫苗（Mumps）560 04443（7.68）3（0.54）0（0.00）2（0.36）0（0.00）48(8.57)
麻腮风疫苗（MMR）954 274395（41.39）2（0.21）0（0.00）7（0.73）0（0.00）404(42.34)
麻腮疫苗（MM）8 7012（22.99）0（0.00）0（0.00）0（0.00）0（0.00）2(22.99)
麻风减毒活疫苗(MR)353 50836（10.18）1（0.28）0（0.00）0（0.00）0（0.00）37(10.47)
A群流脑多糖疫苗 （MPSV-A）930 517126（13.54）1（0.11）0（0.00）6（0.64）0（0.00）133(14.29)
A群C群流脑多糖疫苗（MPSV-AC）1 057 71197（9.17）5（0.47）0（0.00）1（0.09）0（0.00）103(9.74)
A群C群脑膜炎球菌多糖结合疫苗(MPCV-AC)286 97173（25.44）1（0.35）0（0.00）0（0.00）0（0.00）74(25.79)
ACYW135群脑膜炎球菌疫苗(MPV-ACYW)196 73644（22.36）1（0.51）0（0.00）1（0.51）0（0.00）46(23.38)
乙脑减毒活疫苗（JE-L）1 231 482168（13.64）2（0.16）0（0.00）2（0.16）0（0.00）172(13.97)
乙脑灭活疫苗（JE-I）61 84912（19.40）1（1.62）0（0.00）0（0.00）0（0.00）13(21.02)
甲肝减毒活疫苗（HepA-L）533 07453（9.94）0（0.00）0（0.00）0（0.00）0（0.00）53(9.94)
甲肝灭活疫苗（HepA-I）228 60336（15.75）0（0.00）0（0.00）0（0.00）0（0.00）36(15.75)
流感病毒疫苗（Flu）1 794 360361（20.12）5（0.28）0（0.00）4（0.22）0（0.00）370(20.62)
水痘疫苗（VAR）1 091 880160（14.65）1（0.09）0（0.00）2（0.18）0（0.00）163(14.93)
带状疱疹疫苗(HZV)22 56937（163.94）0（0.00）0（0.00）0（0.00）0（0.00）37(163.94)
b型流感嗜血杆菌结合疫苗（Hib）516 75848（9.29）2（0.39）0（0.00）1（0.19）0（0.00）51(9.87)
轮状病毒疫苗（RV）505 45059（11.67）0（0.00）0（0.00）1（0.20）0（0.00）60(11.87)
23价肺炎球菌疫苗（PPSV-23）385 106131（34.02）4（1.04）0（0.00）6（1.56）0（0.00）141(36.61)
13价肺炎球菌疫苗（PCV-13）284 749348（122.21）1（0.35）0（0.00）6（2.11）0（0.00）355(124.67)
狂犬病疫苗(RabV)254 91229（11.38）3（1.18）0（0.00）1（0.39）0（0.00）33(12.95)
霍乱疫苗（CV）203 99419（9.31）0（0.00）0（0.00）0（0.00）0（0.00）19(9.31)
无细胞百白破b型流感嗜血杆菌（结合）联合疫苗(DTaP-Hib)243 852210（86.12）2（0.82）0（0.00）3（1.23）0（0.00）215(88.17)
吸附无细胞百白破灭活脊髓灰质炎和b型流感嗜血杆菌（结合）联合疫苗(DTaP-IPV-Hib271 011185（68.26）3（1.11）0（0.00）3（1.11）0（0.00）191(70.48)
A群C群脑膜炎球菌和b型流感嗜血杆菌疫苗（AC-Hib）64 5745（7.74）0（0.00）0（0.00）0（0.00）0（0.00）5(7.74)
肠道病毒71型灭活疫苗（EV71）759 605124（16.32）0（0.00）0（0.00）4（0.53）0（0.00）128(16.85)
人乳头瘤病毒疫苗（HPV）902 41393（10.31）0（0.00）0（0.00）2（0.22）0（0.00）95(10.53)
新型冠状病毒疫苗(COVID-19V)9 502 069178（1.87）38（0.40）0（0.00）81（0.85）2（0.02）299(3.15)
合计30 743 2814 247（13.81）88（0.29）2（0.01）159（0.52）2（0.01）4 498(14.63)
), ArticleFig(id=1240651454210437753, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240651446983651561, language=CN, label=表5, caption=

2014—2023年贵阳市疫苗AEFI发生情况[n（/10万）]

, figureFileSmall=null, figureFileBig=null, tableContent=
疫苗名称接种剂次一般反应异常反应接种事故偶合症心因性反应合计
卡介苗（BCG）769 60510（1.30）6（0.78）2（0.26）3（0.39）0（0.00）21（2.73）
乙肝疫苗（HepB）2 018 073216（10.70）1（0.05）0（0.00）6（0.30）0（0.00）223（11.05）
脊灰减毒活疫苗（OPV）1 277 65344（3.44）2（0.16）0（0.00）5（0.39）0（0.00）51(3.99)
脊灰灭活疫苗（IPV）891 606210（23.55）1（0.11）0（0.00）5（0.56）0（0.00）216(24.23)
百白破疫苗（DTaP）1 953 815504（25.80）0（0.00）0（0.00）7（0.36）0（0.00）511(26.15)
白破疫苗（DT）625 757191（30.52）2（0.32）0（0.00）0（0.00）0（0.00）193(30.84)
腮腺炎疫苗（Mumps）560 04443（7.68）3（0.54）0（0.00）2（0.36）0（0.00）48(8.57)
麻腮风疫苗（MMR）954 274395（41.39）2（0.21）0（0.00）7（0.73）0（0.00）404(42.34)
麻腮疫苗（MM）8 7012（22.99）0（0.00）0（0.00）0（0.00）0（0.00）2(22.99)
麻风减毒活疫苗(MR)353 50836（10.18）1（0.28）0（0.00）0（0.00）0（0.00）37(10.47)
A群流脑多糖疫苗 （MPSV-A）930 517126（13.54）1（0.11）0（0.00）6（0.64）0（0.00）133(14.29)
A群C群流脑多糖疫苗（MPSV-AC）1 057 71197（9.17）5（0.47）0（0.00）1（0.09）0（0.00）103(9.74)
A群C群脑膜炎球菌多糖结合疫苗(MPCV-AC)286 97173（25.44）1（0.35）0（0.00）0（0.00）0（0.00）74(25.79)
ACYW135群脑膜炎球菌疫苗(MPV-ACYW)196 73644（22.36）1（0.51）0（0.00）1（0.51）0（0.00）46(23.38)
乙脑减毒活疫苗（JE-L）1 231 482168（13.64）2（0.16）0（0.00）2（0.16）0（0.00）172(13.97)
乙脑灭活疫苗（JE-I）61 84912（19.40）1（1.62）0（0.00）0（0.00）0（0.00）13(21.02)
甲肝减毒活疫苗（HepA-L）533 07453（9.94）0（0.00）0（0.00）0（0.00）0（0.00）53(9.94)
甲肝灭活疫苗（HepA-I）228 60336（15.75）0（0.00）0（0.00）0（0.00）0（0.00）36(15.75)
流感病毒疫苗（Flu）1 794 360361（20.12）5（0.28）0（0.00）4（0.22）0（0.00）370(20.62)
水痘疫苗（VAR）1 091 880160（14.65）1（0.09）0（0.00）2（0.18）0（0.00）163(14.93)
带状疱疹疫苗(HZV)22 56937（163.94）0（0.00）0（0.00）0（0.00）0（0.00）37(163.94)
b型流感嗜血杆菌结合疫苗（Hib）516 75848（9.29）2（0.39）0（0.00）1（0.19）0（0.00）51(9.87)
轮状病毒疫苗（RV）505 45059（11.67）0（0.00）0（0.00）1（0.20）0（0.00）60(11.87)
23价肺炎球菌疫苗（PPSV-23）385 106131（34.02）4（1.04）0（0.00）6（1.56）0（0.00）141(36.61)
13价肺炎球菌疫苗（PCV-13）284 749348（122.21）1（0.35）0（0.00）6（2.11）0（0.00）355(124.67)
狂犬病疫苗(RabV)254 91229（11.38）3（1.18）0（0.00）1（0.39）0（0.00）33(12.95)
霍乱疫苗（CV）203 99419（9.31）0（0.00）0（0.00）0（0.00）0（0.00）19(9.31)
无细胞百白破b型流感嗜血杆菌（结合）联合疫苗(DTaP-Hib)243 852210（86.12）2（0.82）0（0.00）3（1.23）0（0.00）215(88.17)
吸附无细胞百白破灭活脊髓灰质炎和b型流感嗜血杆菌（结合）联合疫苗(DTaP-IPV-Hib271 011185（68.26）3（1.11）0（0.00）3（1.11）0（0.00）191(70.48)
A群C群脑膜炎球菌和b型流感嗜血杆菌疫苗（AC-Hib）64 5745（7.74）0（0.00）0（0.00）0（0.00）0（0.00）5(7.74)
肠道病毒71型灭活疫苗（EV71）759 605124（16.32）0（0.00）0（0.00）4（0.53）0（0.00）128(16.85)
人乳头瘤病毒疫苗（HPV）902 41393（10.31）0（0.00）0（0.00）2（0.22）0（0.00）95(10.53)
新型冠状病毒疫苗(COVID-19V)9 502 069178（1.87）38（0.40）0（0.00）81（0.85）2（0.02）299(3.15)
合计30 743 2814 247（13.81）88（0.29）2（0.01）159（0.52）2（0.01）4 498(14.63)
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2014—2023年贵阳市疑似预防接种异常反应监测分析
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程菲 1 , 高岚 1 , 田莲鑫 2 , 李学 1 , 王秋云 1
现代预防医学 | 卫生监督 2024,51(12): 2282-2286
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现代预防医学 | 卫生监督 2024, 51(12): 2282-2286
2014—2023年贵阳市疑似预防接种异常反应监测分析
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程菲1 , 高岚1, 田莲鑫2, 李学1, 王秋云1
作者信息
  • 1.贵阳市疾病预防控制中心，贵州 贵阳 561000
  • 2.贵州医科大学

    • 程菲（1986—），女，本科，主管医师，研究方向：免疫规划及传染病防控相关工作

通讯作者:

程菲，E-mail:
Monitoring and analyses of adverse events following immunization in Guiyang City, 2014-2023
Fei CHENG1 , Lan GAO1, Lian-xin TIAN2, Xue LI1, Qiu-yun WANG1
Affiliations
  • Guiyang Center for Disease Prevention and Control, Guiyang, Guizhou 561000, China
出版时间: 2024-06-25 doi: 10.20043/j.cnki.MPM.202401463
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摘要
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目的

分析2014—2023年贵阳市疑似预防接种异常反应（Adverse Events Following Immunization，AEFI）的发生特征，评价贵阳市预防接种安全性，为提高AEFI监测及处置工作提供依据。

方法

通过“国家免疫规划信息系统”和“贵州省免疫规划信息管理系统”，收集2014—2023年贵阳市AEFI数据和疫苗接种数据，采用描述性流行病学方法对贵阳市AEFI流行病学特征和报告发生率进行统计分析。

结果

2014—2023年贵阳市共报告AEFI个案4 498例，年均报告发生率为14.63/10万，2023年最高（1 358例，42.43/10万），2015年最少（23例，1.85/10万），报告发生率不同年度差异有统计学意义（χ2=3 638.04，P<0.001）。云岩区报告最多（1 539例，25.86/10万），息烽县报告最少（86例，6.67/10万），不同地区差异有统计学意义（χ2=890.10，P<0.001）。11月报告最多（588例，24.7/10万），2月最少（136例，8.37/10万），不同月份差异有统计学意义（χ2=277.31，P<0.001）。男女比为1.10：1.00，≤1岁年龄组报告最多（2 697例，59.96%），96.47%转归为治愈和好转。

结论

2014—2023年贵阳市AEFI主要以一般反应为主，疫苗接种安全性良好，但各地工作开展有差异，仍需进一步提高监测敏感性。

监测  /  疑似预防接种异常反应  /  疫苗
Objective

To analyze the characteristics of suspected adverse events following immunization (AEFI) in Guiyang City from 2014 to 2023, to evaluate the safety of immunization in Guiyang City, and to provide guidance for improving AEFI monitoring.

Methods

Collect AEFI data and vaccine immunization data in Guiyang City from 2014 to 2023 through the “National Immunization Planning Information System” and “Guizhou Province Immunization Planning Information Management System.” Use descriptive epidemiological methods to statistically analyze the epidemiological characteristics and reported incidence rates of AEFI in Guiyang City.

Results

From 2014 to 2023, Guiyang City reported a total of 4 498 cases of AEFI, with an average annual reported incidence rate of 14.63 per 100 000. The incidence rate was the highest in 2023 (1 358 cases, 42.43/100 000) and the lowest in 2015 (23 cases, 1.85/100 000). The reported incidence rate had a statistically significant difference among different years (χ2=3 638.04,P<0.001). Yunyan District reported the most cases (1 539 cases, 25.86/100 000), while Xifeng County reported the least cases (86 cases, 6.67/100 000), and the difference among different regions was statistically significant (χ2=890.10,P<0.001). The most cases were reported in November (588 cases, 24.7/100 000) and the least in February (136 cases, 8.37/100 000), and there was a statistically significant difference among different months (χ2=277.31,P<0.001). The male-to-female ratio was 1.10：1.00, with the highest reports in the age group ≤1 year (2 697 cases, 59.96%). The outcome was recovery or improvement in 96.47% of cases.

Conclusion

2014-2023 AEFI in Guiyang is mainly a general response and the vaccination safety is good. However, the work carried out in different places varies and the monitoring sensitivity needs to be further enhanced.

Surveillance  /  Adverse events following immunization  /  Vaccine
程菲, 高岚, 田莲鑫, 李学, 王秋云. 2014—2023年贵阳市疑似预防接种异常反应监测分析. 现代预防医学, 2024 , 51 (12) : 2282 -2286 . DOI: 10.20043/j.cnki.MPM.202401463
Fei CHENG, Lan GAO, Lian-xin TIAN, Xue LI, Qiu-yun WANG. Monitoring and analyses of adverse events following immunization in Guiyang City, 2014-2023[J]. Modern Preventive Medicine, 2024 , 51 (12) : 2282 -2286 . DOI: 10.20043/j.cnki.MPM.202401463
正文
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在预防接种后发生的怀疑与预防接种有关的反应或事件称为疑似预防接种异常反应[1]（Adverse events following immunization, AEFI）。做好AEFI监测工作，不仅可以评价疫苗安全性，而且能提升公众对预防接种的信心。本研究对2014年至2023年贵阳市AEFI报告的数据进行分析，为提高AEFI的监测的质量和增强疫苗接种安全性提供依据。
1　资料与方法
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1.1　数据来源
1.1.1　AEFI个案
通过“国家免疫规划信息系统”收集包括2014年1月1日至2023年12月31日期间在贵阳市接种疫苗后报告的所有AEFI。
1.1.2　疫苗接种剂次
通过“贵州省免疫规划信息系统”收集包括2014年1月1日至2023年12月31日期间在贵阳市进行的所有国家免疫规划和非免疫规划疫苗的接种剂次数。
1.2　AEFI监测范围与分类
根据2022年版的《全国疑似预防接种异常反应监测方案》[1]，AEFI可分为不良反应、心因性反应、偶合症、疫苗质量事故和接种事故这五类，不良反应主要分为一般反应和异常反应。一般反应是指受种者可能会出现短暂、轻微的生理反应，而异常反应则可能导致受种者的组织器官或功能受损。不良反应是由疫苗本身的特性引起的。
1.3　监测疫苗
2014—2023年报告的AEFI共涉及34种疫苗。包括免疫规划疫苗和非免疫规划疫苗（详见表5）。
1.4　统计分析
本研究采用SPSS 26.0统计软件进行数据录入和分析，利用描述性流行病学方法分析了AEFI的分布特征。AEFI报告发生率(1/10万)=AEFI报告数/疫苗接种剂次数×10万剂。通过卡方检验比较了不同率之间的差异，当P≤0.05时，差异被认为具有统计学意义。
2　结果
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2.1　AEFI报告发生率和分类情况
在2014年至2023年期间，贵阳市完成了30 743 281剂次疫苗接种，共报告了4 498例AEFI，AEFI年均报告发生率为14.63/10万剂。2020年呈现小高峰, 2021年开始报告发生率有所下降，2022年报告发生率回升至2023年最高，不同年份之间报告发生率差异有统计学意义（χ2 =3 638.04，P<0.001）。
4 498例AEFI中，一般反应占比为94.42%（4 247例），异常反应占比为1.96%（88例），偶合症占比为3.53%（159例），心因性反应占比为0.04%（2例），怀疑接种差错相关反应占比为0.04%（2例）。见表1。
2.2　AEFI分布情况
2.2.1　人群分布
4 498例AEFI中,男性占52.73%，女性占47.27%，男女性别比为1.10：1.00。<2岁的人群报告最多占总报告数的59.96%，严重AEFI共有121例，其中≥18岁年龄组占47.93%，不同年龄组差异有统计学意义（χ2=154.52，P<0.001），男女性别差异无统计学意义（χ2=2.88，P=0.09），见表2。
2.2.2　时间分布
每月均有AEFI报告，11月报告发生率最高（24.70/10万），其次是4月（17.11/10万），2月最低（8.37/10万），不同月份AEFI报告发生率差异有统计学意义（χ2=277.31，P<0.001）。见表3。
2.2.3　地区分布
贵阳市10个县（区、市）均有病例报告，报告发生率排位前三依次为云岩区（25.86/10万）、观山湖区（19.12/10万）、南明区（15.76/10万），不同地区AEFI报告发生率差异有统计学意义（χ2=890.10，P<0.001）。见表4。
2.3　疫苗分布
贵阳市AEFI报告发生率范围在2.73/10万至163.94/10万之间。其中，报告的一般反应发生率较高的疫苗包括带状疱疹疫苗（163.94/10万）、13价肺炎球菌疫苗（122.21/10万）和无细胞百白破b型流感嗜血杆菌（结合）联合疫苗（86.12/10万）；而异常反应发生率较高的疫苗则分别是乙脑灭活疫苗（1.62/10万）、狂犬病疫苗（1.18/10万）和吸附无细胞百白破灭活脊髓灰质炎和b型流感嗜血杆菌（结合）联合疫苗（1.11/10万）。见表5。
2.4　AEFI病例转归情况
报告的AEFI病例，有4 357例（占96.87%）治愈或好转，有68例(占1.51%)正在接受治疗，有49例(占1.09%)出现后遗症，有10例(占0.22%)不幸死亡，有3例(占0.07%)病情加重，还有11例(占0.24%)情况不详。所有死亡病例都是偶合症，其中6例进行了尸检，4例因家属拒绝尸体解剖而导致死因不明。11例不详病例中有10例为一般反应，1例怀疑与接种差错相关。
3　讨论
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2014—2023年贵阳市AEFI年均报告发生率为14.63/10万剂，呈整体上升趋势，2023年达到最高42.43/10万，略高于全国水平[2-5]的40.94/10万和贵州省平均水平[6]。提示随着AEFI监测工作的规范开展，贵阳市AEFI监测敏感性在不断提高[7]。2021年报告发生率有所下降可能是因为新冠肺炎疫情的发生，部分地区实施封控等政策，疫苗接种工作稍有延缓，导致AEFI监测工作的敏感性减弱。
与全国[5]及其他地区[8-12]研究结果相同，贵阳市AEFI主要为一般反应，异常反应极少。有2例接种卡介苗后怀疑与接种差错相关反应，可能与预防接种人员未严格执行“三查七对一验证”有关，应进一步强化接种人员安全、规范接种意识，再加强接种人员的接种技能培训。有2例接种新冠疫苗后出现心因性反应，不排除新型冠状病毒感染疫情发生后，新冠疫苗的快速使用导致部分个体对疫苗安全信任度降低，提示要进一步加强疫苗安全性宣传，提高公众信任度。
AEFI病例男性多于女性,这与全国监测结果基本一致；病例主要集中在7岁以下（84.86%），这与免疫规划预防接种目标儿童主要为7岁以下儿童的策略相符，18岁及以上人群AEFI比例有所增加，这与张丽娜等人[5]的研究一致，近几年新冠疫苗、宫颈癌疫苗、带状疱疹疫苗等成人使用的疫苗增加，可能与受种者个体差异及疫苗所含的佐剂等因素相关。
AEFI所有月份均有病例报告，11月高发，其次为4月，与全国[2-5]及贵州省[6]的有所不同，贵阳市每年11月及4月气温波动幅度较大，部分受种者因适应季节变化引起的机体反应与接种后反应相似，可能导致报告数增加。各县（区、市）AEFI报告情况差异较大，这与各县（区、市）对AEFI监测工作的重视程度及工作人员对监测敏感度等因素有关，提示应进一步加强监测工作培训。
AEFI不良反应报告发生率排名前3的疫苗均为非免疫规划疫苗，原因可能与这些疫苗价格较高,受种方和预防接种单位对接种后的不良反应比较关注或者与疫苗本身的特性有关[9]。从异常反应报告发生率看，报告疫苗主要是JE-I、RabV和DTaP-IPV-Hib，均为过敏反应；从异常反应报告例数看，报告疫苗主要是BCG和COVID-19V，BCG引起的6例AEFI有4例为先天性免疫缺陷患儿和2例为过敏性反应，COVID-19V引起的分别为36例过敏性反应和2例脑炎。过敏性反应病例主要是以过敏性皮疹为主，表明贵阳市疫苗接种安全性较好，但提示在预防接种实施过程中，应做好接种前的健康询问,严格把握禁忌症，落实受种者接种后留观30 min的要求。
90%以上的AEFI转归为治愈或好转，说明多数AEFI临床症状较轻,预后良好。监测中存在转归不详的个案,提示贵阳市要持续追踪受种者的健康状态,及时更新受种者病情转归情况，为展开更深入评估奠定基础。
综上,2014—2023年贵阳市AEFI监测系统运转良好，预防接种安全性较高，但各地工作开展不平衡，整体监测能力仍有提升空间。因此，除了积极开展对基层人员的培训和技术指导,提高监测能力和工作质量,促进AEFI监测各项工作科学、规范、有序的开展外,还可通过家长自我监测、医护主动监测、保险补偿监测等多种形式进一步提高贵阳市AEFI的监测敏感性。AEFI监测及处置是预防接种工作重要组成部分,为能对AEFI调查诊断提供更为详实的线索，同时判定疫苗接种禁忌，应探索新的主动监测摸索，从而更全面、持续、系统地评估疫苗的安全性。
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2024年第51卷第12期
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doi: 10.20043/j.cnki.MPM.202401463
  • 接收时间：2024-01-29
  • 首发时间：2026-03-17
  • 出版时间：2024-06-25
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  • 收稿日期：2024-01-29
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    1.贵阳市疾病预防控制中心，贵州 贵阳 561000
    2.贵州医科大学

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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