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Article(id=1240730061704319830, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240730050669113883, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202412222, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1734019200000, receivedDateStr=2024-12-13, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773742698359, onlineDateStr=2026-03-17, pubDate=1745510400000, pubDateStr=2025-04-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773742698359, onlineIssueDateStr=2026-03-17, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773742698359, creator=13701087609, updateTime=1773742698359, updator=13701087609, issue=Issue{id=1240730050669113883, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='8', pageStart='1345', pageEnd='1536', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773742695728, creator=13701087609, updateTime=1773742807836, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240730520988995837, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240730050669113883, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240730520988995838, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240730050669113883, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1497, endPage=1501, ext={EN=ArticleExt(id=1240730062065029993, articleId=1240730061704319830, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Compensation for adverse events following immunization of National Immunization Program vaccines, Anhui, 2012-2024, columnId=1228016573156360233, journalTitle=Modern Preventive Medicine, columnName=Disease Control and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the compensation for adverse events following immunization from vaccination under Anhui Province’s National Immunization Program (NIP) from 2012 to 2024.

Methods

Data from cases compensated for adverse events following immunization from vaccination in Anhui Province from 2012 to 2024 were collected and analyzed using descriptive NIP demiological methods.

Results

From 2012 to 2024, there were a total of 80 AEFI compensation cases in Anhui Province for NIP vaccines, with the lowest compensation amount being 13 200 yuan and the highest compensation amount being 1.54 million yuan. The total compensation amounted to 35.49 million yuan, with an average compensation of 443 600 yuan per case (ranging from 13 200 yuan to 1.54 million yuan). The number of cases and compensation amount for those under 1 year old were the highest, with 64 cases (80.00%) and 25.29 million yuan (71.26%) respectively. In the vaccine distribution, BCG vaccine had the highest number of AEFI compensation cases and compensation amount, with 33 cases (41.25%) and 1.05 million yuan (29.64%), respectively. In terms of clinical diagnoses, neurological diseases had the highest number of cases and total compensation amount, with 33 cases (41.25%) and 2.03 million yuan (57.26%). In the damage severity classification, Grade IV had the most compensation cases, with 20 cases (25.00%), while Grade II-B had the highest total compensation amount, totaling 7.49 million yuan(21.09%). The average payment time after the investigation and diagnosis conclusion was 252.28 days.

Conclusion

The overall implementation of compensation for adverse events following immunization from vaccination under Anhui Province’s NIP is good, but there is a need for further improvement in compensation procedures and mechanisms.

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目的

分析安徽省2012—2024年免疫规划(National Immunization Program，NIP)疫苗预防接种异常反应补偿情况。

方法

收集整理安徽省2012—2024年NIP疫苗预防接种异常反应的补偿个案资料，采用描述流行病学方法进行分析。

结果

2012—2024年安徽省NIP疫苗预防接种异常反应补偿个案共80例，最低补偿金额1.32万元，最高补偿金额154.10万元，补偿总金额3 549.03万元，平均每例补偿44.36万元(1.32万元～154.10万元)。<1岁补偿例数和补偿金额均最高，分别为64例(80.00%)和2 529.06万元(71.26%)。疫苗分布中卡介苗预防接种异常反应的补偿例数和补偿金额均最高，分别为共33例(41.25%)和1 051.98万元(29.64%)。临床诊断分布中神经系统疾病的例数和补偿总金额均最高，分别为33例(41.25%)和2 032.06万元(57.26%)。损害程度分级中四级的补偿例数最多，共20例(25.00%)，二级乙等补偿总金额最高，金额为748.57万元(21.09%)。在作出调查诊断或鉴定结论至补偿款支付的时间间隔为252.28 d。

结论

安徽省NIP疫苗预防接种异常反应补偿工作总体实施情况良好，需进一步完善补偿程序和机制。

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王斌冰，E-mail:
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孟凡亚和胡文怡为共同第一作者。

孟凡亚(1982—），女，博士，主任医师，研究方向：疫苗安全性；

胡文怡（2000—），女，硕士在读，研究方向：疫苗安全性

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孟凡亚(1982—），女，博士，主任医师，研究方向：疫苗安全性；

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孟凡亚(1982—），女，博士，主任医师，研究方向：疫苗安全性；

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胡文怡（2000—），女，硕士在读，研究方向：疫苗安全性

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胡文怡（2000—），女，硕士在读，研究方向：疫苗安全性

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tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730061704319830, language=CN, orderNo=2, keyword=预防接种异常反应), Keyword(id=1241070728460685376, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730061704319830, language=CN, orderNo=3, keyword=补偿)], refs=[Reference(id=1241070729656062107, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730061704319830, doi=null, pmid=null, pmcid=null, year=2023, volume=29, issue=4, pageStart=451, pageEnd=457, url=null, language=null, rfNumber=[1], rfOrder=0, authorNames=张丽娜, 李克莉, 李燕, journalName=中国疫苗和免疫, refType=null, unstructuredReference=张丽娜，李克莉，李燕，等.2017—2020年中国人乳头瘤病毒疫苗疑似预防接种异常反应监测[J].中国疫苗和免疫，2023, 29(4): 451-457., articleTitle=2017—2020年中国人乳头瘤病毒疫苗疑似预防接种异常反应监测, refAbstract=null), Reference(id=1241070729756725411, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730061704319830, doi=null, pmid=null, pmcid=null, year=2023, volume=29, issue=4, 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(In Chinese), articleTitle=A case report of lymph node tuberculosis caused by BCG vaccination, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1241070724329296727, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730061704319830, xref=1., ext=[AuthorCompanyExt(id=1241070724346073946, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730061704319830, companyId=1241070724329296727, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui 230601, China), AuthorCompanyExt(id=1241070724354462556, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730061704319830, companyId=1241070724329296727, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.安徽省疾病预防控制中心，安徽　合肥　230601)]), AuthorCompany(id=1241070724442542945, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730061704319830, xref=2., ext=[AuthorCompanyExt(id=1241070724446737252, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730061704319830, companyId=1241070724442542945, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.蚌埠医科大学)])], figs=[ArticleFig(id=1241070728670400597, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730061704319830, language=EN, label=Table 1, caption=

Number of compensation cases and compensation amounts for adverse events following immunization to NIP vaccines in Anhui Province from 2012 to 2024

, figureFileSmall=null, figureFileBig=null, tableContent=
年份补偿个案补偿金额(万元)
例数构成比(%)最低最高平均总计构成比(%)
2012年67.5036.1851.9844.76268.597.57
2013年45.0034.8758.6847.89191.565.40
2014年3 3.75 13.97 62.23 42.12126.37 3.56
2015年12 15.00 20.83 64.01 43.32519.89 14.65
2016年9 11.25 7.04 76.11 35.76321.88 9.07
2017年7 8.75 6.22 58.75 33.88237.19 6.68
2018年4 5.00 18.02 67.50 43.04172.16 4.85
2019年3 3.75 44.57 85.47 69.53208.58 5.88
2020年10 12.50 8.35 90.52 34.81348.14 9.81
2021年7 8.75 13.35 154.10 65.15456.08 12.85
2022年3 3.75 23.40 129.48 59.56178.67 5.03
2023年9 11.25 1.32 101.14 41.44372.97 10.51
2024年3 3.75 38.64 65.56 48.98146.95 4.14
合计80 100.00 1.32 154.10 44.363549.03 100.00
), ArticleFig(id=1241070728796229727, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730061704319830, language=CN, label=表1, caption=

2012—2024年安徽省NIP疫苗预防接种异常反应补偿例数和补偿金额

, figureFileSmall=null, figureFileBig=null, tableContent=
年份补偿个案补偿金额(万元)
例数构成比(%)最低最高平均总计构成比(%)
2012年67.5036.1851.9844.76268.597.57
2013年45.0034.8758.6847.89191.565.40
2014年3 3.75 13.97 62.23 42.12126.37 3.56
2015年12 15.00 20.83 64.01 43.32519.89 14.65
2016年9 11.25 7.04 76.11 35.76321.88 9.07
2017年7 8.75 6.22 58.75 33.88237.19 6.68
2018年4 5.00 18.02 67.50 43.04172.16 4.85
2019年3 3.75 44.57 85.47 69.53208.58 5.88
2020年10 12.50 8.35 90.52 34.81348.14 9.81
2021年7 8.75 13.35 154.10 65.15456.08 12.85
2022年3 3.75 23.40 129.48 59.56178.67 5.03
2023年9 11.25 1.32 101.14 41.44372.97 10.51
2024年3 3.75 38.64 65.56 48.98146.95 4.14
合计80 100.00 1.32 154.10 44.363549.03 100.00
), ArticleFig(id=1241070728934641769, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730061704319830, language=EN, label=Table 2, caption=

Gender, age, and regional distribution of compensation cases and compensation amounts for adverse events following immunization to NIP vaccines in Anhui Province from 2012 to 2024

, figureFileSmall=null, figureFileBig=null, tableContent=
分类补偿个案补偿金额(万元)
例数构成比(%)最低最高平均总计构成比(%)
性别
男57 71.25 1.32 129.48 42.462 420.3768.20
女23 28.75 2.14 154.10 49.071 128.6631.80
年龄（岁）
<164 80.00 1.32 129.48 39.522 529.0671.26
14 5.00 7.04 78.54 45.97183.88 5.18
2～68 10.00 42.75 101.14 72.21577.7116.28
>64 5.00 26.84 154.10 64.60258.39 7.28
地区
皖南25 31.25 7.24 154.10 55.561 389.0639.14
皖北28 35.00 1.32 101.14 42.341 185.4333.40
皖中27 33.75 2.14 85.47 36.09974.5427.46
合计80100.00 1.32 154.10 44.363 549.03100.00
), ArticleFig(id=1241070729052082294, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730061704319830, language=CN, label=表2, caption=

2012—2024年安徽省NIP疫苗预防接种异常反应补偿例数和补偿金额的性别、年龄和地区分布

, figureFileSmall=null, figureFileBig=null, tableContent=
分类补偿个案补偿金额(万元)
例数构成比(%)最低最高平均总计构成比(%)
性别
男57 71.25 1.32 129.48 42.462 420.3768.20
女23 28.75 2.14 154.10 49.071 128.6631.80
年龄（岁）
<164 80.00 1.32 129.48 39.522 529.0671.26
14 5.00 7.04 78.54 45.97183.88 5.18
2～68 10.00 42.75 101.14 72.21577.7116.28
>64 5.00 26.84 154.10 64.60258.39 7.28
地区
皖南25 31.25 7.24 154.10 55.561 389.0639.14
皖北28 35.00 1.32 101.14 42.341 185.4333.40
皖中27 33.75 2.14 85.47 36.09974.5427.46
合计80100.00 1.32 154.10 44.363 549.03100.00
), ArticleFig(id=1241070729177911423, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730061704319830, language=EN, label=Table 3, caption=

Distribution of vaccines related to compensation cases and compensation amounts for adverse events following immunization to NIP vaccines in Anhui Province from 2012 to 2024

, figureFileSmall=null, figureFileBig=null, tableContent=
疫苗名称补偿例数补偿金额(万元)
例数构成比(%)最小值最大值平均值总和构成比(%)
BCG33 41.25 1.32 90.11 31.881 051.9829.64
tOPV19 23.75 24.20 74.11 50.03950.5226.78
DTaP4 5.00 7.04 78.54 44.23176.91 4.98
MPV－AC3 3.75 76.11 154.10 108.91326.72 9.21
MMR3 3.75 26.84 36.07 30.4391.29 2.57
JE－L3 3.75 39.03 101.14 76.90230.70 6.50
DTaP和bOPV3 3.75 10.84 129.48 61.38184.14 5.19
bOPV3 3.75 49.32 85.47 61.48184.44 5.20
H1N12 2.50 34.87 42.58 38.7277.45 2.18
DTaP和tOPV2 2.50 50.18 67.50 58.84117.68 3.32
MV1 1.25 51.98 51.98 51.9851.98 1.46
MR和MPCV－AC1 1.25 13.70 13.70 13.7013.70 0.39
MPCV－AC1 1.25 57.02 57.02 57.0257.02 1.61
HepB和BCG1 1.25 13.97 13.97 13.9713.97 0.39
HepB1 1.25 20.55 20.55 20.5520.55 0.58
总计80100.00 1.32 154.10 44.363549.03100.00
), ArticleFig(id=1241070729282769029, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730061704319830, language=CN, label=表3, caption=

2012—2024年安徽省NIP疫苗预防接种异常反应补偿例数和补偿金额的疫苗分布

, figureFileSmall=null, figureFileBig=null, tableContent=
疫苗名称补偿例数补偿金额(万元)
例数构成比(%)最小值最大值平均值总和构成比(%)
BCG33 41.25 1.32 90.11 31.881 051.9829.64
tOPV19 23.75 24.20 74.11 50.03950.5226.78
DTaP4 5.00 7.04 78.54 44.23176.91 4.98
MPV－AC3 3.75 76.11 154.10 108.91326.72 9.21
MMR3 3.75 26.84 36.07 30.4391.29 2.57
JE－L3 3.75 39.03 101.14 76.90230.70 6.50
DTaP和bOPV3 3.75 10.84 129.48 61.38184.14 5.19
bOPV3 3.75 49.32 85.47 61.48184.44 5.20
H1N12 2.50 34.87 42.58 38.7277.45 2.18
DTaP和tOPV2 2.50 50.18 67.50 58.84117.68 3.32
MV1 1.25 51.98 51.98 51.9851.98 1.46
MR和MPCV－AC1 1.25 13.70 13.70 13.7013.70 0.39
MPCV－AC1 1.25 57.02 57.02 57.0257.02 1.61
HepB和BCG1 1.25 13.97 13.97 13.9713.97 0.39
HepB1 1.25 20.55 20.55 20.5520.55 0.58
总计80100.00 1.32 154.10 44.363549.03100.00
), ArticleFig(id=1241070729387626635, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730061704319830, language=EN, label=Table 4, caption=

Distribution of damage levels for compensation cases and compensation amounts for adverse events following immunization to NIP vaccines in Anhui Province from 2012 to 2024

, figureFileSmall=null, figureFileBig=null, tableContent=
损害分级补偿例数构成比(%)补偿金额(万元)构成比(%)
一级甲等13 16.25558.53 15.74
一级乙等1 1.25129.48 3.65
二级甲等2 2.50122.69 3.46
二级乙等11 13.75748.57 21.09
二级丙等4 5.00225.45 6.35
二级丁等11 13.75609.60 17.18
三级甲等5 6.25222.60 6.27
三级乙等3 3.75161.46 4.55
三级丙等5 6.25225.83 6.36
三级丁等1 1.2590.11 2.54
三级戊等4 5.00142.19 4.01
四级20 25.00312.53 8.81
合计80 100.003549.03100.00
), ArticleFig(id=1241070729488289939, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730061704319830, language=CN, label=表4, caption=

2012—2024年安徽省NIP疫苗预防接种异常反应补偿例数和补偿金额损害等级分布

, figureFileSmall=null, figureFileBig=null, tableContent=
损害分级补偿例数构成比(%)补偿金额(万元)构成比(%)
一级甲等13 16.25558.53 15.74
一级乙等1 1.25129.48 3.65
二级甲等2 2.50122.69 3.46
二级乙等11 13.75748.57 21.09
二级丙等4 5.00225.45 6.35
二级丁等11 13.75609.60 17.18
三级甲等5 6.25222.60 6.27
三级乙等3 3.75161.46 4.55
三级丙等5 6.25225.83 6.36
三级丁等1 1.2590.11 2.54
三级戊等4 5.00142.19 4.01
四级20 25.00312.53 8.81
合计80 100.003549.03100.00
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安徽省2012—2024年免疫规划疫苗预防接种异常反应补偿情况分析
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孟凡亚 1 , 胡文怡 2 , 史四九 1 , 薛文庆 1 , 苏颖 1 , 王斌冰 1
现代预防医学 | 疾病预防控制 2025,52(8): 1497-1501
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现代预防医学 | 疾病预防控制 2025, 52(8): 1497-1501
安徽省2012—2024年免疫规划疫苗预防接种异常反应补偿情况分析
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孟凡亚1, 胡文怡2, 史四九1, 薛文庆1, 苏颖1, 王斌冰1
作者信息
  • 1.安徽省疾病预防控制中心，安徽　合肥　230601
  • 2.蚌埠医科大学

    • 孟凡亚(1982—），女，博士，主任医师，研究方向：疫苗安全性；

    胡文怡（2000—），女，硕士在读，研究方向：疫苗安全性

通讯作者:

王斌冰，E-mail:
Compensation for adverse events following immunization of National Immunization Program vaccines, Anhui, 2012-2024
Fan-ya MENG1, Wen-yi HU2, Si-jiu SHI1, Wen-qing XUE1, Ying SU1, Bin-bing WANG1
Affiliations
  • Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui 230601, China
出版时间: 2025-04-25 doi: 10.20043/j.cnki.MPM.202412222
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摘要
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目的

分析安徽省2012—2024年免疫规划(National Immunization Program，NIP)疫苗预防接种异常反应补偿情况。

方法

收集整理安徽省2012—2024年NIP疫苗预防接种异常反应的补偿个案资料，采用描述流行病学方法进行分析。

结果

2012—2024年安徽省NIP疫苗预防接种异常反应补偿个案共80例，最低补偿金额1.32万元，最高补偿金额154.10万元，补偿总金额3 549.03万元，平均每例补偿44.36万元(1.32万元～154.10万元)。<1岁补偿例数和补偿金额均最高，分别为64例(80.00%)和2 529.06万元(71.26%)。疫苗分布中卡介苗预防接种异常反应的补偿例数和补偿金额均最高，分别为共33例(41.25%)和1 051.98万元(29.64%)。临床诊断分布中神经系统疾病的例数和补偿总金额均最高，分别为33例(41.25%)和2 032.06万元(57.26%)。损害程度分级中四级的补偿例数最多，共20例(25.00%)，二级乙等补偿总金额最高，金额为748.57万元(21.09%)。在作出调查诊断或鉴定结论至补偿款支付的时间间隔为252.28 d。

结论

安徽省NIP疫苗预防接种异常反应补偿工作总体实施情况良好，需进一步完善补偿程序和机制。

免疫规划疫苗  /  预防接种异常反应  /  补偿
Objective

To analyze the compensation for adverse events following immunization from vaccination under Anhui Province’s National Immunization Program (NIP) from 2012 to 2024.

Methods

Data from cases compensated for adverse events following immunization from vaccination in Anhui Province from 2012 to 2024 were collected and analyzed using descriptive NIP demiological methods.

Results

From 2012 to 2024, there were a total of 80 AEFI compensation cases in Anhui Province for NIP vaccines, with the lowest compensation amount being 13 200 yuan and the highest compensation amount being 1.54 million yuan. The total compensation amounted to 35.49 million yuan, with an average compensation of 443 600 yuan per case (ranging from 13 200 yuan to 1.54 million yuan). The number of cases and compensation amount for those under 1 year old were the highest, with 64 cases (80.00%) and 25.29 million yuan (71.26%) respectively. In the vaccine distribution, BCG vaccine had the highest number of AEFI compensation cases and compensation amount, with 33 cases (41.25%) and 1.05 million yuan (29.64%), respectively. In terms of clinical diagnoses, neurological diseases had the highest number of cases and total compensation amount, with 33 cases (41.25%) and 2.03 million yuan (57.26%). In the damage severity classification, Grade IV had the most compensation cases, with 20 cases (25.00%), while Grade II-B had the highest total compensation amount, totaling 7.49 million yuan(21.09%). The average payment time after the investigation and diagnosis conclusion was 252.28 days.

Conclusion

The overall implementation of compensation for adverse events following immunization from vaccination under Anhui Province’s NIP is good, but there is a need for further improvement in compensation procedures and mechanisms.

National immunization program vaccines  /  Adverse events following immunization  /  Compensation
孟凡亚, 胡文怡, 史四九, 薛文庆, 苏颖, 王斌冰. 安徽省2012—2024年免疫规划疫苗预防接种异常反应补偿情况分析. 现代预防医学, 2025 , 52 (8) : 1497 -1501 . DOI: 10.20043/j.cnki.MPM.202412222
Fan-ya MENG, Wen-yi HU, Si-jiu SHI, Wen-qing XUE, Ying SU, Bin-bing WANG. Compensation for adverse events following immunization of National Immunization Program vaccines, Anhui, 2012-2024[J]. Modern Preventive Medicine, 2025 , 52 (8) : 1497 -1501 . DOI: 10.20043/j.cnki.MPM.202412222
正文
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预防接种是维护公众健康、预防传染病最有效的手段之一。疑似预防接种异常反应(Adverse events following immunization，AEFI)是指在预防接种后发生的怀疑与预防接种有关的反应或事件。在我国AEFI以一般反应为主，异常反应极为罕见，尤其像过敏性休克等严重异常反应报告发生率处于极低水平[1]。然而，一旦发生这类反应，会对预防接种事业产生不利影响。因此，保护受种者的利益，妥善处理AEFI，完善预防接种异常反应补偿制度，做好预防接种保障工作尤为重要[2-3]。在此背景下，为规范预防接种异常反应补偿工作，保护各方的合法权益，安徽省于2012年出台《安徽省预防接种异常反应补偿办法（试行）》(简称《补偿办法》)。通过《补偿办法》对安徽省行政区域内符合预防接种异常反应的受种者给予补偿。为了解《补偿办法》实施以来的预防接种异常反应补偿现状，进一步规范预防接种异常反应的补偿工作程序，本文对2012—2024年安徽省NIP疫苗预防接种异常反应补偿情况进行分析。
1　资料与方法
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1.1　资料来源
收集整理2012—2024年安徽省NIP疫苗预防接种异常反应补偿个案资料。其中受种者基本信息、预防接种异常反应临床诊断和损害级别信息来源于省、市、县(区)疾病预防控制机构出具的调查诊断书或省、市医学会出具的鉴定书。补偿项目来源于县级卫生行政部门审核表。补偿金额、签订补偿协议日期、补偿款支付日期等信息来源于省级卫生行政部门异常反应补偿决定书。
1.2　统计分析
将2012—2024年安徽省NIP疫苗异常反应补偿个案资料进行整理汇总，采用Microsoft Excel 2021软件建立数据库，通过描述性流行病学方法对预防接种异常反应补偿例数、构成比、补偿金额等数据进行分析。本研究中皖南地区包括黄山市、池州市、马鞍山市、芜湖市、安庆市，皖北地区包括淮北市、亳州市、宿州市、蚌埠市、阜阳市、淮南市、明光市、凤阳县、定远县、霍邱县，皖中地区包括合肥市、六安市、滁州市。
2　结果
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2.1　补偿总体情况
2012—2024年安徽省NIP疫苗预防接种异常反应补偿个案共80例，补偿总金额为3 549.03万元，最低补偿1.32万元，最高补偿154.10万元。平均每例补偿44.36万元。见表1。
2.2　性别、年龄和地区分布
在2012—2024年安徽省NIP疫苗预防接种异常反应补偿个案中，男性57例(71.25%)、女性23例(28.75%)，男性、女性补偿个案中平均每例补偿金额分别为42.46万元、49.07万元；<1岁、1岁、2～6岁、>6岁个案平均每例补偿金额分别为39.52万元、45.97万元、72.21万元、64.60万元；皖南、皖北、皖中地区个案平均每例补偿金额分别为55.56万元、42.34万元、36.09万元。见表2。
2.3　疫苗分布
在2012—2024年安徽省NIP疫苗预防接种异常反应补偿个案中，补偿包含12种NIP疫苗，补偿例数位居前三位的疫苗为分别为BCG(33例)、tOPV(19例)、DTaP(4例)；补偿总金额位居前三位的疫苗为BCG(1 051.98万元)、tOPV(950.52万元)、MPV－AC(326.72万元)；平均每例补偿金额位居前三位的疫苗为MPV－AC(108.91万元)、JE－L(76.90万元)、bOPV(61.48万元)。见表3。
2.4　临床诊断分布
在2012—2024年安徽省NIP疫苗预防接种异常反应补偿个案中，BCG特异性疾病、神经系统疾病、免疫系统疾病分别为32例(40.00%)、33例(41.25%)、15例(18.75%)。三类系统疾病的补偿总金额分别为1 014.66万元、2 032.06万元、502.32万元，平均每例补偿金额分别为31.71万元、61.58万元、33.49万元。
2.5　损害级别分布
在2012—2024年安徽省NIP疫苗预防接种异常反应补偿个案中，损害分级中一级甲等、一级乙等、二级甲等、二级乙等、二级丙等、二级丁等、三级甲等、三级乙等、三级丙等、三级丁等、三级戊等、四级分别为13例(16.25%)、1例(1.25%)、2例(2.50%)、11例(13.75%)、4例(5.00%)、11例(13.75%)、5例(6.25%)、3例(3.75%)、5例(6.25%)、1例(1.25%)、4例(5.00%)、20例(25.00%)。二级乙等补偿总金额最多，金额为748.57万元(21.09%)。见表4。
2.6　补偿款支付时限
在2012—2024年安徽省NIP疫苗预防接种异常反应所有补偿个案中，从作出调查诊断或鉴定结论至补偿款支付的平均时间间隔为252.28 d，其中≤30 d、31～60 d、61～180 d、181～365 d、>365 d分别为3例(3.75%)、4例(5.00%)、32例(40.00%)、31例(38.75%)、10例(12.50%)。从申请补偿至提交补偿材料的平均时间间隔为58.39 d，其中≤30 d、31～60 d、61～180 d分别为31例(38.75%)、21例(26.25%)、28例(35.00%)。从提交补偿材料至补偿款支付的平均时间间隔为84.19d，其中≤30d、31～60 d、61～180 d、>365 d分别为3例(3.75%)、15例(18.75%)、61例(76.25%)、1例(1.25%)。
3　讨论
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在2012—2024年安徽省NIP疫苗预防接种异常反应补偿个案中，男性补偿例数和补偿金额均高于女性，与湖北省[4]、河南省[5]数据一致，可能与男女性别比或男童受关注度更高相关。<1岁年龄段是主要补偿对象，占总补偿例数的80.00%，与重庆市[6]数据分布一致。因国家免疫规划疫苗接种多在此年龄段进行，与免疫程序相关。地区之间的补偿例数和金额差异不大，皖南地区的平均每例补偿金额略高于其他地区，可能与疫苗安全性的关注度有关。疫苗分布中BCG预防接种异常反应补偿例数最多，与重庆市[6]、无锡市[7]数据相似，占总补偿例数的41.25%，tOPV次之，占总补偿例数的23.75%。2016年tOPV停用后，疫苗相关麻痹型脊髓灰质炎病例(Vaccine Associated Paralytic Poliomyelitis, VAPP)数显著下降，BCG异常反应病例的补偿占比逐渐超过了VAPP，位居免疫规划疫苗补偿首位。BCG是新生儿出生时接种的疫苗。流行病学分析显示，免疫缺陷儿童在接种BCG后发生异常反应的风险较高[8]。BCG播散性感染可能与慢性肉芽肿病[9]和严重联合免疫缺陷病等遗传性疾病有关[10]。因此，建议在新生儿接种BCG前，对有免疫缺陷家族史的新生儿进行基因检测，评估其免疫状况和接种风险。此外，建议加强AEFI主动监测，提高AEFI监测敏感性。临床诊断分布中，神经系统疾病例数和补偿总金额均最多，这可能与疫苗对神经系统的影响有关，尤其是在某些高风险人群中。因此，针对神经系统疾病的风险评估和预防措施应当加强，以减少接种后的不良反应发生率。免疫系统疾病的补偿案例虽然相对较少，但也显示出疫苗接种后可能引发的免疫相关问题。对于这一领域的研究仍需进一步深入，以明确疫苗接种与免疫系统疾病之间的潜在关联。临床诊断在疫苗接种异常反应中的分布情况提示我们，在疫苗接种的同时，必须加强对接种后不良反应的监测和管理，以确保公众的健康安全。未来的研究应关注不同人群的反应差异，以便制定更为精准的接种策略。补偿金额方面，四级损伤的案例数最多，占总补偿例数的25.00%。二级乙等损伤的补偿金额最高，达到总金额的21.09%。此外，相较于其他地区，安徽省的补偿款支付时间较长，平均补偿款支付时间间隔252.28d，这与补偿办法中规定的时限有关，安徽省规定接种免疫规划疫苗的受种者自收到调查诊断书或者鉴定书之日起6个月内，可以向接种地县级卫生健康主管部门提出书面补偿申请，且省级财政补偿是以季度方式受理。申请补偿到提交材料的平均时间间隔为58.39d，虽然部分受种者能在较短时间内提交材料，但仍有一部分受种者存在提交材料时间过长的情况，延迟的原因可能是受种者在准备和提交材料的过程中对材料准备要求不清楚所致。对此，应加强对受种者的信息指导，确保其了解补偿申请流程、所需材料及各环节的时间要求，以减少因信息不明而导致提交延迟。另外，提交材料到补偿款支付的平均时间间隔为84.19d，多数时间间隔都在3个月以内，仅有一例时间间隔过长，是源于该案例受种者对补偿条款及补偿金额的不满意，未在补偿决定书上签字，而导致时间延迟。为了提高补偿款支付效率并保障受种者权益，未来需进一步改进补偿程序、优化补偿申请审批和支付流程，简化手续并建立高效的信息管理系统，缩短支付时限，从而提升补偿效率，确保补偿申请能够及时处理，提高受种者的满意度并保障其合法权益。
本研究显示，预防接种异常反应的补偿案例数相对较少，这可能与省级财政补偿的是严重病例，且严重病例较为罕见有关。目前，安徽省免疫规划疫苗预防接种异常反应补偿费用由省人民政府财政部门在预防接种经费中安排，虽然总体补偿发生率不高，但补偿资金来源比较单一。未来可以借鉴其他省份的相关经验和规定，建议有条件有意愿的地区可以尝试保险等多元补偿方式[11-12]，以分担政府财政压力、精确评估风险和补偿需求，提高补偿效率，促进接种补偿、社会保障与保险补偿的良性互动，为受种者和社会公众提供更全面的保障和安全[13]。同时，还可以制定预防接种补偿救助或精神抚慰制度及实施细则，建立第三方鉴定机构，减少因预防接种补偿工作引起的纠纷和负面影响[14]。进一步优化补偿机制的预算核算和执行流程，确保资金使用的透明度和效率性。未来建立更为完善的疫苗接种异常反应监测和报告系统，及时发现和处理异常反应案例，提高对异常反应补偿案例的及时响应和管理能力。此外，建议加强针对公众和医护人员的补偿知识宣传和政策告知工作，包括免疫接种后可能出现的异常反应及其补偿机制[15]。通过提升信息透明度，增强公众对疫苗接种异常反应补偿制度的认知和理解，提高公众参与度和支持度，确保补偿机制的可持续性和公众信任度。
综上所述，安徽省NIP疫苗预防接种异常反应补偿工作总体实施情况良好，还需进一步完善预防接种异常反应的补偿程序、优化申请和审批流程，提高免疫规划疫苗预防接种异常反应的工作效率和服务质量，并加强公众异常反应补偿政策的宣传教育，确保公众在接种过程中的安全和信任。未来应加强对现行政策实施效果的监测和评估，探索更有效的管理模式，以确保政策的合理性和实施的有效性。通过本研究，为安徽省及其他地区疫苗接种安全管理和补偿机制的优化提供了实证数据支持和可行性建议，有助于进一步提升免疫规划疫苗预防接种异常反应的管理水平和公众满意度，实现更好的补偿制度和服务质量。
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doi: 10.20043/j.cnki.MPM.202412222
  • 接收时间：2024-12-13
  • 首发时间：2026-03-17
  • 出版时间：2025-04-25
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  • 收稿日期：2024-12-13
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    1.安徽省疾病预防控制中心，安徽　合肥　230601
    2.蚌埠医科大学

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王斌冰，E-mail:
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2种不同金属材料的力学参数
科
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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