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Article(id=1321169914451308596, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321169839390053177, articleNumber=null, orderNo=null, doi=10.11847/zgggws1145177, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1718121600000, receivedDateStr=2024-06-12, revisedDate=1733068800000, revisedDateStr=2024-12-02, acceptedDate=1743523200000, acceptedDateStr=2025-04-02, onlineDate=1792921053755, onlineDateStr=2026-10-25, pubDate=1749484800000, pubDateStr=2025-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792921053755, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792921053755, creator=13701087609, updateTime=1792921053755, updator=13701087609, issue=Issue{id=1321169839390053177, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='6', pageStart='641', pageEnd='768', issueExtLink='null', onlineDate='null', pubDate='1749484800000', pubDateStr='2025-06-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792921035859, creator='13701087609', updateTime=1792921035859, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=750, endPage=754, ext={EN=ArticleExt(id=1321169914690383925, articleId=1321169914451308596, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Suspected adverse events following human papillomavirus vaccination in Ningbo city, 2018-2022: a surveillance data analysis, columnId=1320427686514770171, journalTitle=Chinese Journal of Public Health, columnName=Survey and Report, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the characteristics of suspected adverse events following immunization (AEFI) with human papillomavirus (HPV) vaccine administered in Ningbo city and evaluate the safety of the vaccine.

Methods

Data on reported AEFI cases after HPV vaccination from 2018 to 2022 were collected from the National Adverse Event Following Immunization Surveillance System. The number of HPV vaccine doses administered was obtained from the Zhejiang Province Vaccine and Immunization Management Information System. Indicators such as the reported AEFI incidence rates, distribution characteristics, and clinical symptoms were analyzed to assess the safety of HPV vaccination.

Results

A total of 843 913 doses of HPV vaccine were administered in Ningbo city over a 5-year period, during which 262 cases of AEFI related to HPV vaccination were reported. The mean annual reporting incidence rate was 31.05 per 100 000 doses. The reported AEFI cases were predominantly adverse reactions (259 cases), with a total reporting incidence rate of 30.69 per 100 000 doses. Among the adverse reactions, 253 cases (96.56%) were common reactions, and 6 cases (2.29%) were rare reactions, with incidence rates of 29.98 and 0.71 per 100 000 doses, respectively. The reporting incidence rates of main common reactions were 15.76, 9.01, and 8.06 per 100 000 doses for local redness and swelling, fever, and local induration, respectively. The reported rare reactions included 3 cases of allergic rash and 2 cases of urticaria. No serious AEFIs were reported. The reported AEFIs mainly occurred within 0 - 1 day after HPV vaccination (217 cases, 82.82%) and following the first dose (112 cases, 42.75%). They were primarily observed in the 20 - 39 age group (201 cases, 76.72%). All 262 AEFI cases recovered or improved during the follow-up observation periods.

Conclusions

From 2018 to 2022 in Ningbo city, the reported AEFIs associated with the HPV vaccine were primarily common reactions, with very few rare reactions and no serious AEFIs reported, indicating a favorable safety profile for the HPV vaccine.

, authors=Shaoying ZHOU, Jianmei WANG, Qiuhong MEI, Yueyi FENG, Xingqiang PAN, Rui MA, authorsList=Shaoying ZHOU, Jianmei WANG, Qiuhong MEI, Yueyi FENG, Xingqiang PAN, Rui MA, authorCompany=null, correspAuthors=Rui MA, authorNote=null, correspAuthorsNote=
MA Rui, E-mail:
, copyrightStatement=Copyright © 2025 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1321169915235643446, articleId=1321169914451308596, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=2018—2022年宁波市人乳头瘤病毒疫苗疑似预防接种异常反应监测分析, columnId=1320427686770622717, journalTitle=中国公共卫生, columnName=调查报告与分析, runingTitle=null, highlight=null, articleAbstract=
目的

分析宁波市人乳头瘤病毒（HPV）疫苗接种后疑似预防接种异常反应（AEFI）发生特征，评价HPV疫苗的安全性。

方法

通过中国疾病预防控制信息系统收集宁波市2018年1月1日—2022年12月31日HPV疫苗接种后AEFI个案数据，通过浙江省疫苗和预防接种管理信息系统收集HPV 疫苗接种剂次数，分析AEFI 报告发生率、AEFI 分布特征和临床症状等指标，评价 HPV疫苗接种的安全性。

结果

宁波市 2018年1月1日—2022年12月31日共接种HPV疫苗843 913剂次，报告与HPV疫苗接种后相关的AEFI个案262例，年均AEFI总报告发生率为31.05/10万剂。发生的AEFI个案主要为不良反应，为259例，总报告发生率为30.69/10万剂，其中一般反应253例（96.56%）、异常反应6例（2.29%），报告发生率分别为29.98/10万剂、0.71/10万剂；一般反应主要为局部红肿、发热和局部硬结，报告发生率分别为15.76/10万剂、9.01/10万剂和8.06/10万剂；异常反应主要为过敏性皮疹（3例）和荨麻疹（2例）。无严重 AEFI报告。AEFI主要发生在HPV疫苗接种后0～1 d（（217例，82.82%）和第一剂接种后（112例，42.75%），且主要发生在20～39岁年龄组（201例，76.72%）。262例 AEFI 者均痊愈或好转。

结论

宁波市2018—2022年HPV疫苗AEFI主要为一般反应，异常反应极少，无严重 AEFI报告，HPV疫苗安全性良好。

, authors=周绍英, 王建美, 梅秋红, 冯玥溢, 潘兴强, 马瑞*, *, authorsList=周绍英, 王建美, 梅秋红, 冯玥溢, 潘兴强, 马瑞, authorCompany=null, correspAuthors=马瑞, authorNote=

周绍英（1979—），副主任医师， 硕士， 研究方向：免疫规划

, correspAuthorsNote=
马瑞，E-mail：
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journalId=1319373219989389464, articleId=1321169914451308596, 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=null, journalName=null, refType=null, unstructuredReference=孔北华, 马丁, 段涛. 妇产科学[M]. 10版. 北京: 人民卫生出版社, 2024., articleTitle=null, refAbstract=null), Reference(id=1321169923292901479, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=2, rfOrder=1, authorNames=null, journalName=null, refType=null, unstructuredReference=Wang R J, Pan W, Jin L, et al. Human papillomavirus vaccine against cervical cancer: opportunity and challenge[J]. Cancer Letters, 2020, 471: 88-102., articleTitle=null, refAbstract=null), Reference(id=1321169923376787560, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=3, rfOrder=2, authorNames=null, journalName=null, refType=null, unstructuredReference=Bruni L, Albero G, Serrano B, et al. ICO/IARC information centre on HPV and cancer (HPV Information Centre). Human papillomavirus and related diseases in the world[EB/OL]. (2023-03-10)[2024-04-25]. https://hpvcentre.net/statistics/reports/XWX.pdf?t=1678773236590., articleTitle=null, refAbstract=null), Reference(id=1321169923431313513, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=4, rfOrder=3, authorNames=null, journalName=null, refType=null, unstructuredReference=Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA: A Cancer Journal for Clinicians, 2021, 71(3): 209-249., articleTitle=null, refAbstract=null), Reference(id=1321169923498422378, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=5, rfOrder=4, authorNames=null, journalName=null, refType=null, unstructuredReference=Hildesheim A, Wacholder S, Catteau G, et al. Efficacy of the HPV-16/18 vaccine: final according to protocol results from the blinded phase of the randomized Costa Rica HPV-16/18 vaccine trial[J]. Vaccine, 2014, 32(39): 5087-5097., articleTitle=null, refAbstract=null), Reference(id=1321169923565531243, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=6, rfOrder=5, authorNames=null, journalName=null, refType=null, unstructuredReference=陈祺, 吴婷, 张军, 等. 中国预防性人乳头瘤病毒疫苗研制及应用[J]. 中华疾病控制杂志, 2023, 27(3): 249-253., articleTitle=null, refAbstract=null), Reference(id=1321169923628445804, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=7, rfOrder=6, authorNames=null, journalName=null, refType=null, unstructuredReference=World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem[EB/OL]. (2020-11-17)[2024-05-14]. https://www.who.int/publications/i/item/9789240014107., articleTitle=null, refAbstract=null), Reference(id=1321169923712331885, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=8, rfOrder=7, authorNames=null, journalName=null, refType=null, unstructuredReference=国家卫生健康委, 教育部, 民政部, 等. 关于印发加速消除宫颈癌行动计划(2023—2030年)的通知[EB/OL]. (2023-01-05)[2024-05-14]. https://www.gov.cn/zhengce/zhengceku/2023-01/21/content_5738364.htm., articleTitle=null, refAbstract=null), Reference(id=1321169923775246446, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=9, rfOrder=8, authorNames=null, journalName=null, refType=null, unstructuredReference=国家卫生健康委员会, 国家食品药品监督管理局. 全国疑似预防接种异常反应监测方案[S]. 2022-06-10., articleTitle=null, refAbstract=null), Reference(id=1321169923833966703, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=10, rfOrder=9, authorNames=null, journalName=null, refType=null, unstructuredReference=Bruni L, Saura-Lázaro A, Montoliu A, et al. HPV vaccination introduction worldwide and WHO and UNICEF estimates of national HPV immunization coverage 2010 - 2019[J]. Preventive Medicine, 2021, 144: 106399., articleTitle=null, refAbstract=null), Reference(id=1321169923913658480, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=11, rfOrder=10, authorNames=null, journalName=null, refType=null, unstructuredReference=国家药品监督管理局. 2016年7月份总局批准31件药品上市[EB/OL]. (2016-08-15)[2024-04-27]. https://www.nmpa.gov.cn/directory/web/nmpa/yaopin/ypjgdt/20160815165101751.html., articleTitle=null, refAbstract=null), Reference(id=1321169923984961649, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=12, rfOrder=11, authorNames=null, journalName=null, refType=null, unstructuredReference=国家药品监督管理局. 首个国产重组人乳头瘤病毒疫苗获批上市[EB/OL]. (2019-12-31)[2024-04-27]. https://www.nmpa.gov.cn/directory/web/nmpa/zhuanti/ypqxgg/gggzjzh/20191231160701608.html., articleTitle=null, refAbstract=null), Reference(id=1321169924052070514, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=13, rfOrder=12, authorNames=null, journalName=null, refType=null, unstructuredReference=国家药品监督管理局. 2022年03月24日药品批准证明文件待领取信息发布[EB/OL]. (2022-03-24)[2024-04-27]. https://www.nmpa.gov.cn/zwfw/sdxx/sdxxyp/yppjfb/20220324160221168.html., articleTitle=null, refAbstract=null), Reference(id=1321169924140150899, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=14, rfOrder=13, authorNames=null, journalName=null, 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=null, refAbstract=null), Reference(id=1321169924207259764, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=15, rfOrder=14, authorNames=null, journalName=null, refType=null, unstructuredReference=刘捷宸, 吴琳琳, 白庆瑞, 等. 上海市2017—2019年人乳头瘤病毒疫苗接种率和疑似预防接种异常反应监测[J]. 中国疫苗和免疫, 2020, 26(3): 322-325, 348., articleTitle=null, refAbstract=null), Reference(id=1321169924282757237, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=16, rfOrder=15, authorNames=null, journalName=null, refType=null, unstructuredReference=周开举, 赵占杰, 梁文佳, 等. 2018—2020年广东省人乳头瘤病毒疫苗疑似预防接种异常反应监测分析[J]. 华南预防医学, 2022, 48(6): 707-710., articleTitle=null, refAbstract=null), Reference(id=1321169924345671798, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=17, rfOrder=16, authorNames=null, journalName=null, refType=null, unstructuredReference=黄荣东, 张冬娟, 萧剑雄. 福建省2020年人乳头瘤病毒疫苗疑似预防接种异常反应监测[J]. 海峡预防医学杂志, 2021, 27(5): 10-12., articleTitle=null, refAbstract=null), Reference(id=1321169924421169271, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=18, rfOrder=17, authorNames=null, journalName=null, refType=null, unstructuredReference=江伟, 刘艳, 杜渐, 等. 2017—2021年杭州市HPV疫苗疑似预防接种异常反应监测结果[J]. 预防医学, 2023, 35(1): 71-73,77., articleTitle=null, refAbstract=null), Reference(id=1321169924488278136, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=19, rfOrder=18, authorNames=null, journalName=null, refType=null, unstructuredReference=Egoavil C M, Tuells J, Carreras J J, et al. Trends of adverse events following immunization (AEFI) reports of human papillomavirus vaccine in the Valencian Community-Spain (2008-2018)[J]. Vaccines, 2020, 8(1): 117., articleTitle=null, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1321169915546021943, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, xref=null, ext=[AuthorCompanyExt(id=1321169915558604856, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, companyId=1321169915546021943, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Ningbo Center for Disease Control and Prevention, Ningbo 315010, China), AuthorCompanyExt(id=1321169915571187769, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, companyId=1321169915546021943, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=宁波市疾病预防控制中心，宁波 315010)])], figs=[ArticleFig(id=1321169921061531744, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, language=EN, label=Tab.1, caption=

Reported number and incidence of adverse events per 100 000 doses following immunization with human papillomavirus vaccine (2-valent, 4-valent, 9-valent, and total) administered in Ningbo city from 2018 to 2022, by year, type of reaction, and administrative area

, figureFileSmall=null, figureFileBig=null, tableContent=
变量HPV2HPV4HPV9合计
例数发生率例数发生率例数发生率例数发生率
年份
　2018439.131456.9000.001851.68
　2019959.671022.10625.322529.75
　2020949.691920.672036.914829.23
　20211548.912623.692630.916729.84
　20221520.864440.684528.8110430.93
分类
　一般反应5034.2511028.979329.2225329.98
　异常反应10.6830.7920.6360.71
　偶合反应10.6800.00 10.3120.24
　心因反应00.0000.00 10.3110.12
地区
　海曙区13.4947.41716.57129.61
　江北区236.401153.15337.051646.66
　镇海区563.941650.36728.802843.82
　北仑区338.541749.27523.612539.39
　鄞州区626.691116.851628.253322.85
　奉化区216.911236.11829.542230.49
　慈溪市18135.392155.652048.685964.05
　余姚市622.891526.681737.133829.64
　宁海县638.87312.3914.121015.64
　象山县343.08313.601347.221933.59
合计5235.6211329.769730.4826231.05
), ArticleFig(id=1321169921137029217, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, language=CN, label=表1, caption=

宁波市2018—2022年HPV疫苗接种AEFI报告发生率/10万剂

, figureFileSmall=null, figureFileBig=null, tableContent=
变量HPV2HPV4HPV9合计
例数发生率例数发生率例数发生率例数发生率
年份
　2018439.131456.9000.001851.68
　2019959.671022.10625.322529.75
　2020949.691920.672036.914829.23
　20211548.912623.692630.916729.84
　20221520.864440.684528.8110430.93
分类
　一般反应5034.2511028.979329.2225329.98
　异常反应10.6830.7920.6360.71
　偶合反应10.6800.00 10.3120.24
　心因反应00.0000.00 10.3110.12
地区
　海曙区13.4947.41716.57129.61
　江北区236.401153.15337.051646.66
　镇海区563.941650.36728.802843.82
　北仑区338.541749.27523.612539.39
　鄞州区626.691116.851628.253322.85
　奉化区216.911236.11829.542230.49
　慈溪市18135.392155.652048.685964.05
　余姚市622.891526.681737.133829.64
　宁海县638.87312.3914.121015.64
　象山县343.08313.601347.221933.59
合计5235.6211329.769730.4826231.05
), ArticleFig(id=1321169921237692514, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, language=EN, label=Tab.2, caption=

Reported number and proportion of adverse events following immunization with human papillomavirus vaccine (2-valent, 4-valent, 9-valent, and total) administered in Ningbo city from 2018 to 2022, by age group, onset from vaccination (days), and dose number

, figureFileSmall=null, figureFileBig=null, tableContent=
变量HPV2HPV4HPV9合计
例数构成比/%例数构成比/%例数构成比/%例数构成比/%
年龄/岁
　 9～1459.6210.8811.0372.67
　15～1923.8500.002121.65238.78
　20～29917.311916.817577.3210339.31
　30～392751.927162.8300.009837.40
　≥40917.312219.4700.003111.83
时间/d
　0～13873.089987.618082.4721782.82
　2～359.6297.961313.402710.31
　4～7815.3843.5411.03134.96
　8～1400.0010.8811.0320.76
　≥1511.9200.0022.0631.15
剂次
　11426.925447.794445.3611242.75
　21426.922723.892929.907026.72
　32446.153228.322424.748030.53
合计52100.00113100.0097100.00262100.00
), ArticleFig(id=1321169921342550115, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, language=CN, label=表2, caption=

宁波市2018—2022年HPV疫苗接种AEFI分布特征

, figureFileSmall=null, figureFileBig=null, tableContent=
变量HPV2HPV4HPV9合计
例数构成比/%例数构成比/%例数构成比/%例数构成比/%
年龄/岁
　 9～1459.6210.8811.0372.67
　15～1923.8500.002121.65238.78
　20～29917.311916.817577.3210339.31
　30～392751.927162.8300.009837.40
　≥40917.312219.4700.003111.83
时间/d
　0～13873.089987.618082.4721782.82
　2～359.6297.961313.402710.31
　4～7815.3843.5411.03134.96
　8～1400.0010.8811.0320.76
　≥1511.9200.0022.0631.15
剂次
　11426.925447.794445.3611242.75
　21426.922723.892929.907026.72
　32446.153228.322424.748030.53
合计52100.00113100.0097100.00262100.00
), ArticleFig(id=1321169921418047588, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, language=EN, label=Tab.3, caption=

Reported number and incidence of adverse clinical manifestations per 100 000 doses following immunization with human papillomavirus vaccine (2-valent, 4-valent, 9-valent, and total) administered in Ningbo city, 2018 - 2022, by common and rare reactions

, figureFileSmall=null, figureFileBig=null, tableContent=
临床表现HPV2HPV4HPV9合计
例数发生率例数发生率例数发生率例数发生率
一般反应
局部红肿3221.925815.284313.5113315.76
发热1711.64287.37319.74769.01
局部硬结1913.01256.58247.54688.06
乏力53.42153.9582.51283.32
肌痛53.4282.1182.51212.49
头痛64.1161.5851.57172.01
头晕00.0092.3782.51172.01
瘙痒21.3751.3251.57121.42
恶心10.6830.7941.2680.95
出汗00.0010.2651.5760.71
面色苍白00.0020.5330.9450.59
呕吐21.3700.0020.6340.47
食欲不振21.3710.2600.0030.36
麻木10.6820.5300.0030.36
胸闷00.0010.2620.6330.36
异常反应
过敏反应
　过敏性皮疹00.0020.5310.3130.36
　荨麻疹10.6810.2600.0020.24
其他异常反应
无菌性脓肿00.0000.0010.3110.12
), ArticleFig(id=1321169923095769189, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169914451308596, language=CN, label=表3, caption=

宁波市2018—2022年HPV疫苗接种后一般反应及异常反应临床表现/10万剂

, figureFileSmall=null, figureFileBig=null, tableContent=
临床表现HPV2HPV4HPV9合计
例数发生率例数发生率例数发生率例数发生率
一般反应
局部红肿3221.925815.284313.5113315.76
发热1711.64287.37319.74769.01
局部硬结1913.01256.58247.54688.06
乏力53.42153.9582.51283.32
肌痛53.4282.1182.51212.49
头痛64.1161.5851.57172.01
头晕00.0092.3782.51172.01
瘙痒21.3751.3251.57121.42
恶心10.6830.7941.2680.95
出汗00.0010.2651.5760.71
面色苍白00.0020.5330.9450.59
呕吐21.3700.0020.6340.47
食欲不振21.3710.2600.0030.36
麻木10.6820.5300.0030.36
胸闷00.0010.2620.6330.36
异常反应
过敏反应
　过敏性皮疹00.0020.5310.3130.36
　荨麻疹10.6810.2600.0020.24
其他异常反应
无菌性脓肿00.0000.0010.3110.12
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2018—2022年宁波市人乳头瘤病毒疫苗疑似预防接种异常反应监测分析
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周绍英 , 王建美 , 梅秋红 , 冯玥溢 , 潘兴强 , 马瑞 *, *
中国公共卫生 | 调查报告与分析 2025,41(6): 750-754
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中国公共卫生 |调查报告与分析 2025 , 41 (6) : 750 -754
2018—2022年宁波市人乳头瘤病毒疫苗疑似预防接种异常反应监测分析
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周绍英, 王建美, 梅秋红, 冯玥溢, 潘兴强, 马瑞*, *
作者信息
  • 宁波市疾病预防控制中心，宁波 315010
通讯作者:
马瑞，E-mail：
作者简介:

周绍英（1979—），副主任医师， 硕士， 研究方向：免疫规划

Suspected adverse events following human papillomavirus vaccination in Ningbo city, 2018-2022: a surveillance data analysis
Shaoying ZHOU, Jianmei WANG, Qiuhong MEI, Yueyi FENG, Xingqiang PAN, Rui MA
Affiliations
  • Ningbo Center for Disease Control and Prevention, Ningbo 315010, China
    • Corresponding Author:
    MA Rui, E-mail:
出版时间: 2025-06-10 doi: 10.11847/zgggws1145177
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摘要
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目的

分析宁波市人乳头瘤病毒（HPV）疫苗接种后疑似预防接种异常反应（AEFI）发生特征，评价HPV疫苗的安全性。

方法

通过中国疾病预防控制信息系统收集宁波市2018年1月1日—2022年12月31日HPV疫苗接种后AEFI个案数据，通过浙江省疫苗和预防接种管理信息系统收集HPV 疫苗接种剂次数，分析AEFI 报告发生率、AEFI 分布特征和临床症状等指标，评价 HPV疫苗接种的安全性。

结果

宁波市 2018年1月1日—2022年12月31日共接种HPV疫苗843 913剂次，报告与HPV疫苗接种后相关的AEFI个案262例，年均AEFI总报告发生率为31.05/10万剂。发生的AEFI个案主要为不良反应，为259例，总报告发生率为30.69/10万剂，其中一般反应253例（96.56%）、异常反应6例（2.29%），报告发生率分别为29.98/10万剂、0.71/10万剂；一般反应主要为局部红肿、发热和局部硬结，报告发生率分别为15.76/10万剂、9.01/10万剂和8.06/10万剂；异常反应主要为过敏性皮疹（3例）和荨麻疹（2例）。无严重 AEFI报告。AEFI主要发生在HPV疫苗接种后0～1 d（（217例，82.82%）和第一剂接种后（112例，42.75%），且主要发生在20～39岁年龄组（201例，76.72%）。262例 AEFI 者均痊愈或好转。

结论

宁波市2018—2022年HPV疫苗AEFI主要为一般反应，异常反应极少，无严重 AEFI报告，HPV疫苗安全性良好。

人乳头瘤病毒疫苗  /  疑似预防接种异常反应  /  监测  /  宁波市
Objective

To analyze the characteristics of suspected adverse events following immunization (AEFI) with human papillomavirus (HPV) vaccine administered in Ningbo city and evaluate the safety of the vaccine.

Methods

Data on reported AEFI cases after HPV vaccination from 2018 to 2022 were collected from the National Adverse Event Following Immunization Surveillance System. The number of HPV vaccine doses administered was obtained from the Zhejiang Province Vaccine and Immunization Management Information System. Indicators such as the reported AEFI incidence rates, distribution characteristics, and clinical symptoms were analyzed to assess the safety of HPV vaccination.

Results

A total of 843 913 doses of HPV vaccine were administered in Ningbo city over a 5-year period, during which 262 cases of AEFI related to HPV vaccination were reported. The mean annual reporting incidence rate was 31.05 per 100 000 doses. The reported AEFI cases were predominantly adverse reactions (259 cases), with a total reporting incidence rate of 30.69 per 100 000 doses. Among the adverse reactions, 253 cases (96.56%) were common reactions, and 6 cases (2.29%) were rare reactions, with incidence rates of 29.98 and 0.71 per 100 000 doses, respectively. The reporting incidence rates of main common reactions were 15.76, 9.01, and 8.06 per 100 000 doses for local redness and swelling, fever, and local induration, respectively. The reported rare reactions included 3 cases of allergic rash and 2 cases of urticaria. No serious AEFIs were reported. The reported AEFIs mainly occurred within 0 - 1 day after HPV vaccination (217 cases, 82.82%) and following the first dose (112 cases, 42.75%). They were primarily observed in the 20 - 39 age group (201 cases, 76.72%). All 262 AEFI cases recovered or improved during the follow-up observation periods.

Conclusions

From 2018 to 2022 in Ningbo city, the reported AEFIs associated with the HPV vaccine were primarily common reactions, with very few rare reactions and no serious AEFIs reported, indicating a favorable safety profile for the HPV vaccine.

human papillomavirus vaccine  /  suspected adverse events following immunization  /  surveillance  /  Ningbo city
周绍英, 王建美, 梅秋红, 冯玥溢, 潘兴强, 马瑞. 2018—2022年宁波市人乳头瘤病毒疫苗疑似预防接种异常反应监测分析. 中国公共卫生, 2025 , 41 (6) : 750 -754 . DOI: 10.11847/zgggws1145177
Shaoying ZHOU, Jianmei WANG, Qiuhong MEI, Yueyi FENG, Xingqiang PAN, Rui MA. Suspected adverse events following human papillomavirus vaccination in Ningbo city, 2018-2022: a surveillance data analysis[J]. Chinese Journal of Public Health, 2025 , 41 (6) : 750 -754 . DOI: 10.11847/zgggws1145177
正文
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人乳头瘤病毒（human papilloma virus，HPV）可引起人类皮肤、黏膜的增生性病变[1]。而高危型HPV的持续感染与宫颈癌的发病密切相关[2]。2023年3月，国际癌症研究署发布的全球HPV和相关疾病报告显示，全球每年新增宫颈癌病例超60万例，死亡超34万例，中国每年宫颈癌新发病例约11万例，死亡约5万例[3]。宫颈癌居2020年全球女性发病和致死癌症的第四位[4]，其已成为严重威胁全球女性健康的公共卫生问题。接种HPV疫苗可有效预防HPV的感染和宫颈癌的发生[5]。目前，上市的HPV疫苗有二价HPV疫苗（2-valent HPV，HPV2）、四价HPV疫苗（4-valent HPV，HPV4）和九价HPV疫苗（9-valent HPV，HPV9）[6]。自HPV疫苗上市后，宁波市就积极为本市适龄女性接种HPV疫苗，并在《加速消除宫颈癌全球战略》[7]和《加速消除宫颈癌行动计划（2023—2030年）》[8]的推动下，积极探索HPV疫苗接种的有效策略。同时，考虑到疫苗安全性是影响HPV疫苗接种意愿的一个重要因素，宁波市自开始接种HPV疫苗，疾病预防控制中心等相关部门就对辖区内HPV疫苗接种后的疑似预防接种异常反应（adverse event following immunization，AEFI）发生情况进行监测。本研究通过对宁波市2018年1月1日—2022年12月31日接种HPV疫苗后的AEFI监测资料分析，评价HPV疫苗的安全性，以期为相关行政部门制定HPV疫苗接种策略提供信息支持和科学依据。
1　资料与方法
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1.1　资料来源
宁波市2018年1月1日—2022年12月31日接种HPV疫苗后的AEFI个案数据来源于中国疾病预防控制信息系统中AEFI信息管理系统，HPV疫苗接种剂次数来源于浙江省疫苗和预防接种管理信息系统。
1.2　疫苗及免疫程序
HPV2（为葛兰素史克的Cervarix®和厦门万泰的馨可宁®）、HPV4（为默沙东的 Gardasil®）、HPV9（为默沙东的Gardasil®9），均为液体（0.5 mL/支）。葛兰素史克的Cervarix®2016—2017年接种人群为9～25岁女性，自2018年7月接种年龄扩大为9～45岁；厦门万泰的馨可宁®接种人群为9～45岁女性；默沙东的 Gardasil® 2017—2019年接种人群为20～45岁女性，自2020年12月接种年龄扩大为9～45岁；默沙东的Gardasil®92018—2021年接种人群为16～26岁女性，自2022年12月接种年龄扩大为9～45岁。所有HPV疫苗均在有效期内。HPV2按0、1、6月免疫程序接种3剂次，HPV4和HPV9按0、2、6月免疫程序接种3剂次；9～14岁女性也可以按照0、6月免疫程序接种2剂次HPV2或HPV9，每剂次0.5 mL，接种部位均为上臂三角肌，肌内注射。本研究通过了宁波市疾病预防控制中心生物医学研究伦理审查委员会伦理审查（批件编号：202306）。
1.3　AEFI定义及分类
根据《全国疑似预防接种异常反应监测方案》（2022年版）[9]，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；按发生原因，AEFI分为不良反应（包括一般反应与异常反应）、疫苗质量事故、接种事故、偶合症和心因性反应；按AEFI的严重程度，分为严重AEFI和非严重AEFI，严重AEFI是指死亡、危及生命、需要住院治疗或延长已在住院治疗的时间、持续的或显著的人体伤残/失能、先天性异常或者出生缺陷（怀疑受种者母亲孕期接种疫苗所致），以及如不干预或者治疗可能出现上述所列情况的情形。
1.4　统计分析
采用SPSS 21.0软件对数据进行整理和分析，对AEFI报告发生率、AEFI分布特征、临床症状等指标进行描述性分析，率的比较采用χ2检验，检验水准α=0.05。
2　结　果
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2.1　AEFI基本概况
2018年1月1日—2022年12月31日，宁波市10个区、县（市）共接种HPV疫苗843 913剂次，其中HPV2 146 002剂次、HPV4 379 675剂次、HPV9 318 236剂次；受种者平均年龄为（26.48±5.98）岁，均为女性。
2.2　AEFI报告发生率（表1）
2.2.1　总报告发生率
2018年1月1日—2022年12月31日，宁波市共报告HPV2、HPV4和HPV9相关的AEFI个案262例，年均AEFI总报告发生率为31.05/10万剂，其中HPV2（52例）、HPV4（113例）、HPV9（97例）的AEFI年均报告发生率分别为35.62/10万剂、29.76/10万剂、30.48/10万剂，三者比较差异均无统计学意义（χ2=1.217，P=0.544）。
2.2.2　各年份报告发生率
2018—2022年各年份AEFI年均报告发生率分别为51.68/10万剂（18例/34 830剂次）、29.75/10万剂（25例/84 024剂次）、29.23/10万剂（48例/164 204剂次）、29.84/10万剂（67例/224 560剂次）、30.93/10万剂（104例/336 295剂次），2018年AEFI年均报告发生率明显高于其他年份平均报告发生率（χ2=4.984，P=0.026）。
2.2.3　分类报告发生率
发生的262例AEFI个案主要为不良反应，为259例（98.85%），报告发生率为30.69/10万剂，其中一般反应253例（96.56%）、异常反应6例（2.29%），报告发生率分别为29.98/10万剂、0.71/10万剂；其次为偶合反应2例（0.76%）、心因反应1例（0.38%），报告发生率分别为0.24/10万剂、0.12/10万剂；无疫苗质量事故报告和接种事故报告，无严重AEFI报告。253例一般反应主要发生在HPV4接种后（110例，43.48%），其次为HPV9（93例，36.76%）；6例异常反应分别发生在HPV2（1例）、HPV4（3例）、HPV9（2例）接种后，2例偶合反应分别发生在HPV2、HPV9接种后，1例心因反应发生在HPV9接种后。
2.2.4　各区、县（市）报告发生率
2018—2022年，宁波市10个区、县（市）均有AEFI个案报告，报告发生率为9.61/10万剂～64.05/10万剂，最高为慈溪市（64.05/10万剂）、最低为海曙区（9.61/10万剂）；城区的AEFI报告发生率（27.03/10万剂，136/503 069）明显低于农村（36.97/10万剂，126/340 844），差异有统计学意义（χ2=6.459，P=0.011）。
2.3　AEFI分布特征（表2）
2.3.1　年龄分布
所有受种年龄组均有AEFI个案报告病例，但主要发生在20～29岁（103例，39.31%）和30～39岁年龄组（98例，37.40%），其中HPV2 、HPV4 AEFI主要发生在30～39岁受种组，HPV9 AEFI主要发生在20～29岁受种组。
2.3.2　接种时间与接种剂次分布
262例AEFI个案主要发生在HPV疫苗接种后的1 d内（217例，82.82%），其次为2～3 d（27例，10.31%）。第一剂、第二剂、第三剂HPV疫苗接种后均报告有AEFI个案病例，但第一剂（112例，42.75%，63.12/10万剂）明显高于第二剂（70例，26.72%，18.04/10万剂）和第三剂（80例，30.53%，28.73/10万剂），差异均有统计学意义（χ2=80.436、8.228，P=000.）。
2.4　临床表现（表3）
2.4.1　一般反应
253例一般反应主要为局部红肿，为133例（50.76%，15.76/10万剂），其中HPV2 、HPV4、HPV9分别为32例、58例和43例；其次为发热（76例，29.01%，9.01/10万剂）和局部硬结（68例，25.95%，8.06/10万剂）；少数受种者有乏力、肌痛、头痛、头晕、瘙痒等临床症状。
2.4.2　异常反应
在6例异常反应中，过敏反应5例，其他异常反应1例。5例过敏反应中，过敏性皮疹3例，分别发生在HPV4（2例）和HPV9（1例）接种后；2例荨麻疹，为HPV2、HPV4接种后各发生1例；1例其他异常反应为无菌性脓肿，发生在HPV9接种后。
2.5　转归
262例AEFI者均痊愈或好转。
3　讨　论
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自2006年HPV疫苗上市至2020年6月，在194个WHO成员国中已有107个国家将HPV疫苗纳入了免疫规划[10]。我国自2016年7月[11]，相继引入了二价、四价和九价HPV疫苗，国产二价HPV疫苗也相继于2019年[12]、2022年[13]获批上市。随着国产HPV疫苗的上市和接种量的增大，接种后发生的 AEFI也越来越受到公众的关注。
2018—2022年宁波市接种HPV疫苗后年均AEFI总报告发生率为31.05/10万剂，与张丽娜等[14]对2017—2020年中国HPV疫苗AEFI监测结果（30.38/10万剂）接近，但低于上海市2017—2019年HPV疫苗AEFI监测结果（256.35/10万剂）[15]，高于2018—2020年广东省的监测结果（11.07/10万剂）[16]、2020年福建省的监测结果（10.11/10万剂）[17]和2017—2021年杭州市的监测结果（25.15/10万剂）[18]，监测结果的明显差异可能与HPV疫苗受种人群AEFI报告意愿和不同地区对AEFI重视程度及监测方式等因素有关。
宁波市2018—2022年接种HPV疫苗后，各年份均有AEFI报告病例，但2018年AEFI报告发生率最高，为51.68/10万剂（18例），随后趋于稳定（29.23/10万剂～30.93/10万剂），这可能是因为HPV疫苗引入初始，公众对其关注度和受种者主动报告AEFI的积极性较高[19]。
宁波市2018—2022年接种HPV疫苗后报告的AEFI病例主要发生在 20～39岁年龄组（76.72%），明显高于9～14岁年龄组（2.67%），其与《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》[14]结果一致。AEFI个案病例主要发生在成年女性人群，其原因可能是此年龄段女性对宫颈癌等与HPV感染相关疾病的发病率和死亡率的关注度较高，同时对HPV疫苗安全性和有效性进行了较详细的了解，因此HPV疫苗接种率较高，AEFI报告数也相对高于青少年女性。
宁波市2018—2022年接种HPV疫苗后发生的AEFI主要为一般反应（253例，96.56%）和异常反应（6例，2.29%），其中一般反应主要为局部红肿、局部硬结和发热，异常反应主要为过敏性皮疹，多发生在HPV疫苗接种后的1 d内，与相关的监测结果[14,16,18]一致；发生的AEFI个案病例主要发生在第一剂HPV疫苗接种后（112例，42.75%），与相关的文献报道结果一致[14,16]。
2018年 1月 1日—2022年 12月 31日，宁波市10个区、县（市）共接种 HPV疫苗 843 913 剂次，均有AEFI报告，最高为慈溪市（64.05/10万剂）、最低为海曙区（9.61/10万剂），地区间AEFI报告发生率有较大的差异（9.61/10万剂～64.05/10万剂），其原因可能与辖区疾病预防控制中心工作人员对AEFI的重视程度、疫苗接种人员对受种者或其监护人的宣传告知及受种者对AEFI的敏感性不同等有关，其具体原因有待进一步研究。
综上所述，宁波市2018—2022年HPV疫苗AEFI主要为发热、接种部位的红肿、硬结等一般反应，异常反应以过敏反应为主，且预后良好，无严重AEFI报告，表明HPV疫苗安全性良好。但本次宁波市HPV疫苗AEFI监测为被动监测，HPV疫苗接种后的AEFI数据来源于受种者或其监护人的自发报告，症状轻微的一般反应可能会出现漏报情况，因此，为提高HPV疫苗AEFI监测数据质量，将在今后的研究中积极采用主动监测方式收集数据。

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2025年第41卷第6期
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doi: 10.11847/zgggws1145177
  • 接收时间：2024-06-12
  • 首发时间：2026-10-25
  • 出版时间：2025-06-10
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  • 收稿日期：2024-06-12
  • 修回日期：2024-12-02
  • 录用日期：2025-04-02
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    宁波市疾病预防控制中心，宁波 315010

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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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