Systematic Review On AEFI And Study On Classification Of Immunization Damage

[Background]Immunization is one of the most cost-effective strategy for people' s health.In the past two decades,immunization has prevented an estimated 20 million deaths globally from vaccine-preventable diseases.China has greatly reduced its burden of vaccine-preventable diseases through childhood immunization.However,no vaccine is perfectly safe or effective.Public concerns refocus from the risk of getting diseases to the risks associated with vaccines as the incidence of vaccine-preventable diseases reducing by increasing coverage.The risk of serious adverse events following immunization(AEFI) in child has caused public concerns,generating fear in the community and leading to a deduction in vaccine uptake with subsequent diseases outbreaks in some European countries.[Objective]To review the literatures of AEFI,to collect attitudes or advices about classification of AEFI from experts,and to draft a national classification standard of immunization damage.[Methods]Searched 3 databases for AEFI papers that published during 1993～2008;According to the results of systemic review,a questionnaire survey on satisfication about drafted standard of vaccination damage classification was conducted among experts.An open question included in the questionnaire survey to collect comments and advices from experts.[Results]911 cases were reported from 734 literatures.The vaccines they vaccinated were Rabies,Japanese Encephalitis,Hepatitis B,Measles, Meningococcus Miningitis,Influenza,Diphtheria-Pertussis-Tetanus, Bacilli Calmette-Guerin,Hepatitis A,Oral Poliovirus Attenuated, etc.The types of AEFI were allergicrash,anaphylaxis,allergic purpura,thrombocytopenic purpura,angioedema,arthus reaction,etc. 86.82%of the cases were recovered.The results of questionnaire showed that experts those be familiar with adverse events are satisfied with the standard that divid the immunization damage into six classes.[Conclusions]86.82%of adverse events are minor reactions,such as allergic reaction which recoved after a short time therapy.The incidence of severe vaccine reactions is low,but the damages is extremely serious,and may cause serious sequela.The six classification was adopted according to the final score and advices.