Explore The Method Of Surveillance For Adverse Events Following Immunization (AEFI) In Luwan District

Objective Summarize the data of passive surveillance of AEFI on 2008-2011 in Luwan district to provide the characteristics and the kinds of reported rate of AEFI. Analysis of data characteristics of active surveillance of AEFI in 2008 and 2011 in Luwan District in 2011 2008, then compared with the passive monitoring data, in order to provide basis for improving the passive monitoring strategies for the work at present. To understand the monitoring information of AEFI in patients and the medical staff who work in the frontline of vaccination in Luwan district. Then to explore the future publicity content and mode of AEFI. And let parents to assist health authorities to prepare monitor and detection response in a timely manner. Methods Use Excel to sort out and analysis the data of the surveillance for AEFI. Call the respondents who comply with the relevant conditions in a week after vaccination know the occurrence of adverse reactions and records and record. Then analyse the recorded data to obtain the active monitoring of adverse reaction rate. Then compare the data with the passive monitoring of adverse reaction reporting rate in 2008-2011, to obtain the missing report rate.and then analysis the other inferential statistical characteristics on immunization safety. Survey of parents is primarily through semi-structured interview outline for personal interviews, then obtain the informed consent to record, then use the recording content to analyse and summarize; Survey of the medical staff respondents is through self-administered by the open questionnaire, then analyse and summarize the feedback, we can learn about the views and perspectives of the staff on the monitoring of adverse events after vaccination. Results The general reported rate of adverse reactions is 155.75/hundred thousands in Luwan district at 2008-2011.The data is different among the four vaccination clinics. The reported rate of adverse reactions in summer is higher than in winter. There are 16kinds of vaccines that deserve adverse events in the surveillance, and the reported rate of adverse reactions of Hib vaccine is the highest(948.77/hundred thousands). The most of the clinical manifestations of adverse reactions is common adverse (accounting for 89.61%) including fever (accounting for 53.62%) and local reactions (20.00%), others are rare adverse reaction which mainly include allergic rash (9.8%). There is a higher missing report rate in the routine passive surveillance. There is no significant difference in the active monitoring of AEFI with the passive monitoring of AEFI. There is no significant difference in vaccine safety among different vaccine manufacturers. There is no significant difference in vaccine safety between different injection site of upper arm deltoid and muscle of anterolateral thigh. There is no significant difference in the sensitivity between the vaccination provide by the government and at their own expense. Fever and rash are the most general understanding of parents for adverse events monitoring. How to determine whether the adverse events are AEFI are not very clear. The most common treatment for AEFI is to drink more water. You should take symptomatic treatment if fever. Parents should report to the hospital which immunized after founding the adverse events. Informing in advance or issuing brochures can eliminate the parental panic about AEFI. The train for immunization and AEFI should be arranged at prenatal check. The parents pay more attention to authoritative advice during the emergency phase. The medical staff who work in the frontline of vaccination in Luwan district consider the surveillance for adverse events following immunization is necessary. They know little about the diagnostic criteria for AEFI. Active surveillance can improve the monitoring quality. There are so many factors can effect surveillance for AEFI, such as:the attitude of parents, the government’s policy, the doctors’and the workload. Informing the possible clinical manifestations and their countermeasures can eliminate unnecessary panic. Conclusion The reported rates of AEFI of 2008-2011 in Luwan District is higher than other districts of Shanghai, which suggests that the monitoring system is working well. The monitoring data of high quality, and it can basically reflects the true level of vaccine safety. We should explore more appropriate management practices to help maintain efficient operation of AEFI surveillance system. Passive monitoring of AEFI have a high missing reported rate, which has affected the reflect of vaccine safety. Active monitoring is suitable for monitoring the safety assessment of single vaccines. Future AEFI monitoring can use the improved passive surveillance. Such strategies as propagandizing the surveillance for adverse events following immunization before the vaccination, informing the possible clinical manifestations and their countermeasures, providing authoritative consultation during the emergency phase, can effectively reduce the parents panic.AEFI monitoring should pay attention to migrant children. The current report ways and means about AEFI should be improved. The relevant agencies should strengthen training and propaganda. The government should introduce compensation plan as soon as possible.