Surveillance Analysis And Prediction Of Adverse Events Following Immunization From 2016 To 2021 In Xinjiang Production And Construction Corps

Objective: To evaluate the operation of the surveillance system for suspected adverse events following immunization(AEFI)in Xinjiang Production and Construction Corps(Xinjiang Corps for short).Comprehensively understand the classification of AEFI cases,epidemiological characteristics and the quality of AEFI monitoring work of each division.Forecast the occurrence of AEFI cases to provide a basis for the reasonable allocation of AEFI disposal resources.Methods: The cases of AEFI in China Immunization Program Information Management System of Xinjiang Corps from 2016 to 2021 were collected and analyzed by descriptive epidemiology.The quality of AEFI monitoring was evaluated based on Technique for Order Preference by Similarity to Ideal Solution(TOPSIS).Graph Pad Prism8.0 software visualizes the distribution of time intervals between vaccination and response.Using R4.1 based on monthly AEFI cases from January 2016 to June 2021,autoregressive integrated moving average model(ARIMA)was established.The model performance was verified by the number of cases from July to December 2021.Results: A total of 2179 cases of AEFI were reported in Xinjiang Corps from January 1,2016 to December 31,2021,with an annual incidence of 50.46/100,000 cases.The operation of AEFI monitoring system was in accordance with the provisions of the "National Surveillance Program for Suspected Abnormal Reactions to Vaccination" of the State Food and Drug Administration.The AEFI monitoring system was in good operation,and there were no deaths,severe disabilities,or mass cases of AEFI that had a significant impact on society.Among the 2179 cases,the proportion of general reaction was the highest,followed by abnormal reaction,and the incidence of coupling disease was the least.The incidence of unintentional reaction,vaccine quality accident and vaccination accident was the same as that of total reported cases in each year.The sex ratio of male to female was 1.28:1,and the youngest was 0 months old and the oldest was 71 years old.The cases were mainly reported in the 0 year old group.In this group,the 8 month old group was the most and the 0 month old group was the least.The occupational distribution is dominated by scattered children,followed by children in nursery care.The reported cases were within a narrow range from2016 to 2018,increased significantly in 2019,and decreased significantly from 2020 to2021.Cases of AEFI were reported every month,gradually increasing from spring to summer,decreasing in autumn,and rising in winter.There were statistically significant differences in the incidence of AEFI cases in different years(P<0.001),with the lowest surveillance sensitivity in 2021 and the highest surveillance sensitivity in 2019.There were cases of AEFI reported in all divisions,and the differences in the incidence of AEFI cases were statistically significant(P<0.001).The sensitivity of Division 11 was the highest,and that of Division 3 was the lowest.The incidence of AEFI was 50.46/100,000,the incidence of immunization program vaccine(NIPV)was 70.10/100,000,and the incidence of nonimmunization program vaccine(NIPV)was 10.30/100,000.The incidence of non-NIPV was lower than that of NIPV(P<0.001),with the highest incidence of DPT vaccine(acellular)AEFI cases in NIPV and the highest incidence of polio inactivated vaccine(Sabin strain)AEFI cases in non-NIPV.The main clinical diagnosis of AEFI cases was fever/redness/induration.Fever was the most common,followed by local redness and swelling reaction and induration reaction.The number of AEFI cases was the highest within1 day.All cases of AEFI were well managed and there were no deaths.The AEFI monitoring of the 7th,11 th and 9th Divisions was weak.Group A meningitis vaccine is prone to fever,inactivated polio vaccine and hepatitis B(CHO)vaccine are prone to redness and swelling,and DTP vaccine and inactivated polio vaccine are prone to induration.The seasonal ARIMA model fitted the number of AEFI cases in Xinjiang Corps well.The difference between the predicted value and the actual value in October was large,but all the other months were small,indicating that the model had a good degree of fit and the prediction results were accurate and reliable.Conclusion: Xinjiang Corps AEFI monitoring information system runs normally,with high sensitivity and timeliness.Continuous dynamic monitoring identified AEFI classification,occurrence population,time,region,vaccine type,main clinical diagnosis and response time as the focus of surveillance.More attention is needed for reactive group A meningitis vaccine,inactivated polio vaccine,hepatitis B(CHO)vaccine,DTP vaccine and measles vaccine.The seasonal ARIMA model can accurately predict the trend of AEFI cases in Xinjiang Corps,and can provide a theoretical basis for the rational allocation of resources required for investigation and diagnosis of AEFI.