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目的 了解山东省脊髓灰质炎 (脊灰 )疫苗相关病例(VAPP)的发病情况。方法 对山东省 1993～ 2 0 0 0年期间通过急性弛缓性麻痹监测系统报告的 81例疑似VAPP病例进行流行病学分析。结果 以脊灰减毒活疫苗 (OPV)投放量计算 ,疑似VAPP发生率为 0 2 7/ 10 0万～ 1 3 3 / 10 0万 ,平均为0 79/ 10 0万 ;首次服苗、再次服苗及全程免疫后 ,疑似VAPP发生率分别为 7 3 4 / 10 0万、2 5 8/ 10 0万和 0 61/ 10 0万。疑似VAPP的发生多为散发 ,男性高于女性 ;病毒分离发现 ,接触病例中以Ⅱ型脊灰病毒为主 ,服苗病例中Ⅱ型和Ⅲ型病毒的分离率基本相同 ;服苗病例的平均潜伏期为 4 5天 ;60天后随访时均残留麻痹。结论 我国应进一步加强对VAPP的研究 ,应考虑以脊灰灭活疫苗 (IPV)替代OPV进行常规免疫 ,以避免VAPP的发生。
Objective To understand the incidence of poliomyelitis (polio) vaccine related cases (VAPP) in Shandong Province. Methods 81 cases of suspected VAPP cases reported from the acute flaccid paralysis monitoring system in Shandong Province between 1993 and 2000 were analyzed by epidemiology. Results The dosage of live attenuated poliovirus (OPV) was calculated. The incidence of suspected VAPP was 0 27/10 million to 1 3 3/10 million with an average of 0 79/10 million. For the first dose of vaccine, After the vaccine and whole-body immunization, the incidence of suspected VAPP was 73.4 / 1.0 million, 25.8 / 1.0 million and 0 61/10 million respectively. The occurrence of suspected VAPP mostly sporadic, men than women; virus separation found that contact with type Ⅱ poliovirus-based, the rate of the type Ⅱ and type Ⅲ virus vaccine was basically the same; the average The incubation period was 45 days; Paralysis remained after 60 days of follow-up. Conclusions Our country should further strengthen the research on VAPP, we should consider polio inactivated vaccine (IPV) instead of OPV for routine immunization to avoid the occurrence of VAPP.