Adverse Event Following Immunization (AEFI) Surveillance in India: Position Paper of Indian Academy of Pediatrics, 2013
Adverse Event Following Immunization (AEFI) Surveillance in India: Position Paper of Indian Academy of Pediatrics, 2013
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DOI：
10.1007/s13312-013-0210-1
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发表时间：
2013-08-01
影响因子：
2.3
通讯作者：
Gupta, S. G.
中科院分区：
文献类型：
--
作者：
Chitkara, A. J.;Thacker, N.;Gupta, S. G.
免疫不良事件（AEFI）是免疫规划的重要组成部分。接种疫苗后发生急性呼吸道感染的风险总是要与不接种疫苗的风险进行权衡。印度通过政府部门的“普遍免疫规划”（UIP）提供的疫苗有一个不断发展的AEFI监测系统，但该国的报告长期处于次优状态，而且几乎没有私营部门的参与。来自私营部门的AEFI报告将提供关于新疫苗和未充分利用疫苗安全性的重要信息，而这不是印度统一免疫计划的一部分。国家指南最近进行了修订和更新。印度儿科学会认为，儿科医生，特别是私营部门的儿科医生在报告使用较新/未充分利用的疫苗的急性呼吸道感染方面可发挥关键作用。规划错误、疫苗反应、注射反应、巧合和未知是规划目的的AEFI的五大类。需要立即报告严重的不良反应（死亡、残疾、群集和住院），并按照规定的程序进行详细调查。一旦发生严重急性脑损伤，分别由在农村或城市地区执业的儿科医生立即通知初级或城市保健中心。该学会的这份倡导文件为从业人员提供了如何报告病例的指导方针，并为IAP成员提供了帮助政府改善该国AEFI监测的方法。关于使用UIP和更新疫苗的已知/预期AEFI的诊断和管理的详细信息将在稍后公布。
Adverse event following immunization (AEFI) is a critical component of immunization program. The risk of AEFI with vaccination is always weighed against the risk of not immunizing a child. There is an evolving AEFI surveillance system in India for the vaccines delivered through 'universal immunization program' (UIP) of government sector, but the reporting remained suboptimal for long in the country, and there is almost no participation from private sector. The AEFI reporting from private sector will provide vital information on the safety of new and underutilized vaccines, not part of the UIP in India. The national guidelines are recently revised and updated. The Indian Academy of Pediatrics believes that pediatricians, especially in private sector have a crucial role to play with reporting of AEFI with newer/underutilized vaccines. Programmatic error, vaccine reaction, injection reactions, coincidental and unknown are the five broad categories of AEFI for programmatic purposes. The serious AEFIs (death, disability, cluster and hospitalization) need to be reported immediately and investigated in detail as per the laid down procedures. Once a serious AEFI happens, primary or urban health centre should be immediately informed by the pediatricians practicing in rural or urban areas, respectively. This advocacy paper from the academy provides guidelines to practitioners on how to report cases, and suggests ways for IAP members to help in ongoing efforts of the government in improving AEFI surveillance in the country. The details about the diagnosis and management of known/expected AEFI with UIP and newer vaccines shall be published later.