儿童多种疫苗联合接种与单种疫苗单独接种的不良反应的对比

Comparison of Adverse Reactions between Simultaneous Multiple Vaccine Administration and Single Vaccine Administration in Children

摘要: 目的：评估多种疫苗联合接种与单种疫苗单独接种在儿童中的不良反应发生情况，为优化免疫策略提供循证依据。方法：采用回顾性队列研究，分析2024年1月至12月在曲靖市妇幼保健院寥廓院区接种门诊完成疫苗接种的1712例儿童，其中联合接种组1161例，单种疫苗单独接种组551例。通过门诊与电话随访记录接种后7日内的不良反应，并比较两组在不良反应发生率及类型上的差异。结果：麻腮风疫苗(MMR)联合接种组与单独接种组的不良反应发生率分别为20.2%与17.8%，差异无统计学意义(P > 0.05)；A群流脑多糖疫苗(MenA)联合接种组与单独接种组的不良反应发生率分别为4.9%与4.6%，差异亦无统计学意义(P > 0.05)。两类疫苗的不良反应均以局部红肿、疼痛和发热为主，未见严重不良事件。所有不良反应均为轻中度，随访期内可自行缓解或经对症处理消失。结论：多种疫苗联合接种与单种疫苗单独接种在不良反应发生率及类型上无显著差异，提示联合接种安全性良好。联合接种不仅有助于减少就诊次数、提高依从性，还可优化公共卫生资源利用，支持其在临床中的推广应用。

Abstract: Objective: To evaluate the occurrence of adverse reactions in children receiving multiple vaccines simultaneously compared with single vaccine administration, and to provide evidence-based support for optimizing immunization strategies. Methods: A retrospective cohort study was conducted on 1712 children who received vaccinations at the Liaokuo outpatient clinic of Qujing Maternal and Child Health-Care Hospital between January and December 2024. Among them, 1161 children received multiple vaccines simultaneously and 551 children received a single vaccine. Adverse reactions within 7 days post-vaccination were recorded through outpatient follow-up and telephone follow-up, and the incidence and types of adverse reactions were compared between the two groups. Results: The incidence of adverse reactions in the measles-mumps-rubella (MMR) combined vaccination group and single vaccination group was 20.2% and 17.8%, respectively, with no statistically significant difference (P > 0.05). For the group receiving meningococcal group A polysaccharide vaccine (MenA), the incidence was 4.9% in the combined vaccination group and 4.6% in the single vaccination group, also showing no significant difference (P > 0.05). The adverse reactions to both vaccines were mainly local redness, pain, and fever. No serious adverse events were observed. All recorded adverse reactions were mild to moderate and resolved spontaneously or after symptomatic treatment during follow-up. Conclusion: There was no significant difference in the incidence or types of adverse reactions between multiple vaccine administration and single vaccine administration in children, suggesting that simultaneous administration of multiple vaccines is safe. Combined vaccination not only ensures safety but also reduces the number of clinic visits, improves compliance, and optimizes the use of public health resources, supporting its wider application in clinical practice.