中部某醫學中心護理人員接種流感疫苗後引發不適反應之研究

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(1)44. 1. 1. 846 6 846. SPSS/PC 10.0. 87.8%. 31.7%. 33.8%. 9.4%. 1.3% 6 67.5%. 1-2 52.9%. 66.1%. 62.9%. 55.4% (. p < 0.01). = 12.89. 2007;12:44-50. B A (RNA. C. B. ) A 10%-20%. [1] 40%-50%. 1. N. 15 H 1 H. 9. 1) (H1N1) (2)1957 H2N2 69,800 (3)1968 33,800 [2] A. B. 2000. (1)1918 4000. B [2-4] 1-4. 2) (106/cc). 4). H3N2. C. [2,3]. A. 404. 3). N N1H1. 91. 2006. 4. 2006. 12. 24 14. 2006. 6. 29. [4].

(2) 45. 2001 1)65. 2) 3). 4). ( ). 5) 6) [2,5]. 2003. SARS. SARS 3 6. -18 9 ( ). [8,14]. Goldstein. [17] 2%. 1-5 Canning. [18] 11%. [3,5-8]. 48 2003 [9,10]. 1-4. ( H1. H3. B. ) 70%-90% 30%-50%. A. [11] (. 27%-39%. 93 9. 9. ) 93. 1. [1,12]. 928 846. (. 91.2%). 1-4 2%-10%. [4,5,11,12] (. [13-16]. (. ) ) (. ). 1) 2) 3). 10 4). 10 (. [2] 1940 10. 1998 54%. 1. 5 ). 6.

(3) 46. (CVI =. (52.1%) (49.3%) 93.6% 6.4% (36.7%) ( ) 87.8%. 0.9). B. 12.2% 10. 34.0% 0.85 6. Huskisson (1974) 10 1 (. 31.7% 2 ). 10. (. ) (N = 846) (%). 94. 4. 15. 5. 15 834 (98.6) 12 ( 1.4). 846 SPSS/PC 10.0. 98.6%) 25-29 (80.3%) (42.5%). (47.5%) (. (23.2%) ). (N = 834 (51.0%) (54.2%) N2 N3 (23.5%) 2-7 23.1%. B 37.2%. (45.7%). ( ) ≤ 24 25-29 ≥ 30. 237 (29.0) 417 (51.0) 163 (20.0) 166 (19.7) 677 (80.3) 25 ( 2.9) 460 (54.2) 364 (42.9) 54 ( 6.5) 211 (25.5) 258 (31.2) 266 (32.2) 37 ( 4.5). N0 N1 N2 N3 N4. 191 (23.5) 145 (17.8) 81 (10.0) 36 ( 4.4) 45 ( 5.5) 64 ( 7.9) 40 ( 4.9) 189 (23.2) 5 ( 0.6) (. ≤2 2-7 ≥7. ) 211 (25.0) 392 (47.5) 222 (26.9).

(4) 47. (47.2%) (35.8%) (53.3%) 2. (N = 846) (%). 6. 1 3(26%). 196 (23.1). 7. (n = 105) 48 (45.7) 37 (35.2) 10 ( 9.5) 8 ( 7.6) 1 ( 1.0) 1 ( 1.0) 73 (37.2). B. A. (n = 73)(. ) 38 (52.1) 36 (49.3) 24 (32.9) 15 (20.5) 5 ( 6.8) 2 ( 2.7) 4 ( 5.5) 54 ( 6.4). 22 1-2 10 (73.1%) (60.1%) (26.9%) (18.9%) (17.6%) (16.0%) 4.8 3.8. (N = 49) 18 (36.7) 4 ( 8.2) 4 ( 8.2) 4 ( 8.2) 3 ( 6.1) 3 ( 6.1) 2 ( 4.1) 2 ( 4.1) 9 (18.4). B. C. 3 (. ( 9.4%) (1.3%) ). 4.9 2.0 5 (26.2%) 10%. ( ) 12.86 (p < 0.01) (odds ratio OR). 1.97(p < 0.01) 1.74. (N = 802 ) (%) 704 (87.8) 238 (33.8) 40 (16.8) 435 (51.4). ≤1 2. ≥3. Robert [11] 10%-20% 34% Nichol. 82 (35.8) 108 (47.2) 39 (17.0). [13]. 98.6% Aoki. [15] 25%-28%. ≤2 3-6 ≥7. 59 (26.0) 121 (53.3) 47 (20.7). [16]. 54%. 5% 16.8%. 210 (89.4) 22 ( 9.4) 3 ( 1.3). Scheifele. 1.3%.

(5) 48. (. ). (N = 238 ) *. (%) 174 (73.1) 143 (60.1) 64 (26.9) 61 (25.6) 54 (22.7) 49 (20.6) 45 (18.9) 42 (17.6) 38 (16.0) 28 (11.8) 23 ( 9.7) 17 ( 7.1) 13 ( 5.5) 11 ( 4.6) *. 10. (Mean. 4.9 2.0 4.8 4.5 4.8 4.3 5.5 5.1 4.8 3.8 3.7 4.8 4.3 2.3. 2.0 2.1 2.5 2.2 2.2 2.2 2.7 2.4 2.6 0.6 2.6 3.2 3.6 1.7. SD). * (95% CI). (95% CI) 1 11.00 (5.16-23.47). 12.86 (4.60-35.96). 1 1.97 (1.42-2.74). 1.74 (0.65-4.69). *. p < 0.05. p < 0.01. [14] 70%-90%[11] 2003 [14]. [19] 93 94. 4. 10. 52.9% 55.4% 6. [8] (OR = 12.86 1.3%. p < 0.01).

(6) 49. 6. Call SA, Vollenweider MA, Hornung CA, et al. Does this patient have influenza? [Review] JAMA 2005;293: 987-97. 7. Banning M. Influenza: incidence, symptoms and treatment. [Review] Br J Nurs 2005;14:1192-7.. (p < 0.01). [10,14]. 8.. 2003;52:92-9. 9. 2001;69:145-8. 10.. 73.1% 4.9. 60.1%. 2.0 (. (. 17.6%). 18.9%) 5. 2004;9:741-7 11. Couch RB. Influenza: prospects for control. [Review] Ann Intern Med 2000;133:992-8. 12. While A, George C, Murgatroyd B. Promoting influenza vaccination in older people: rationale and reality. [Review] Br J Community Nurs 2005;10:427-30. 13. Nichol KL, Margolis KL, Lind A, et al. Side effects associated with influenza vaccination in healthy working adults. A randomized, placebo-controlled trial. Arch Intern Med 1996;156:1546-50. 14.. 1. Cifu A, Levinson W. Influenza. JAMA 2000;284:28479. 2. 2004;47:19-22. 2004;20:649-56 15.Aoki FY, Yassi A, Cheang M, et al. Effects of acetaminophen on adverse effects of influenza vaccination in health care workers. CMAJ 1993;149: 1425-30. 16. Scheifele DW, Bjomson G, Johnston J. Evaluation of adverse events after influenza vaccination in hospital personnel. CMAJ 1990;142:127-30. 17. Goldstein AO, Kincade JE, Gamble G, et al. Policies and practices for improving influenza immunization rates among healthcare workers. Infect Control Hosp Epidemiol 2004;25:908-11. 18. Canning HS, Phillips J, Allsup S. Health care worker beliefs about influenza vaccine and reasons for nonvaccination--a cross-sectional survey. J Clin Nurs 2005;14:922-5. 19.. 3. 2004;53:260-3 4.. 2000;7:1-5 1999;3:701-. 3 5. Morantz CA. ACIP updates guidelines on prevention and control of influenza. Am Fam Physician 2005;72: 1119-28..

(7) 50. Post-influenza Vaccination Symptoms Among Nurses at a Medical Center June-Fong Yang, Shu-Ting Chuang, Ling-Nu Hsu, Yen-Fang Liu, 1. Ya-Chen Ko, Hsien-Wen Kuo 1. Department of Nursing, China Medical University Hospital; Institute of Environmental Health, College of Public Health, China Medical University, Taichung, Taiwan.. Purpose. To investigate the symptoms following influenza vaccination administered to nurses at a medical center in central Taiwan. Methods. A total of 846 nurses were selected from a medical center. A self-administered questionnaire was uesd to gather data regarding demographics, post-influenza vaccination symptoms, whether subjects suffered a common cold within six months of the influenza vaccination, and history of vaccinations. Results. A total of 87.8% of the nurses had received influenza vaccinations; of them 33.8% suffered adverse influenza symptoms. Of those who suffered adverse symptoms, 31.7% complained of swelling at the injection point and 9.4% indicated the desire to take pain relieving medication to alleviate the symptoms. A total of 3 nurses required medication and two days of rest. Sore throat was the major symptom (67.5%), followed by cough (66.1%) and runny nose (62.9%). Overall, 55.4% either took medicine or required a period of rest after having the influenza vaccination. Multivariate logistic regression indicated that development of a common cold within six months of having received an influenza vaccination correlated significantly with patients' histories of post-vaccination symptoms. C o n c l u s i o n s . The proportion of nurses who suffered from adverse post-influenza vaccination symptoms was relatively high. We recommend that all people undergoing influenza vaccination provide a history of previous post-vaccination symptoms and be carefully monitored after the injection. ( Mid Taiwan J Med 2007;12:44-50 ). Key words influenza vaccination, post-influenza vaccination symptoms, nurses, medical center. Received : 24 April 2006.. Revised : 29 June 2006.. Accepted : 14 December 2006. Address reprint requests to : Hsien-Wen Kuo, Institute of Environmental Health, College of Public Health, China Medical University, 91 Hsueh-Shih Road, Taichung 404, Taiwan..

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