ArticleFrontiers in public health2026
Surveillance and analysis of adverse events following immunization (AEFI) with measles, mumps, and rubella (MMR) vaccine in Zhejiang Province, China, 2020-2025.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The Measles, Mumps, and Rubella (MMR) vaccine is a cornerstone of global pediatric health, yet its uptake has been declining amid growing public sensitivity about vaccine safety. This study aimed to analyze the occurrence of adverse events following immunization (AEFI) following MMR administration in Zhejiang Province from January 1, 2020, to December 31, 2025, to evaluate the vaccine's post-marketing safety profile. Methods: AEFI cases reported following MMR vaccination in Zhejiang Province between 2020 and 2025 were collected via the Chinese National Adverse Events Following Immunization Information System (CNAEFIS). Descriptive epidemiological methods were employed to analyze and evaluate the reported data. Results: From 2020 to 2025, a total of 12,597 MMR-related AEFI cases were reported, yielding an overall incidence rate of 213.15 per 100,000 doses. Among these, common adverse reactions, rare adverse reactions, and coincidental events accounted for 10,113 cases (171.12/100,000), 2,421 cases (40.96/100,000), and 63 cases (1.07/100,000), respectively. Incidence rates varied significantly by region (range: 177.30-260.45/100,000). The male-to-female ratio was 1.16:1, with 76.49% of cases occurring in children ≤1 year of age. Reports peaked during the summer and were primarily associated with the first dose. Clinical manifestations were dominated by common reactions such as fever (70.75%), rash (42.81%), and irritability (20.38%). The co-administration group exhibited significantly higher rates of high fever and rash than the MMR-only group. A total of 68 severe AEFIs were reported, with an incidence rate of 1.15 per 100,000 doses. Notably, 95.49% of cases improved without clinical intervention. Conclusions: The MMR demonstrates a safe profile in Zhejiang Province. Future efforts should focus on peak reaction periods, enhancing public communication, and strengthening primary care physician training to maintain high surveillance sensitivity and improve diagnostic and emergency response capabilities.
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