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Aims: The bivalent oral poliovirus vaccine (bOPV; Sabin types 1 and 3) replaced the trivalent OPV (Sabin types 1, 2 and 3) globally in April 2016. A routine schedule of 1 dose of inactivated poliovirus vaccine and 3 subsequent doses of bOPV was implemented in Jiangsu simultaneously. The schedule was changed to 2 inactivated poliovirus vaccines + 2 bOPV on 1 September 2019. Although OPV type 2 has been removed, challenges persist because of adverse events following immunization (AEFIs) with bOPV. Therefore, we analysed and evaluated the safety profile of bOPV administered in children based on passive postmarketing AEFI surveillance. Methods: We collected all bOPV‐related AEFI reports in Jiangsu from the Chinese National AEFI Information System (CNAEFIS) between May 2016 and April 2020. We obtained the administered doses of bOPV from the Jiangsu Provincial Electronic Immunization Registries System. A descriptive analysis was performed. Results: In total, 2084 bOPV‐related AEFIs were retrieved from the CNAEFIS. The overall reporting rate was 24.16 per 100 000 doses. Most AEFIs were nonserious. The most frequently reported symptoms were fever, rash and gastrointestinal disorders. Only 1.34% of AEFIs were serious, which thrombocytopenic purpura accounted for the largest category. Seventeen serious adverse events, including 2 vaccine‐associated paralytic poliomyelitis (VAPP) cases, were considered to be related to bOPV vaccination. The rate of VAPP was 0.2 per million doses. Conclusion: AEFI analysis showed that bOPV was well tolerated. The events most frequently reported were nonserious. However, bOPV can still cause VAPP. Attention should be given to risks related to bOPV. [ABSTRACT FROM AUTHOR]

• Both types of EV71 vaccines showed satisfactory safety profiles in the target population. • The AEFI profiles of EV71 vaccines were identical to those in pre-marketing studies. • AEFIs after EV71 vaccination were mild and common. Two types of enterovirus 71 (EV71) vaccines, manufactured using human diploid (H2) and Vero cells, have been administered in Jiangsu Province, China since 2017. In this study, we evaluated their safety profiles using records collected from the Chinese National Adverse Events Following Immunization (AEFIs) Information System (CNAEFIS) and Electronic Immunization Registries System (EIRS) between 2017 and 2019. Demographic characteristics of the patients, AEFI incidence rates(IRs), symptoms, and time intervals were summarized from the reported AEFI data in the CNAEFIS. Also, the administered doses of the two vaccines were exported from the EIRS to calculate the IRs of AEFIs and thus compare the AEFIs between the two types of EV71 vaccines. In total, 209, 407, and 344 AEFIs cases following EV71 vaccine administration were reported during 2017, 2018, and 2019, respectively, yielding IRs of 59.2, 48.2, and 54.2 per 100,000 doses, respectively. Fever, irritability, allergic eruptions, fatigue, loss of appetite, redness and induration at the injection site were the most commonly reported AEFIs. No significant differences in rare reactions were found between the two types of EV71 vaccinations. The majority of AEFIs were developed within 30 min to 3 days after administration. EV71 vaccines showed satisfactory safety profiles since their first use 3 years ago in the Jiangsu Province. The AEFI profiles were identical to those in pre-marketing studies; most AEFIs after vaccination were mild and common. More active surveillance studies should be performed to provide more comprehensive post-marketing safety data. [ABSTRACT FROM AUTHOR]

Antibiotics have attracted widespread attention around the world because they are ubiquitous in the environment and can lead to antibiotic-resistant microbes developing and pose ecotoxicological risks. In this study, we determined the spatiotemporal distributions of 39 antibiotics in 19 drinking water sources in Jiangsu area of the lower Yangtze River and attempted to identify the sources of the antibiotics and to prioritize the antibiotics. The total antibiotic concentrations in spring and fall were 234.56–6515.99 and 151.12–2562.59 ng/L, respectively. In spring, the total antibiotic concentration gradually increased from upstream to downstream. In fall, the antibiotic concentration did not markedly vary upstream to downstream (total concentrations 151.12–432.17 ng/L) excluding site S9 and S10. Analysis using a positive matrix factorization (PMF) model indicated that the antibiotics had four main sources. Pharmaceutical wastewater was the main source, contributing 34.1% and 41.2% of total antibiotics in spring and fall, respectively, and domestic wastewater was the second most important source, contributing 24.4% and 43% of total antibiotics in spring and fall, respectively. Pharmaceutical wastewater was the main source from midstream to downstream, but the other sources made different contributions in different areas because of the various ranges of human activities. An ecological risk assessment was performed. Stronger risks were posed by antibiotics in spring than fall, and fluoroquinolone antibiotics posed the strongest risks. Optimized risk quotients indicated that norfloxacin was a high-risk contaminant. An assessment of the risk of resistance development indicated that norfloxacin, ciprofloxacin, and enrofloxacin posed moderate to high risks of resistance development and should be prioritized for risk management. The results of this study are important reference data for identifying key sources of antibiotics and developing strategies to manage antibiotic contamination in similar areas. [Display omitted] • 39 antibiotics in drinking water sources from lower Yangtze River were firstly studied. • Total concentration gradually increased from upstream to downstream in spring. • The four potential sources of antibiotics were identified by the PMF model. • Pharmaceutical wastewater was critical sources, domestic wastewater was the second. • Priority antibiotics with high ecological and resistance risks were identified. [ABSTRACT FROM AUTHOR]