Abstract：Objective To analyze the insurance-based compensation provided by basic and supplementary insurance for adverse reactions following vaccination in Jiaxing City, Zhejiang Province, so as to provide a basis for improving the vaccine insurance compensation mechanism and promoting vaccination services. Methods Individual records of insurance compensation for adverse reactions following vaccination in Jiaxing City from 2024 to 2025 were collected. A descriptive analysis was conducted to characterize the number of insurance-based compensation cases, compensation amounts, severity grades, vaccine types and clinical diagnoses. Results A total of 479 cases of adverse reactions following vaccination received insurance-based compensation in Jiaxing City, with a total compensation amount of 1 538 900 yuan. Basic insurance compensated 9 cases, with a total compensation amount of 683 600 yuan. Among these, one case classified as Grade Ⅲ, Class B received compensation of 656 000 yuan, while eight cases classified as Grade Ⅳ and other cases received compensation totaling 27 600 yuan. Supplementary insurance compensated 470 cases, with a total compensation amount of 855 300 yuan. One death case involving a coincidental illness received compensation of 150 000 yuan, 469 Grade Ⅳ and other cases received compensation totaling 705 300 yuan. The three most frequently compensated vaccine categories under supplementary insurance were diphtheria and tetanus toxoid with acellular pertussis, inactivated poliovirus vaccine-inactivated, and Haemophilus influenzae type B vaccine (DTaP-IPV-Hib), combined vaccination with hepatitis B vaccine (HepB) and bacille calmette-guérin vaccine (BCG), and 13-valent pneumococcal polysaccharide conjugate vaccine (PCV13), accounting for 72, 54 and 39 cases, respectively. The three vaccine categories associated with the highest compensation amounts were combined vaccination with HepB and BCG, DTaP-IPV-Hib, and PCV13, with compensation amounts of 263 700, 125 300 and 48 300 yuan, respectively. The three most common clinical diagnoses among compensated cases were acute upper respiratory tract infection, pneumonia and acute bronchitis, accounting for 175, 81 and 54 cases, respectively. Conclusions The insurance-based compensation mechanism for adverse reactions following vaccination in Jiaxing City demonstrates a tiered coverage pattern: basic insurance primarily covers severe cases, while supplementary insurance mainly covers mild cases. Surveillance of adverse reactions following vaccination associated with standalone administration of DTaP-IPV-Hib, combined vaccination with HepB and BCG, and PCV13 should be strengthened, and particular attention should be paid to distinguishing coincidental illness.
