Tosti M E, Traversa G, Bianco E, Mele A
Laboratory of Epidemiology, National Institute of Health, Rome, Italy.
Ital J Gastroenterol Hepatol. 1999 Jun-Jul;31(5):388-91.
Since 1994, the hypothesis of a potential causal relationship between vaccination against hepatitis B and multiple sclerosis (and other demyelinating diseases) was brought to the attention of the French health authority, and to public debate. In Italy, since 1991, vaccination against hepatitis B has been mandatory for newborns and 12-year-old children, and also recommended for high-risk groups.
To re-evaluate the risk/benefit profile of the Italian strategy of hepatitis B vaccination.
The study population is a hypothetical cohort of 100,000 newborns.
We present a simulation of the hepatitis B cases that could be prevented with the vaccination and of the potential excess of multiple sclerosis cases which would occur, assuming different odds ratios of multiple sclerosis among vaccinees, and by effecting the vaccination at different ages.
In the cohort, we would expect 1,099 hepatitis B cases, that would be prevented with vaccination. Assuming that the highest odds ratio of 1.7 reported is true, the excess of "life-time" multiple sclerosis incidence would be 0.3% for 12-year-old subjects, and 2.9% for adults.
On the basis of these data, our opinion is that the hepatitis B vaccination strategy presently adopted in Italy for newborns, teen-agers and high risk groups should not be modified.
自1994年以来，乙肝疫苗接种与多发性硬化症（及其他脱髓鞘疾病）之间潜在因果关系的假说引起了法国卫生当局的关注，并引发了公众辩论。在意大利，自1991年起，新生儿和12岁儿童的乙肝疫苗接种成为强制性要求，高危人群也被推荐接种。
重新评估意大利乙肝疫苗接种策略的风险/收益情况。
研究人群为假设的10万名新生儿队列。
我们进行了一项模拟，假设接种疫苗者中多发性硬化症的不同比值比，并在不同年龄进行接种，以此来模拟接种疫苗可预防的乙肝病例以及可能出现的多发性硬化症病例潜在增加情况。
在该队列中，预计有1099例乙肝病例可通过接种疫苗预防。假设所报道的最高比值比1.7属实，12岁受试者“终身”多发性硬化症发病率的增加幅度为0.3%，成人为2.9%。
基于这些数据，我们认为意大利目前针对新生儿、青少年和高危人群所采用的乙肝疫苗接种策略不应改变。
