Laubereau B, Grote V, Hölscher G, Hölscher B, Frye C, Wichmann H E, Heinrich J
GSF - Forschungszentrum für Umwelt und Gesundheit, Institut für Epidemiologie, Neuherberg, Germany.
Eur J Med Res. 2002 Sep 30;7(9):387-92.
Although routine childhood immunisations are known to prevent severe diseases there is an ongoing discussion on possible side effects in later life. In this paper we investigated the association of Haemophilus influenzae type b (Hib)-vaccination and atopic diseases and allergic sensitisation in children in Eastern Germany.
From 1998-1999 a cross-sectional survey of school children aged 5 to 14 years on long-term health effects of air pollution was conducted in three regions of Eastern Germany. Atopic outcome was defined by parental reporting of wheezing and doctor's diagnosed asthma (including asthma-like bronchitis), hay fever and eczema. Specific serum IgE against 5 aeroallergens were analysed by RAST-technique. Vaccination status was assessed by vaccination records from the respective local health authorities. Analysis is restricted to 1943 children with complete information on age, gender, place of residence, parental education and 1676 children with available blood data.
Lifetime prevalence were 4.9% for asthma, 21.1% for wheezing, 6.6% for hay fever, 11.4% for eczema. 32% of the children had at least one specific IgE RAST>0. Hib-vaccination coverage was 42 % overall, 93 % in 5-7 yr olds, 59 % in 8-10 yr olds and 11 % in 11-14 yr olds. Odds Ratios adjusted for age, gender, place of residence, and parental education were 1.86 (1.05-3.32) for asthma, 1.55 (0.95-2.54) for hay fever, 1.03 (0.70-1.50) for eczema and 1.25 (0.94-1.67) for at least 1 specific IgE RAST>0.
We found little evidence for an association between Hib-vaccination and some atopic outcomes and causality cannot be ascertained. Our findings do not give sufficient support to question the value of Hib vaccination given the substantial contribution of mass immunisations to public health. Specific research on possible long-term effects of vaccines is needed to enable final conclusions on this topic.
尽管已知常规儿童免疫可预防严重疾病，但关于其对日后生活可能产生的副作用的讨论仍在继续。在本文中，我们调查了德国东部儿童中b型流感嗜血杆菌（Hib）疫苗接种与特应性疾病及过敏致敏之间的关联。
1998 - 1999年，在德国东部的三个地区对5至14岁学童进行了一项关于空气污染长期健康影响的横断面调查。特应性结果由父母报告的喘息及医生诊断的哮喘（包括哮喘样支气管炎）、花粉热和湿疹来定义。通过放射变应原吸附试验（RAST）技术分析针对5种空气过敏原的特异性血清IgE。疫苗接种状况通过各自当地卫生当局的接种记录进行评估。分析限于1943名在年龄、性别、居住地点、父母教育程度方面信息完整的儿童以及1676名有可用血液数据的儿童。
哮喘的终生患病率为4.9%，喘息为21.1%，花粉热为6.6%，湿疹为11.4%。32%的儿童至少有一种特异性IgE RAST>0。Hib疫苗接种总体覆盖率为42%，5至7岁儿童中为93%，8至10岁儿童中为59%，11至14岁儿童中为11%。经年龄、性别、居住地点和父母教育程度调整后的比值比，哮喘为1.8（1.05 - 3.32），花粉热为1.55（0.95 - 2.54），湿疹为1.03（0.70 - 1.50），至少一种特异性IgE RAST>0为1.25（0.94 - 1.67）。
我们几乎没有发现Hib疫苗接种与某些特应性结果之间存在关联的证据，因果关系也无法确定。鉴于大规模免疫对公共卫生的重大贡献，我们的研究结果不足以支持质疑Hib疫苗接种的价值。需要对疫苗可能的长期影响进行具体研究，以便就该主题得出最终结论。
