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基于疫苗不良事件报告系统(VAERS)数据库分析的风疹和乙肝疫苗接种后慢性关节炎的一年随访。

A one year followup of chronic arthritis following rubella and hepatitis B vaccination based upon analysis of the Vaccine Adverse Events Reporting System (VAERS) database.

作者信息

Geier D A, Geier M R

机构信息

MedCon, Inc., Silver Spring, Maryland, USA.

出版信息

Clin Exp Rheumatol. 2002 Nov-Dec;20(6):767-71.

PMID:12508767
Abstract

OBJECTIVES

This analysis examined the incidence rate of chronic arthritis adverse reactions reported following adult rubella and hepatitis B vaccinations. In this analysis, etiologic mechanisms for chronic arthritis following adult rubella and hepatitis B vaccines were also explored.

METHODS

The Vaccine Adverse Events Reporting System (VAERS) database was analyzed for the incidence rate of reported cases of chronic arthritis in comparison to Tetanus-diphtheria (Td) and tetanus toxoid adult vaccine control groups.

RESULTS

Chronic arthritis adverse reactions following adult rubella vaccination were primarily reported in females (female/male ratio = 3.0), at about 45 years-old, and at a mean onset time of 10-11 days following vaccination. Chronic arthritis adverse reactions following adult hepatitis B vaccination were also primarily reported in females(female/male ratio = 3.5), at about 33 years-old, and with a mean onset time of 16 days following vaccination. The incidence rates of chronic arthritis following adult rubella and adult hepatitis B vaccinations were statistically significantly increased, by chi 2 analysis, in comparison to the adult vaccine control groups. The attributable risk of chronic arthritis following adult rubella vaccine ranged from 32 to 53 and from 5.1 to 9.0 following adult hepatitis B vaccine in comparison to the adult vaccine control groups.

CONCLUSION

This study revealed that adult rubella and adult hepatitis B vaccines were statistically associated with chronic arthritis which persisted for at least one year. The etiology for these adverse reactions may involve autoimmune mechanisms. Furthermore, potential biases in the reporting rates of adverse reactions to VAERS were not observed.

摘要

目的

本分析研究了成人接种风疹疫苗和乙肝疫苗后报告的慢性关节炎不良反应的发生率。本分析还探讨了成人接种风疹疫苗和乙肝疫苗后慢性关节炎的病因机制。

方法

分析疫苗不良事件报告系统(VAERS)数据库中报告的慢性关节炎病例的发生率,并与破伤风-白喉(Td)和破伤风类毒素成人疫苗对照组进行比较。

结果

成人接种风疹疫苗后的慢性关节炎不良反应主要报告于女性(女性/男性比例 = 3.0),年龄约为45岁,平均发病时间为接种后10 - 11天。成人接种乙肝疫苗后的慢性关节炎不良反应也主要报告于女性(女性/男性比例 = 3.5),年龄约为33岁,平均发病时间为接种后16天。通过卡方分析,与成人疫苗对照组相比,成人接种风疹疫苗和乙肝疫苗后慢性关节炎的发生率在统计学上显著增加。与成人疫苗对照组相比,成人接种风疹疫苗后慢性关节炎的归因风险范围为32至53,成人接种乙肝疫苗后为5.1至9.0。

结论

本研究表明,成人接种风疹疫苗和乙肝疫苗与持续至少一年的慢性关节炎在统计学上相关。这些不良反应的病因可能涉及自身免疫机制。此外,未观察到VAERS不良反应报告率中的潜在偏差。

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