Martin Bryan L, Nelson Michael R, Hershey Joyce N, Engler Renata J M
Allergy-Immunology Department, Walter Reed Army Medical Center, Washington, DC, USA.
Clin Rev Allergy Immunol. 2003 Jun;24(3):263-76. doi: 10.1385/CRIAI:24:3:263.
(The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.) Immunization healthcare is becoming increasingly complex as the number and types of vaccines have continued to expand. Like all prescription drugs, vaccines may be associated with adverse events. The majority of these reactions are self-limited and not associated with prolonged disability. The media, Internet and public advocacy groups have focused on potentially serious vaccine-associated adverse events with questions raised about causal linkages to increasing frequencies of diseases such as autism and asthma. Despite a lack of evidence of a causal relationship to a variety of vaccine safety concerns, including extensive reviews by the Institute of Medicine, questions regarding vaccine safety continue to threaten the success of immunization programs. Risk communication arid individual risk assessment is further challenged by the public health success of vaccine programs creating the perception that certain vaccines are no longer necessary or justified because of the rare reaction risk. There is a need for improved understanding of true vaccine contraindications and precautions as well as host factors and disease threat in order to develop a patient specific balanced risk communication intervention. When they occur, vaccine related adverse events must be treated, documented and reported through the VAERS system. The increasing complexity of vaccination health care has led the Center of Disease Control and Prevention (CDC) to identify Vaccine Safety Assessment and Evaluation as a potential new specialty.
（本文所包含的观点或主张仅为作者的个人观点，不应被视为官方观点，也不反映陆军部或国防部的观点。）随着疫苗数量和种类的不断增加，免疫保健正变得日益复杂。与所有处方药一样，疫苗可能会引发不良事件。这些反应大多是自限性的，不会导致长期残疾。媒体、互联网和公共宣传团体关注的是与疫苗相关的潜在严重不良事件，并对自闭症和哮喘等疾病发病率上升的因果关系提出了质疑。尽管缺乏证据表明疫苗与各种疫苗安全问题存在因果关系，包括医学研究所进行的广泛审查，但有关疫苗安全的问题仍在威胁着免疫计划的成功。疫苗计划在公共卫生方面的成功让公众觉得某些疫苗因存在罕见反应风险而不再必要或不合理，这进一步挑战了风险沟通和个体风险评估。为了制定针对患者的平衡风险沟通干预措施，有必要更好地了解真正的疫苗禁忌症和预防措施以及宿主因素和疾病威胁。疫苗相关不良事件一旦发生，必须通过VAERS系统进行治疗、记录和报告。疫苗保健的日益复杂性促使疾病控制与预防中心（CDC）将疫苗安全评估与评价确定为一个潜在的新专业领域。
