Lane J Michael, Goldstein Joel
Department of Family and Preventive Medicine, Emory University School of Medicine, 869 Clifton Road, Atlanta, GA 30307, USA.
Semin Pediatr Infect Dis. 2003 Jul;14(3):189-95. doi: 10.1016/s1045-1870(03)00032-3.
We reviewed the literature on adverse events reported to occur after smallpox vaccination. Nearly one-half of the United States population is vaccinia-naïve and may be at risk for development of serious adverse events. We describe the clinical features of postvaccinial central nervous system disease, progressive vaccinia, eczema vaccinatum, accidental implantations, "generalized vaccinia," and the common erythematous and/or urticarial rashes. In the 1960s, death occurred approximately once in every million primary vaccinations, with fatalities resulting from progressive vaccinia, postvaccinial encephalitis, and eczema vaccinatum. Death in revaccinees occurred less commonly and almost entirely from progressive vaccinia. In today's population, death rates might be higher because of the increased prevalence of immune deficiency and atopic dermatitis.
我们查阅了有关天花疫苗接种后报告发生的不良事件的文献。近一半的美国人口未曾接种过牛痘，可能有发生严重不良事件的风险。我们描述了接种后中枢神经系统疾病、进行性牛痘、牛痘性湿疹、意外接种、“全身性牛痘”以及常见的红斑和/或荨麻疹皮疹的临床特征。在20世纪60年代，每百万次初次接种中约有一例死亡，死亡原因是进行性牛痘、接种后脑炎和牛痘性湿疹。再次接种者的死亡情况较少见，几乎完全是由进行性牛痘导致的。在当今人群中，由于免疫缺陷和特应性皮炎患病率的增加，死亡率可能会更高。
