Bremner S A, Carey I M, DeWilde S, Richards N, Maier W C, Hilton S R, Strachan D P, Cook D G
Department of Community Health Sciences, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK.
Arch Dis Child. 2005 Jun;90(6):567-73. doi: 10.1136/adc.2004.051714.
Suggestions that immunisation influences allergic disease risk, either positively (pertussis) or negatively (BCG) are of concern for vaccination policy.
To determine whether DTP, MMR, and BCG vaccination in infancy influenced hay fever risk.
Case-control study of 7098 hay fever cases and controls, within two primary care databases. One control per case was matched for practice, age, and sex. Odds ratios (OR) were derived using conditional logistic regression.
Compared to those completing in month 5 (base group) (39.3%), DTP unvaccinated children (4.3%) had a similar risk of hay fever (OR = 0.94, 95% CI 0.73 to 1.23). However, those completing after 12 months (4.2%) had a reduced risk (OR = 0.60, 95% CI 0.45 to 0.76) compared to the base group. Compared to those vaccinated in month 14 (base group) (29.5%), MMR unvaccinated children (2.3%) had an OR of 0.79 (95% CI 0.58 to 1.08). Completion of MMR after two years was associated with reduced hay fever risk (OR = 0.62, 95% CI 0.48 to 0.80) compared to the base group. The effects of late immunisation with DTP and MMR were independent. Those vaccinated with BCG by age 2 (2.4%) had an odds ratio of 1.28 (95% CI 0.96 to 1.70). Adjustment for consulting behaviour, social factors, or sibship size did not alter these associations.
Immunisation against DTP or MMR does not increase the risk of hay fever. The lower confidence limit for BCG vaccination contradicts the hypothesised protective effect. The reduced risk of hay fever among children immunised late may be explained by a third factor causing both postponement and reduced risk such as intercurrent febrile illnesses.
关于免疫接种对过敏性疾病风险有正面（百日咳）或负面（卡介苗）影响的建议，对接种政策而言令人担忧。
确定婴儿期接种白百破疫苗（DTP）、麻腮风疫苗（MMR）和卡介苗（BCG）是否会影响花粉热风险。
在两个初级保健数据库中对7098例花粉热病例和对照进行病例对照研究。每个病例匹配一名对照，匹配条件为诊所、年龄和性别。使用条件逻辑回归得出比值比（OR）。
与在第5个月完成接种的儿童（基础组，占39.3%）相比，未接种DTP疫苗的儿童（占4.3%）患花粉热的风险相似（OR = 0.94，95%置信区间0.73至1.23）。然而，与基础组相比，在12个月后完成接种的儿童（占4.2%）患花粉热的风险降低（OR = 0.60，95%置信区间0.45至0.76）。与在第14个月接种疫苗的儿童（基础组，占29.5%）相比，未接种MMR疫苗的儿童（占2.3%）的OR为0.79（95%置信区间0.58至1.08）。与基础组相比，在两岁后完成MMR接种与花粉热风险降低相关（OR = 0.62，95%置信区间0.48至0.80）。DTP和MMR延迟免疫的效果是独立的。两岁前接种卡介苗的儿童（占2.4%）的比值比为1.28（95%置信区间0.96至1.70）。对咨询行为、社会因素或同胞数量进行调整并未改变这些关联。
接种DTP或MMR疫苗不会增加花粉热风险。卡介苗接种的较低置信区间与假设的保护作用相矛盾。延迟免疫儿童中花粉热风险降低可能由导致延迟和风险降低的第三个因素解释，如并发的发热性疾病。
