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儿童免疫接种与7至32岁的特应性疾病有关吗?

Is childhood immunisation associated with atopic disease from age 7 to 32 years?

作者信息

Nakajima Kazunori, Dharmage Shyamali C, Carlin John B, Wharton Cathryn L, Jenkins Mark A, Giles Graham G, Abramson Michael J, Haydn Walters E, Hopper John L

机构信息

Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, The University of Melbourne, Level 2, 723 Swanston Street, Carlton, VIC 3053 Australia.

出版信息

Thorax. 2007 Mar;62(3):270-5. doi: 10.1136/thx.2006.062547. Epub 2006 Nov 7.

Abstract

BACKGROUND

There is ongoing conjecture over whether childhood immunisation leads to an increased risk of developing atopic diseases.

OBJECTIVE

To examine associations between childhood immunisation and the risk of atopic disease.

METHOD

Immunisation histories of 8443 Tasmanian children born in 1961 obtained from school medical records were linked to the Tasmanian Asthma Study. Associations between immunisation status and atopic diseases were examined while adjusting for possible confounders using multiple logistic regression.

RESULTS

Diphtheria immunisation was weakly associated with an increased risk of asthma by age 7 years (odds ratio (OR) 1.3, 95% confidence interval (CI) 1.1 to 1.7), but there was no evidence of any association for four other vaccinations studied. An increased risk of eczema by age 7 years was associated with immunisation against diphtheria (OR 1.5, 95% CI 1.1 to 2.1), tetanus (OR 1.5, 95% CI, 1.1 to 2.0), pertussis (OR 1.5, 95% CI 1.1 to 1.9) and polio (OR 1.4, 95% CI 1.0 to 1.9) but not small pox. Similar but slightly weaker patterns of association were observed between the risk of food allergies and immunisation against diphtheria (OR 1.5, 95% CI 1.0 to 2.1), pertussis (OR 1.4, 95% CI 1.1 to 1.9), polio (OR 1.4, 95% CI 1.00 to 2.1) and tetanus (OR 1.30 95% CI 0.99 to 1.70), but not with small pox. There was no evidence of associations between immunisation history and hay fever, or incidence of later-onset atopic outcomes.

CONCLUSIONS

The few effects seen in this study are small and age-dependent, and nearly all our findings support numerous previous studies of no effect of vaccines on asthma. Based on these findings, the fear of their child developing atopic disease should not deter parents from immunising their children, especially when weighed against the benefits.

摘要

背景

关于儿童免疫接种是否会增加患特应性疾病的风险,一直存在争议。

目的

研究儿童免疫接种与患特应性疾病风险之间的关联。

方法

从学校医疗记录中获取了1961年出生的8443名塔斯马尼亚儿童的免疫接种史,并将其与塔斯马尼亚哮喘研究相关联。在使用多元逻辑回归调整可能的混杂因素的同时,研究免疫接种状况与特应性疾病之间的关联。

结果

白喉免疫接种与7岁时哮喘风险增加之间存在微弱关联(优势比(OR)为1.3,95%置信区间(CI)为1.1至1.7),但对于所研究的其他四种疫苗接种,没有证据表明存在任何关联。7岁时湿疹风险增加与白喉免疫接种(OR为1.5,95%CI为1.1至2.1)、破伤风免疫接种(OR为1.5,95%CI为1.1至2.0)、百日咳免疫接种(OR为1.5,95%CI为1.1至1.9)和脊髓灰质炎免疫接种(OR为1.4,95%CI为1.0至1.9)有关,但与天花免疫接种无关。在食物过敏风险与白喉免疫接种(OR为1.5,95%CI为1.0至2.1)、百日咳免疫接种(OR为1.4,95%CI为1.1至1.9)、脊髓灰质炎免疫接种(OR为1.4,95%CI为1.00至2.1)和破伤风免疫接种(OR为1.30,95%CI为0.99至1.70)之间观察到类似但稍弱的关联模式,但与天花免疫接种无关。没有证据表明免疫接种史与花粉症或迟发性特应性疾病的发病率之间存在关联。

结论

本研究中观察到的少数影响较小且与年龄有关,几乎所有我们的发现都支持先前众多关于疫苗对哮喘无影响的研究。基于这些发现,担心孩子患特应性疾病不应阻止父母为孩子进行免疫接种,尤其是权衡其益处时。

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