Taylor Brent, Andrews Nick, Stowe Julia, Hamidi-Manesh Laila, Miller Elizabeth
General and Adolescent Paediatric Unit, Institute of Child Health, University College London, London, UK.
Arch Dis Child. 2007 Oct;92(10):887-9. doi: 10.1136/adc.2006.105247. Epub 2007 Apr 27.
To investigate whether meningococcal C conjugate vaccine (MCCV) caused relapse in children with steroid-responsive nephrotic syndrome.
A population-based study was conducted using an active surveillance system, developed to assess adverse events following vaccination, which linked hospital record information on relapses of nephrotic syndrome to community child health population MCCV data. An ecological study looking at hospital admissions for nephrotic syndrome in different age cohorts of children before and after the MCCV introductory campaign was also carried out.
South East England, and England and Wales.
52 children having 162 relapses of nephrotic syndrome. Also, all hospital admissions of children aged 2-18 years with steroid-responsive nephrotic syndrome in England and Wales between 1995 and 2003, relating admissions to when MCCV was introduced in specific age cohorts. MAIN OUTCOME MEASURES AND ANALYSIS METHOD: Self-controlled case series analysis looking for increased risk of relapse following MCCV and changes in admission rates for nephrotic syndrome (incidence ratio) following the introduction of MCCV to different age cohorts of children.
There was no increased risk of relapse following MCCV in the self-control case series, where a relative incidence of 0.95 (95% confidence interval (CI) 0.61-1.47) was found in the 6-month post-vaccination period, or in the ecological study, which gave an incidence rate ratio of 1.05 (95% CI 0.95 to 1.15) for the quarter when MCCV was introduced and the following two quarters.
We found no association between MCCV and nephrotic syndrome, which is therefore not a contraindication to meningococcal vaccination.
调查脑膜炎球菌C结合疫苗（MCCV）是否会导致激素敏感型肾病综合征患儿病情复发。
采用基于人群的研究，运用一个为评估疫苗接种后不良事件而开发的主动监测系统，该系统将肾病综合征复发的医院记录信息与社区儿童健康人群的MCCV数据相联系。还开展了一项生态学研究，观察在MCCV推广活动前后不同年龄组儿童肾病综合征的住院情况。
英格兰东南部以及英格兰和威尔士。
52名有162次肾病综合征复发的儿童。此外，纳入了1995年至2003年英格兰和威尔士2至18岁激素敏感型肾病综合征患儿的所有住院病例，并将住院情况与MCCV在特定年龄组引入的时间相关联。主要观察指标和分析方法：采用自身对照病例系列分析，寻找接种MCCV后复发风险增加的情况，以及在不同年龄组儿童中引入MCCV后肾病综合征住院率的变化（发病率比）。
在自身对照病例系列中接种MCCV后复发风险未增加，在接种疫苗后6个月期间相对发病率为0.95（95%置信区间（CI）0.61 - 1.47）；在生态学研究中，引入MCCV的季度及随后两个季度的发病率比为1.05（95%CI 0.95至1.15）。
我们发现MCCV与肾病综合征之间无关联，因此肾病综合征并非脑膜炎球菌疫苗接种的禁忌证。
