Folio Les R, Yao Eveline F
Uniformed Services University of Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814-4712, USA.
J Am Osteopath Assoc. 2007 Dec;107(12):547-53.
President George W. Bush announced a national smallpox vaccination program (SVP) on December 13, 2002, for military personnel, civilian healthcare workers, and "first responders." The program was intended to protect these individuals against exposure to weaponized smallpox. The US Air Force (USAF) began implementation of the SVP on January 7, 2003.
To determine if the SVP affected USAF personnel readiness, and, based on these results, to determine the overall safety of a large-scale SVP.
A retrospective cohort study of duty-restriction rates measured by duties not to include flying (DNIFs) of C-17 aircrews in the USAF Air Mobility Command (AMC). Data from January 2002 to May 2002 (prevaccination) and January 2003 to May 2003 (vaccination) were compiled by month from three of the 11 AMC bases. Total DNIFs associated with or attributed to the smallpox vaccine were recorded. In addition, total 2003 DNIFs in 1662 study subjects (678 [40.8%] of whom received smallpox vaccination) were recorded and compared with total 2002 DNIFs in 1602 control subjects before SVP implementation. Differences in monthly DNIF rates were calculated using the one-tailed paired t test.
In the 678 subjects who received smallpox vaccination, 13 vaccine-related DNIFs (1.9%) occurred. Differences in DNIF rates were statistically significant (P<.05) during 2 months at one AMC base. However, the SVP did not increase overall DNIF rates in the SVP study period.
With DNIF status as a health marker, the SVP did not impose operational constraints or adversely affect aircrew preparedness in the USAF AMC. The authors suggest that a similar SVP with comparable screening measures would indicate the overall safety of the vaccine.
2002年12月13日，乔治·W·布什总统宣布了一项针对军事人员、文职医护人员和“第一响应者”的全国性天花疫苗接种计划（SVP）。该计划旨在保护这些人免受武器化天花的暴露。美国空军（USAF）于2003年1月7日开始实施SVP。
确定SVP是否影响美国空军人员的战备状态，并根据这些结果确定大规模SVP的总体安全性。
对美国空军空中机动司令部（AMC）中C-17机组人员的飞行限制率进行回顾性队列研究，飞行限制率通过不包括飞行（DNIF）的职责来衡量。2002年1月至2002年5月（接种疫苗前）和2003年1月至2003年5月（接种疫苗期间）的数据按月份从11个AMC基地中的3个基地收集。记录与天花疫苗相关或归因于天花疫苗的总DNIF。此外，记录了1662名研究对象（其中678人[40.8%]接种了天花疫苗）2003年的总DNIF，并与SVP实施前1602名对照对象2002年的总DNIF进行比较。使用单尾配对t检验计算每月DNIF率的差异。
在678名接种天花疫苗的受试者中，发生了1（1.9%）起与疫苗相关的DNIF。在一个AMC基地的2个月期间，DNIF率的差异具有统计学意义（P<.05）。然而，SVP在SVP研究期间并未提高总体DNIF率。
以DNIF状态作为健康指标，SVP并未对美国空军AMC的作战造成限制或对机组人员的战备状态产生不利影响。作者建议，采用类似筛查措施的类似SVP将表明该疫苗的总体安全性。
