Grüber C, Warner J, Hill D, Bauchau V
Department of Pediatric Pneumology and Immunology, Charité - Universitätsmedizin, Berlin, Germany.
Allergy. 2008 Nov;63(11):1464-72. doi: 10.1111/j.1398-9995.2008.01696.x.
There are frequent concerns about early immunizations among the parents of children at heightened risk for atopy. The study assessed the effect of vaccine immunization before the first birthday on eczema severity and allergic sensitization in the second year of life.
A total of 2184 infants, aged 1-2 years, with established atopic dermatitis and a family history of allergy, from 97 study centres in 10 European countries, South Africa and Australia were included. Exposure to vaccines (diphtheria, tetanus, pertussis, polio, Haemophilus influenzae Type B, hepatitis B, mumps, measles, rubella, varicella, BCG, meningococci and pneumococci) and immunization dates were recorded from immunization cards. Immunoglobulin E (IgE) was determined by RAST and eczema severity was assessed by scoring atopic dermatitis (SCORAD).
Immunization against any target was not associated with an increased risk of allergic sensitization to food or inhalant allergens. Varicella immunization (only 0.7% immunized) was inversely associated with total IgE > 30 kU/l (OR 0.27; 95% CI 0.08-0.87) and eczema severity (OR 0.34; 95% CI 0.12-0.93). Pertussis immunization (only 1.7% nonimmunized) was inversely associated with eczema severity (OR 0.30; 95% CI 0.10-0.89). Cumulative received vaccine doses were inversely associated with eczema severity (P = 0.0107). The immunization coverage of infants before and after the onset of atopic dermatitis was similar.
In children at heightened risk for atopy, common childhood immunization in the first year is not associated with an increased risk of more severe eczema or allergic sensitization. Parents of atopic children should be encouraged to fully immunize their children.
特应性风险较高儿童的父母经常担心早期免疫接种问题。本研究评估了一岁前进行疫苗免疫接种对儿童第二年湿疹严重程度和过敏致敏的影响。
纳入了来自欧洲10个国家、南非和澳大利亚97个研究中心的2184名1至2岁患有特应性皮炎且有过敏家族史的婴儿。从免疫接种卡上记录疫苗（白喉、破伤风、百日咳、脊髓灰质炎、B型流感嗜血杆菌、乙型肝炎、腮腺炎、麻疹、风疹、水痘、卡介苗、脑膜炎球菌和肺炎球菌）暴露情况及免疫接种日期。通过放射性变应原吸附试验（RAST）测定免疫球蛋白E（IgE），并通过特应性皮炎评分（SCORAD）评估湿疹严重程度。
针对任何目标的免疫接种与食物或吸入性过敏原过敏致敏风险增加无关。水痘免疫接种（仅0.7%接种）与总IgE>30 kU/l呈负相关（比值比[OR]0.27；95%置信区间[CI]0.08 - 0.87），与湿疹严重程度呈负相关（OR 0.34；95% CI 0.12 - 0.93）。百日咳免疫接种（仅1.7%未接种）与湿疹严重程度呈负相关（OR 0.30；95% CI 0.10 - 0.89）。累计接种疫苗剂量与湿疹严重程度呈负相关（P = 0.0107）。特应性皮炎发病前后婴儿的免疫接种覆盖率相似。
在特应性风险较高的儿童中，第一年进行的常见儿童免疫接种与更严重湿疹或过敏致敏风险增加无关。应鼓励特应性儿童的父母让孩子进行充分免疫接种。
