Centre for MEGA Epidemiology, The University of Melbourne, Melbourne, Vic, Australia.
Pediatr Allergy Immunol. 2010 Mar;21(2 Pt 1):301-6. doi: 10.1111/j.1399-3038.2009.00950.x. Epub 2009 Dec 7.
The association between childhood immunizations and risk of atopic diseases is unclear. No study has examined possible associations between childhood immunizations and such diseases in middle age. The Tasmanian Longitudinal Health Study (TAHS) is a population based cohort study of respiratory disease. The TAHS participants were followed from 7 to 44 yrs of age. Immunizations during childhood were examined for any association with asthma and atopic disease at age 44 yrs. Multivariable regression models were used to estimate relative risks while adjusting for confounders. Cox regression was used to estimate the association between childhood immunizations and asthma developing after the age of 7 yrs. We found no association between any childhood immunization (Diphtheria, Tetanus, Pertussis, Polio, Smallpox) and asthma (ORs ranged from 0.87 to 1.17 p > 0.05), eczema (ORs ranged from 0.99 to 1.07 p > 0.05), food allergy (ORs ranged from 0.97 to 1.11 p > 0.05), or hay fever (ORs ranged from 1.02 to 1.05 p > 0.05) at age 44. Nor did we find any association between childhood immunizations and an increased risk of incident asthma after the age of 7 yrs (Diphtheria HR = 1.06, 95% CI 0.82, 1.36; Tetanus HR = 1.13, 95% CI 0.88, 1.44; Pertussis HR = 1.03, 95% CI 0.81, 1.30; Polio HR = 1.15, 95% CI 0.86, 1.54; Smallpox HR = 1.21, 95% CI 0.99, 1.48; DTP HR = 1.05, 95% CI 0.85, 1.30). Our analysis does not support any association between common childhood immunizations and risk of asthma and atopic disease in middle-age. Our findings should provide reassurance that in terms of life time risk of asthma and atopic disease, childhood immunization is safe.
儿童免疫接种与特应性疾病风险之间的关系尚不清楚。尚无研究探讨儿童免疫接种与中年特应性疾病之间的可能关联。塔斯马尼亚纵向健康研究(TAHS)是一项基于人群的呼吸道疾病队列研究。TAHS 参与者从 7 岁到 44 岁接受随访。在 44 岁时,使用多变量回归模型评估儿童时期免疫接种与哮喘和特应性疾病之间的相关性,同时调整混杂因素。使用 Cox 回归估计 7 岁以后发生哮喘与儿童免疫接种之间的关联。我们发现,任何儿童免疫接种(白喉、破伤风、百日咳、脊髓灰质炎、天花)与哮喘(比值比范围为 0.87 至 1.17,p > 0.05)、湿疹(比值比范围为 0.99 至 1.07,p > 0.05)、食物过敏(比值比范围为 0.97 至 1.11,p > 0.05)或花粉症(比值比范围为 1.02 至 1.05,p > 0.05)之间均无关联。我们也未发现儿童免疫接种与 7 岁以后新发哮喘风险增加之间存在关联(白喉 HR = 1.06,95%CI 0.82,1.36;破伤风 HR = 1.13,95%CI 0.88,1.44;百日咳 HR = 1.03,95%CI 0.81,1.30;脊髓灰质炎 HR = 1.15,95%CI 0.86,1.54;天花 HR = 1.21,95%CI 0.99,1.48;DTP HR = 1.05,95%CI 0.85,1.30)。我们的分析不支持常见儿童免疫接种与中年哮喘和特应性疾病风险之间存在关联。我们的研究结果应能提供保证,即就哮喘和特应性疾病的终生风险而言,儿童免疫接种是安全的。