Institute for Health Research, Kaiser Permanente Colorado, Denver, CO 80237-8066, USA.
Vaccine. 2011 Jan 29;29(5):994-9. doi: 10.1016/j.vaccine.2010.11.085. Epub 2010 Dec 8.
An increasing number of parents are choosing to decline immunizations for their children. This study examined the association between the parental decision to decline pneumococcal conjugate (PCV7) vaccinations and the risk of hospitalization due to pneumococcal disease or lobar pneumonia in children.
We conducted a case-control study nested within a cohort of children enrolled in the Kaiser Permanente Colorado (KPCO) health plan between 2004 and 2009. Each child hospitalized with pneumococcal disease or lobar pneumonia (n=106) was matched to 4 randomly selected controls (n=401). Cases were matched to controls by age, sex, high-risk status, calendar time, and length of enrollment in KPCO. Disease status and parental vaccination decisions were validated with medical record review. Cases and controls were classified as vaccine decliners or vaccine acceptors.
Among 106 cases, there were 6 (6%) PCV7 vaccine decliners; among 401 controls, there were 4 (1%) vaccine decliners. Children of parents who declined PCV7 immunization were 6.5 times (OR=6.5; 95% CI=1.7, 24.5) more likely to be hospitalized for invasive pneumococcal disease or lobar pneumonia than vaccinated children.
Parental decline of pneumococcal vaccination apparently increases the risk for hospitalization due to pneumococcal disease or lobar pneumonia in children. Providers can use this information when helping parents weigh the benefits and risks of immunizing their children.
越来越多的父母选择不为孩子接种疫苗。本研究旨在探讨父母决定不为孩子接种肺炎球菌结合疫苗（PCV7）与儿童因肺炎球菌疾病或大叶性肺炎住院风险之间的关系。
我们开展了一项病例对照研究，研究对象为 2004 年至 2009 年期间参加 Kaiser Permanente Colorado（KPCO）健康计划的儿童队列中的儿童。每例因肺炎球菌疾病或大叶性肺炎住院的儿童（n=106）匹配 4 名随机选择的对照（n=401）。通过年龄、性别、高危状态、日历时间和 KPCO 登记时间长短，对病例和对照进行匹配。通过病历审查对疾病状态和父母的疫苗接种决定进行验证。将病例和对照分为疫苗拒绝者或疫苗接受者。
在 106 例病例中，有 6 例（6%）为 PCV7 疫苗拒绝者；在 401 例对照中，有 4 例（1%）为疫苗拒绝者。父母拒绝 PCV7 免疫接种的儿童因侵袭性肺炎球菌疾病或大叶性肺炎住院的可能性是接种疫苗儿童的 6.5 倍（OR=6.5；95% CI=1.7, 24.5）。
父母拒绝接种肺炎球菌疫苗显然会增加儿童因肺炎球菌疾病或大叶性肺炎住院的风险。医生可以在帮助父母权衡为孩子接种疫苗的益处和风险时使用这些信息。
