Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Canada.
Vaccine. 2011 Oct 26;29(46):8267-74. doi: 10.1016/j.vaccine.2011.08.107. Epub 2011 Sep 9.
Birth weight of children born at term may theoretically be associated with risk of adverse events from immunization.
We analyzed data on children born between April 1st 2002 and March 31st 2009 in the province of Ontario. Using the self-controlled case series design, we examined the risk of the combined endpoint of emergency room visit and hospital admission in the immediate three days post vaccination at 2 months of age compared to a control period 9-18 days after vaccination. In term children, we conducted 4 comparisons of relative incidence (RI) of events: (1) 4 lower birth weight quintiles compared to the largest quintile (2) SGA10 infants compared to non SGA10 infants, (3) low birth weight infants (<2500g) compared to non low birth weight infants and (4) SGA10 infants vaccinated before 60 days compared to those vaccinated after 60 days.
There was a significant trend towards increasing relative incidence of the combined endpoint with decreasing birth weight quintile (p=0.016). There was an increased relative incidence of events in SGA10 versus non SGA10 infants (RI 1.25 (95% CI 1.09-1.44)) and in SGA10 children vaccinated before 60 days of age compared to after 60 days of age (RI 1.57 (95% CI 1.14-2.18)). No significant effect was observed in low birth weight children. The impact of birth weight was primarily mediated through an increase in ER visits in the 24h following vaccination.
Lower birth weight appears to be correlated with an increased risk of emergency room visits within 24h of vaccination. The absolute risk is small and there was no impact on admissions or death.
足月出生的儿童的出生体重理论上可能与免疫接种的不良事件风险有关。
我们分析了 2002 年 4 月 1 日至 2009 年 3 月 31 日期间安大略省出生的儿童的数据。使用自我对照病例系列设计，我们检查了与疫苗接种后 2 个月龄时的急诊就诊和住院的联合终点相比，疫苗接种后 9-18 天的对照期内的风险。在足月儿童中，我们进行了 4 项相对发病率 (RI) 事件比较：(1) 与最大五分位数相比，前 4 个五分位数出生体重较低；(2) 与非 SGA10 婴儿相比，SGA10 婴儿；(3) 与非低出生体重婴儿相比，低出生体重 (<2500g) 婴儿；(4) 在 60 天之前接种疫苗的 SGA10 婴儿与在 60 天之后接种疫苗的婴儿。
随着出生体重五分位数的降低，联合终点的相对发病率呈显著上升趋势 (p=0.016)。与非 SGA10 婴儿相比，SGA10 婴儿的事件相对发病率更高（相对发病率 1.25（95%CI 1.09-1.44）），并且在 60 天龄之前接种疫苗的 SGA10 婴儿与 60 天龄之后接种疫苗的婴儿相比，其相对发病率更高（相对发病率 1.57（95%CI 1.14-2.18））。在低出生体重儿童中未观察到显著影响。出生体重的影响主要通过疫苗接种后 24 小时内急诊就诊次数的增加来介导。
较低的出生体重似乎与接种疫苗后 24 小时内急诊就诊的风险增加有关。绝对风险很小，对住院或死亡没有影响。
