Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada.
Hum Vaccin Immunother. 2012 May;8(5):592-5. doi: 10.4161/hv.19377. Epub 2012 May 1.
Using a population based self-controlled case series study design we examined data on 834,740 children in the province of Ontario, Canada. We observed that when comparing to SGA10 term children (term children born in the lowest 10th percentile of weight for a given gestational age), relative incidence of emergency room visits and admission in the 3 d post 2 mo vaccination progressively decreased in near term (relative incidence ratio 0.89 (95% CI 0.74-1.07)) and very premature children [(0.67(0.49-0.93)]. When compared with all term children this decrease in risk is not statistically significant. We speculate that the immune response is reduced in premature children resulting in reduced adverse events. This is masked when comparing to all term children because the reduced birth weight of premature children results in a comparatively increased dose of vaccine. This in turn results in an increased immune response and risk of immediate adverse reactions. Future studies of immune response in premature children should examine the impact of weight at the time of immunization.
我们采用基于人群的自身对照病例系列研究设计，研究了加拿大安大略省 834740 名儿童的数据。我们发现，与 SGA10 足月儿童（在特定胎龄体重最低 10%的足月儿童）相比，在 2 个月后 3 天内，急诊就诊和住院的相对发生率在接近足月（相对发病率比为 0.89（95%CI0.74-1.07））和非常早产儿中逐渐降低[0.67（0.49-0.93)]。与所有足月儿童相比，这种风险降低没有统计学意义。我们推测，早产儿的免疫反应降低导致不良事件减少。当与所有足月儿童相比时，这种情况被掩盖了，因为早产儿的出生体重较低会导致疫苗剂量相对增加。这反过来又会导致免疫反应和立即不良反应的风险增加。未来对早产儿免疫反应的研究应检查免疫接种时体重的影响。
