Department of Medicine, University of Ottawa, Ottawa, ON, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; ICES@uOttawa, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; ICES@uOttawa, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada; Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON, Canada.
Vaccine. 2014 Feb 26;32(10):1153-9. doi: 10.1016/j.vaccine.2014.01.010. Epub 2014 Jan 15.
Previous studies have suggested that a child's sex may be a predictor of vaccine reactions.
We used a self-controlled case series design, an extension of retrospective cohort methodology which controls for fixed confounders using a conditional Poisson modeling approach. We compared a risk period immediately following vaccination to a control period farther removed from vaccination in each child and estimated the relative incidence of emergency room visits and/or hospital admissions following the 2-, 4-, 6-, and 12-month vaccinations to investigate the effect of sex on relative incidence. All infants born in Ontario, Canada between April 1, 2002 and March 31, 2009 were eligible for study inclusion.
In analyses combining immunizations at 2, 4 and 6 months and examining these vaccinations separately, there was no significant relationship between the relative incidence of an event and sex of the child. At 12 months, we observed a significant effect of sex, with female sex being associated with a significantly higher relative incidence of events (P=0.0027). The relative incidence ratio (95% CI) comparing females to males following the 12-month vaccination was 1.08 (1.03 to 1.14), which translates to 192 excess events per 100,000 females vaccinated compared to the number of events that would have occurred in 100,000 males vaccinated.
As the MMR vaccine is given at 12 months of age in Ontario, our findings suggest that girls may have an increased reactogenicity to the MMR vaccine which may be indicative of general sex differences in the responses to the measles virus.
先前的研究表明，儿童的性别可能是疫苗反应的预测因素。
我们使用了自我对照病例系列设计，这是回顾性队列方法的一种扩展，通过条件泊松建模方法控制固定混杂因素。我们比较了每个儿童接种疫苗后立即的风险期和接种疫苗后更远的对照期，并估计了接种疫苗后 2 个月、4 个月、6 个月和 12 个月后急诊就诊和/或住院的相对发生率，以调查性别的影响对相对发生率的影响。所有 2002 年 4 月 1 日至 2009 年 3 月 31 日期间在安大略省出生的婴儿都有资格参加研究。
在结合了 2、4 和 6 个月的免疫接种并分别检查这些免疫接种的分析中，事件的相对发生率与儿童的性别之间没有显著关系。在 12 个月时，我们观察到性别的显著影响，女性性别与事件的相对发生率显著升高相关（P=0.0027）。与男性相比，接种 12 个月后女性的相对事件发生率为 1.08（1.03 至 1.14），这意味着每 10 万名接种女性中会有 192 例额外的事件，而每 10 万名接种男性中会发生的事件数量。
由于在安大略省，MMR 疫苗在 12 个月大时接种，我们的研究结果表明，女孩可能对 MMR 疫苗的反应性更高，这可能表明对麻疹病毒的反应存在一般的性别差异。
