Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Pharmacoepidemiol Drug Saf. 2014 May;23(5):548-53. doi: 10.1002/pds.3575. Epub 2014 Feb 4.
We conducted weekly surveillance for pre-specified adverse events following receipt of the 2012-2013 influenza vaccines in the Vaccine Safety Datalink (VSD).
For each outcome, risk intervals (i.e., period after vaccination with a potentially increased risk) were defined on the basis of biologic plausibility and prior literature. Seizures following inactivated influenza vaccine (IIV) were monitored in children in three age groups (6-23 months, 24-59 months, and 5-17 years) using a self-controlled risk interval design. We also monitored for Guillain-Barré syndrome, encephalitis, and anaphylaxis following IIV in patients ≥6 months of age using a cohort design with historical controls. In the risk intervals following live attenuated influenza vaccine (LAIV), we collected weekly counts of Guillain-Barré syndrome, encephalitis, and anaphylaxis in patients ages 2-49. Among LAIV vaccinees, numbers of expected events based on rates in historical controls were calculated, adjusted for age and site.
At the end of surveillance, approximately 3.6 million first doses of IIV and 250 000 first doses of LAIV had been administered in the VSD. No elevated risks were identified in risk intervals following 2012-2013 IIV, as compared with a self-matched control interval or to historical controls. For each outcome, fewer than three events occurred in the risk interval following 2012-2013 LAIV, and we thus were unable to estimate measures of relative risks.
No increased risk was identified for any of the pre-specified outcomes following 2012-2013 influenza vaccinations in the VSD. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.
我们在疫苗安全数据链(VSD)中对 2012-2013 年流感疫苗接种后的特定不良事件进行了每周监测。
对于每个结局,根据生物学合理性和先前的文献定义了风险间隔(即接种疫苗后潜在风险增加的时期)。使用自我对照风险间隔设计,在三个年龄组(6-23 个月、24-59 个月和 5-17 岁)的儿童中监测灭活流感疫苗(IIV)接种后的癫痫发作。还使用队列设计和历史对照监测了≥6 个月的患者接种 IIV 后的格林-巴利综合征、脑炎和过敏反应。在接受活减毒流感疫苗(LAIV)后的风险间隔内,我们每周收集 2-49 岁患者的格林-巴利综合征、脑炎和过敏反应的病例数。在 LAIV 疫苗接种者中,根据历史对照中的发病率计算了每个年龄和地点的预期事件数。
监测结束时,VSD 中约有 360 万剂 IIV 和 25 万剂 LAIV 首次接种。与自我匹配的对照间隔或历史对照相比,2012-2013 年 IIV 后没有发现风险增加。对于每个结局,在 2012-2013 年 LAIV 后风险间隔内发生的事件少于 3 例,因此我们无法估计相对风险的度量。
在 VSD 中,2012-2013 年流感疫苗接种后没有发现任何预定结局的风险增加。2014 年发表。本文是美国政府的一项工作,在美国属于公有领域。