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有或无麻疹、腮腺炎和风疹疫苗接种史的儿童的哮喘和过敏情况。

Asthma and allergy in children with and without prior measles, mumps, and rubella vaccination.

作者信息

Timmermann Clara Amalie Gade, Osuna Christa Elyse, Steuerwald Ulrike, Weihe Pál, Poulsen Lars K, Grandjean Philippe

机构信息

Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark.

Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

出版信息

Pediatr Allergy Immunol. 2015 Dec;26(8):742-9. doi: 10.1111/pai.12391. Epub 2015 May 11.

Abstract

BACKGROUND

The existing literature on the association between measles vaccination and subsequent risk of allergic disease is inconclusive. The aim of this study was, therefore, to determine whether measles, mumps, and rubella (MMR) vaccination administered in early childhood was associated with asthma and allergic diseases at ages 5, 7 and 13 yrs in a birth cohort.

METHODS

In the Faroe Islands, 640 children were followed from birth. Follow-up examinations at ages 5, 7 and 13 yrs included a physical examination and a maternal questionnaire about the child's health. At age 7, total and grass-specific IgE was quantified in the child's serum, and at age 13, the children underwent skin prick tests (SPT). The child's vaccination card was reviewed at examinations.

RESULTS

At age 5, 533 of 555 children had been vaccinated for MMR. After confounder adjustment, we found early life MMR vaccination to be associated with a two-third reduction in the odds of asthma (OR: 0.33, 95% CI: 0.12; 0.90) and hypersensitivity/allergy (OR: 0.32, 95% CI: 0.11; 0.88) at age 5, and the substantially decreased odds of asthma were replicated at age 13 (OR: 0.22, 95% CI: 0.08; 0.56). At age 7, serum total IgE was reduced by 62.8% (CI 95%: -84.3%; -11.9%) in the vaccinated children. MMR vaccination was not significantly associated with allergic rhinoconjuctivitis symptoms, eczema, or SPT reactions at age 13.

CONCLUSIONS

MMR vaccination early in life may have a protective effect against allergy at least up to age 7 and against asthma through age 13 yrs.

摘要

背景

关于麻疹疫苗接种与后续过敏性疾病风险之间关联的现有文献尚无定论。因此,本研究的目的是确定在一个出生队列中,幼儿期接种麻疹、腮腺炎和风疹(MMR)疫苗是否与5岁、7岁和13岁时的哮喘及过敏性疾病有关。

方法

在法罗群岛,对640名儿童从出生开始进行随访。5岁、7岁和13岁时的随访检查包括体格检查以及一份关于儿童健康状况的母亲问卷。7岁时,对儿童血清中的总IgE和草特异性IgE进行定量检测,13岁时,儿童接受皮肤点刺试验(SPT)。在每次检查时查阅儿童的预防接种证。

结果

555名儿童中有533名在5岁时接种了MMR疫苗。在对混杂因素进行调整后,我们发现生命早期接种MMR疫苗与5岁时哮喘(比值比:0.33,95%置信区间:0.12;0.90)和超敏反应/过敏(比值比:0.32,95%置信区间:0.11;0.88)的几率降低三分之二有关,且在13岁时哮喘几率大幅降低的情况再次出现(比值比:0.22,95%置信区间:0.08;0.56)。7岁时,接种疫苗的儿童血清总IgE降低了62.8%(95%置信区间:-84.3%;-11.9%)。MMR疫苗接种与13岁时的过敏性鼻结膜炎症状、湿疹或皮肤点刺试验反应无显著关联。

结论

生命早期接种MMR疫苗可能至少在7岁前对过敏具有保护作用,在13岁前对哮喘具有保护作用。

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