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泰国儿童接种百白破疫苗(DTaP)和全细胞百白破疫苗(DTwP)后的不良事件

ADVERSE EVENTS POST-DTAP AND DTwP VACCINATION IN THAI CHILDREN.

作者信息

Fortuna Librada, Sirivichayakul Chukiat, Watanaveeradej Veerachai, Soonthornworasiri Ngamphol, Sitcharungsi Raweerat

出版信息

Southeast Asian J Trop Med Public Health. 2015 Jul;46(4):764-74.

Abstract

We conducted a prospective study to compare the development of fever (axillary T ≥ 37.9 °C) within 4 hours of vaccination, determine the proportion of children who develop high fever (T ≥ 39°C) and evaluate parental days missed from work due to their children's vaccination with either the diphtheria-tetanus-whole cell pertussis (DTwP) or diphtheria-tetanus-acellular pertussis (DTaP) vaccine. The results of this study can help physicians and parents decide whether to have their child vaccinated with the DTwP or more expensive DTaP vaccine. We studied 140 healthy Thai children aged 2 months to 6 years from December 2011 to March 2012 who presented for vaccination. Parents recorded their child's temperature, local and systemic adverse reactions and missed days from work due to these adverse events on a diary card. Of the 140 participants, 72 received the DTwP vaccine and 68 received the DTaP vaccine. The median (IQR) age was 4 (2-6) months and the median weight was 7.1 (5.6-8.7) kg. Twenty children developed fever (axillary T ≥ 37.9°C) within 4 hours following vaccination, 17 (23.6%) had received the DTwP vaccine and 3 (4.4%) had received the DTaP vaccine (p = 0.040). One child (1.4%) who had received the DTwP vaccine and none who received the DTaP vaccine developed high fever (T ≥ 39°C) within 4 hours of vaccination (p = 0.329). Parents of two children who received the DTwP vaccine and one child who received the DTaP vaccine missed work following vaccination (p = 0.059). In conclusion, children who received the DTwP vaccines were more likely to have early post-vaccination fever and higher fever but there was no significant difference between the two groups in parental days lost from work.

摘要

我们进行了一项前瞻性研究,以比较接种疫苗后4小时内发热(腋温T≥37.9°C)的发生情况,确定高热(T≥39°C)儿童的比例,并评估因孩子接种白喉-破伤风-全细胞百日咳疫苗(DTwP)或白喉-破伤风-无细胞百日咳疫苗(DTaP)而导致家长误工的天数。本研究结果可帮助医生和家长决定让孩子接种DTwP疫苗还是更昂贵的DTaP疫苗。我们研究了2011年12月至2012年3月期间前来接种疫苗的140名2个月至6岁的健康泰国儿童。家长在日记卡上记录孩子的体温、局部和全身不良反应以及因这些不良事件导致的误工天数。140名参与者中,72人接种了DTwP疫苗,68人接种了DTaP疫苗。年龄中位数(IQR)为4(2 - 6)个月,体重中位数为7.1(5.6 - 8.7)kg。20名儿童在接种疫苗后4小时内出现发热(腋温T≥37.9°C),其中17名(23.6%)接种了DTwP疫苗,3名(4.4%)接种了DTaP疫苗(p = 0.040)。1名接种DTwP疫苗的儿童(1.4%)在接种疫苗后4小时内出现高热(T≥39°C),接种DTaP疫苗的儿童无人出现高热(p = 0.329)。2名接种DTwP疫苗的儿童和1名接种DTaP疫苗的儿童的家长在孩子接种疫苗后误工(p = 0.059)。总之,接种DTwP疫苗的儿童在接种后早期更易发热且发热程度更高,但两组家长的误工天数无显著差异。

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