Bardenheier Barbara H, Duderstadt Susan K, Engler Renata J M, McNeil Michael M
Immunization Safety Office, Centers for Disease Control & Prevention, Atlanta, GA 30333, United States.
Immunization Healthcare Branch, Defense Health Agency, (including legacy Vaccine Healthcare Centers Network, Public Health Command), Walter Reed National Military Medical Center America, 8901 Wisconsin Avenue, Bethesda, MA 20889-0001, United States.
Vaccine. 2016 Aug 17;34(37):4406-14. doi: 10.1016/j.vaccine.2016.07.019. Epub 2016 Jul 19.
No comparative review of Vaccine Adverse Event Reporting System (VAERS) submissions following pandemic influenza A (H1N1) 2009 and seasonal influenza vaccinations during the pandemic season among U.S. military personnel has been published.
We compared military vs. civilian adverse event reporting rates. Adverse events (AEs) following vaccination were identified from VAERS for adults aged 17-44years after pandemic (monovalent influenza [MIV], and seasonal (trivalent inactivated influenza [IIV3], live attenuated influenza [LAIV3]) vaccines. Military vaccination coverage was provided by the Department of Defense's Defense Medical Surveillance System. Civilian vaccination coverage was estimated using data from the National 2009 H1N1 Flu Survey and the Behavioral Risk Factor Surveillance System survey.
Vaccination coverage was more than four times higher for MIV and more than twenty times higher for LAIV3 in the military than in the civilian population. The reporting rate of serious AE reports following MIV in service personnel (1.19 per 100,000) was about half that reported by the civilian population (2.45 per 100,000). Conversely, the rate of serious AE reports following LAIV3 among service personnel (1.32 per 100,000) was more than twice that of the civilian population. Although fewer military AEs following MIV were reported overall, the rate of Guillain-Barré Syndrome (GBS) (4.01 per million) was four times greater than that in the civilian population. (1.04 per million).
Despite higher vaccination coverage in service personnel, the rate of serious AEs following MIV was about half that in civilians. The rate of GBS reported following MIV was higher in the military.
关于2009年甲型H1N1流感大流行期间美国军事人员接种大流行流感疫苗和季节性流感疫苗后向疫苗不良事件报告系统(VAERS)提交报告的比较性综述尚未发表。
我们比较了军事人员与平民的不良事件报告率。从VAERS中识别出17 - 44岁成年人在大流行后接种疫苗(单价流感疫苗[MIV])以及季节性疫苗(三价灭活流感疫苗[IIV3]、减毒活流感疫苗[LAIV3])后的不良事件(AE)。国防部的国防医疗监测系统提供军事人员的疫苗接种覆盖率。使用2009年甲型H1N1流感全国调查和行为危险因素监测系统调查的数据估算平民的疫苗接种覆盖率。
军事人员中MIV的接种覆盖率比平民高四倍多,LAIV3的接种覆盖率比平民高二十倍多。军事人员接种MIV后严重AE报告的报告率(每10万人中1.19例)约为平民报告率(每10万人中2.45例)的一半。相反,军事人员接种LAIV3后严重AE报告的发生率(每10万人中1.32例)是平民的两倍多。尽管总体上报的军事人员接种MIV后的AE较少,但吉兰 - 巴雷综合征(GBS)的发生率(每百万中4.01例)是平民的四倍(每百万中1.04例)。
尽管军事人员的疫苗接种覆盖率较高,但接种MIV后严重AE的发生率约为平民的一半。军事人员接种MIV后报告的GBS发生率较高。