2005-2014 年美国儿童使用灭活疫苗和活疫苗后非目标传染病住院的风险。
Risk of Nontargeted Infectious Disease Hospitalizations Among US Children Following Inactivated and Live Vaccines, 2005-2014.
机构信息
Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia.
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
出版信息
Clin Infect Dis. 2017 Sep 1;65(5):729-737. doi: 10.1093/cid/cix442.
BACKGROUND
Recent studies have shown that some vaccines have beneficial effects that cannot be explained solely by the prevention of their respective targeted disease(s).
METHODS
We used the MarketScan US Commercial Claims Databases for 2005 to 2014 to assess the risk of hospital admission for nontargeted infectious (NTI) diseases in children aged 16 through 24 months according to the last vaccine type (live and/or inactivated). We included children continuously enrolled within a month of birth through 15 months who received at least 3 doses of diphtheria-tetanus-acellular pertussis vaccine by the end of 15 months of age. We used Cox regression to estimate hazard ratios (HRs), stratifying by birthdate to control for age, year, and seasonality and adjusting for sex, chronic diseases, prior hospitalizations, number of outpatient visits, region of residence, urban/rural area of domicile, prematurity, low birth weight, and mother's age.
RESULTS
311663 children were included. In adjusted analyses, risk of hospitalization for NTI from ages 16 through 24 months was reduced for those who received live vaccine alone compared with inactivated alone or concurrent live and inactivated vaccines (HR, 0.50; 95% confidence interval [CI], 0.43, 0.57 and HR, 0.78; 95% CI, 0.67, 0.91, respectively) and for those who received live and inactivated vaccines concurrently compared with inactivated-only (HR, 0.64; 95% CI, 0.58, 0.70).
CONCLUSIONS
We found lower risk of NTI disease hospitalizations from age 16 through 24 months among children whose last vaccine received was live compared with inactivated vaccine, as well as concurrent receipt compared with inactivated vaccine.
背景
最近的研究表明，某些疫苗具有不能仅通过预防其各自的目标疾病来解释的有益效果。
方法
我们使用 2005 年至 2014 年的 MarketScan 美国商业索赔数据库，根据最后一次疫苗类型（活疫苗和/或灭活疫苗）评估 16 至 24 个月大儿童患非目标感染性（NTI）疾病的住院风险。我们纳入了在出生后一个月内连续入组并在 15 个月龄前至少接受 3 剂白喉、破伤风、无细胞百日咳疫苗的儿童。我们使用 Cox 回归估计风险比（HRs），按出生日期分层以控制年龄、年份和季节性，并调整性别、慢性疾病、既往住院、门诊就诊次数、居住地、城乡居住地区、早产、低出生体重和母亲年龄。
结果
共纳入 311663 名儿童。在调整分析中，与单独使用灭活疫苗或同时使用活疫苗和灭活疫苗相比，单独使用活疫苗的儿童在 16 至 24 个月时因 NTI 住院的风险降低（HR，0.50；95%置信区间[CI]，0.43，0.57 和 HR，0.78；95% CI，0.67，0.91），与单独使用灭活疫苗相比，同时使用活疫苗和灭活疫苗的儿童住院风险也降低（HR，0.64；95% CI，0.58，0.70）。
结论
我们发现，与接种灭活疫苗相比，最近一次接种的疫苗为活疫苗的儿童在 16 至 24 个月期间因 NTI 疾病住院的风险较低，同时接种疫苗与接种灭活疫苗相比风险也较低。
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