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疫苗接种与过敏:欧洲变态反应和临床免疫学会立场文件,实践要点

Vaccination and allergy: EAACI position paper, practical aspects.

作者信息

Nilsson Lennart, Brockow Knut, Alm Johan, Cardona Victoria, Caubet Jean-Christoph, Gomes Eva, Jenmalm Maria C, Lau Susanne, Netterlid Eva, Schwarze Jürgen, Sheikh Aziz, Storsaeter Jann, Skevaki Chrysanthi, Terreehorst Ingrid, Zanoni Giovanna

机构信息

Allergy Center, University Hospital, Linköping, Sweden.

Department of Dermatology and Allergy Biederstein, Technical University Munich, Munich, Germany.

出版信息

Pediatr Allergy Immunol. 2017 Nov;28(7):628-640. doi: 10.1111/pai.12762. Epub 2017 Oct 10.

Abstract

Immunization is highly effective in preventing infectious diseases and therefore an indispensable public health measure. Allergic patients deserve access to the same publicly recommended immunizations as non-allergic patients unless risks associated with vaccination outweigh the gains. Whereas the number of reported possible allergic reactions to vaccines is high, confirmed vaccine-triggered allergic reactions are rare. Anaphylaxis following vaccination is rare, affecting <1/100 000, but can occur in any patient. Some patient groups, notably those with a previous allergic reaction to a vaccine or its components, are at heightened risk of allergic reaction and require special precautions. Allergic reactions, however, may occur in patients without known risk factors and cannot be predicted by currently available tools. Unwarranted fear and uncertainty can result in incomplete vaccination coverage for children and adults with or without allergy. In addition to concerns about an allergic reaction to the vaccine itself, there is fear that routine childhood immunization may promote the development of allergic sensitization and disease. Thus, although there is no evidence that routine childhood immunization increases the risk of allergy development, such risks need to be discussed.

摘要

免疫接种在预防传染病方面非常有效,因此是一项不可或缺的公共卫生措施。除非接种疫苗的风险超过收益,否则过敏患者应与非过敏患者一样能够获得相同的公共推荐免疫接种。虽然报告的对疫苗可能的过敏反应数量很多,但确诊的疫苗引发的过敏反应却很少见。接种疫苗后的过敏反应很少见,发生率<1/100 000,但任何患者都可能发生。一些患者群体,特别是那些以前对疫苗或其成分有过敏反应的患者,发生过敏反应的风险更高,需要特别预防措施。然而,过敏反应也可能发生在没有已知风险因素的患者中,并且目前可用的工具无法预测。无端的恐惧和不确定性可能导致有或没有过敏的儿童和成人疫苗接种覆盖率不完整。除了担心对疫苗本身的过敏反应外,人们还担心儿童常规免疫接种可能会促进过敏致敏和疾病的发展。因此,尽管没有证据表明儿童常规免疫接种会增加过敏发生的风险,但仍需要讨论此类风险。

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