Halsey Neal A, Proveaux Tina
Institute for Vaccine Safety, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD, USA.
Institute for Vaccine Safety, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD, USA.
Vaccine. 2017 Oct 27;35(45):6154-6159. doi: 10.1016/j.vaccine.2017.09.049. Epub 2017 Sep 27.
Unpublished data can sometimes provide valuable information on the safety of biologic products.
We assessed information potentially available from regulatory authorities, manufacturers, and public health agencies. We explored 4 recently established vaccine registries, reviewed package inserts from 99 influenza vaccines, and contacted vaccine manufacturers and regulatory agencies for data on influenza vaccine safety in pregnant women.
The vaccine registries did not have sufficient data to analyze and there are problems with the quality of the information. The majority of package inserts provided no product-specific safety information for pregnant women, especially in less developed countries. The majority of available data come from reports gathered from passive adverse event reporting systems in the general population and reports of women enrolled in clinical trials of influenza vaccines who became pregnant at various times before or after receiving influenza vaccine. The information was not collected in a systematic manner, there are inconsistencies in the follow up of pregnant women and the available information about pregnancy outcomes. Considerable resources would be needed to systematically identify all of the information, try to obtain missing follow up information, and conduct analyses. There would be substantial limitations to any attempt to conduct a systematic analysis.
The value of trying to analyze unpublished data on the safety of influenza vaccine in pregnancy is limited and would require considerable resources to thoroughly investigate. Expanding efforts to identify and review unpublished data regarding the safety of influenza vaccines in pregnancy is not likely to produce information of high scientific value or information that could not be identified from publications and other publically available data.
未发表的数据有时可提供有关生物制品安全性的有价值信息。
我们评估了可能从监管机构、制造商和公共卫生机构获取的信息。我们研究了4个最近建立的疫苗登记处,审查了99种流感疫苗的说明书,并联系疫苗制造商和监管机构以获取孕妇流感疫苗安全性的数据。
疫苗登记处没有足够的数据进行分析,且信息质量存在问题。大多数说明书未提供针对孕妇的特定产品安全性信息,尤其是在欠发达国家。现有数据大多来自普通人群被动不良事件报告系统收集的报告以及参与流感疫苗临床试验且在接种疫苗前后不同时间怀孕的女性的报告。这些信息并非以系统方式收集,孕妇随访及妊娠结局的现有信息存在不一致之处。要系统地识别所有信息、设法获取缺失的随访信息并进行分析,需要大量资源。任何进行系统分析的尝试都会有很大局限性。
试图分析关于孕妇流感疫苗安全性的未发表数据的价值有限,且需要大量资源进行全面调查。加大力度识别和审查关于孕妇流感疫苗安全性的未发表数据,不太可能产生具有高科学价值的信息,也不太可能产生无法从已发表文献和其他公开数据中识别的信息。