Infectious Diseases Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Department of Paediatrics, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
J Paediatr Child Health. 2019 Sep;55(9):1099-1102. doi: 10.1111/jpc.14364. Epub 2019 Jan 2.
Q fever is a zoonotic disease caused by the bacterium Coxiella burnetii and is associated with significant morbidity and mortality in both adults and children. Australia is the only country that has produced and registered a Q fever vaccine for human use, but this vaccine is licenced only for people aged over 15 years as data and experience in children are limited. This review describes the experience of Q fever vaccination of known paediatric cases in Australia to date.
Patients aged younger than 15 years who received the Q fever vaccination had data abstracted from medical records after consent was obtained from the relevant guardians. Data on risk factors for Q fever, skin testing procedure, dose of vaccination, adverse effects and follow-up assessment were obtained.
Twelve children were identified as having received the Q fever vaccination. Vaccination was feasible, with empirical weight-based dose adjustment performed for younger children. There were no significant adverse effects.
Q fever vaccine may be safe in children and should be considered in children who are at significant risk of Q fever infection. Safe vaccine protocols with proven efficacy will allow children of all ages to be protected. Prospective studies of vaccination in children are indicated. Expanding available Q fever registries to include children would allow outcomes to be systematically followed.
Q 热是一种由贝氏柯克斯体引起的人畜共患病，在成人和儿童中都与较高的发病率和死亡率相关。澳大利亚是唯一生产并注册了人类用 Q 热疫苗的国家，但该疫苗仅许可 15 岁以上人群使用，因为在儿童中的数据和经验有限。这篇综述描述了迄今为止澳大利亚已知儿科病例接种 Q 热疫苗的经验。
在获得相关监护人同意后，从病历中提取了年龄小于 15 岁接受 Q 热疫苗接种的患者的数据。获得了 Q 热的危险因素、皮肤试验程序、疫苗剂量、不良反应和随访评估的数据。
确定了 12 名儿童接种了 Q 热疫苗。疫苗接种是可行的，对于年龄较小的儿童，根据经验进行了基于体重的剂量调整。没有明显的不良反应。
Q 热疫苗在儿童中可能是安全的，对于有发生 Q 热感染重大风险的儿童，应考虑接种。具有已证实疗效的安全疫苗方案将使所有年龄段的儿童都能得到保护。建议对儿童进行疫苗接种的前瞻性研究。扩大现有的 Q 热登记处以纳入儿童，可以系统地跟踪结果。
