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轮状病毒疫苗接种对儿童因癫痫住院的影响:异源或意外的直接疫苗效应?

Impact of rotavirus vaccination on childhood hospitalizations for seizures: Heterologous or unforeseen direct vaccine effects?

机构信息

Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Hospital Clínico Universitario and Universidade de Santiago de Compostela (SERGAS), Galicia, Spain; Unidade de Xenética, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, and GenPoB Research Group, Instituto de Investigaciones Sanitarias (IDIS), Hospital Clínico Universitario de Santiago (SERGAS), Galicia, Spain.

Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Hospital Clínico Universitario and Universidade de Santiago de Compostela (SERGAS), Galicia, Spain.

出版信息

Vaccine. 2019 May 31;37(25):3362-3368. doi: 10.1016/j.vaccine.2019.04.086. Epub 2019 May 4.

Abstract

There is a growing interest in the possible relationship between rotavirus (RV) vaccine and hospitalizations due to childhood seizures. We explored variation in hospitalization rates after 9 years of vaccination against pre-vaccination period for children <5 years of age from Galicia (Northwest Spain) before and after the introduction of the RV vaccines. Hospitalization rates for childhood seizures in Galician children were compared before and after RV vaccine introduction (in 2007) using different statistical approaches, including time series analyses. Our study cohort totaled 7,712 children <5 years of age admitted to hospital between 2002 and 2015 for "all kind of childhood seizures". Hospitalization rates decreases steadily with reductions ranging from 22.3% (95% CI: 15.0-29.1) in 2008, to 50.9% (95% CI: 45.5-55.7) in 2014, and significant results were also observed for <1, 1, and 2-year-old children in comparison with pre-vaccination period hospitalization rate. Regression models indicate a negative association between RV vaccination and hospitalizations for all kind of seizures. In addition, time series analyses are consistent with this finding and predict that vaccination coverage will affect hospitalization rates for "all kind of seizures" after 9 months. The results strongly support that RV vaccination has significantly reduced hospitalization rates due to childhood seizures.

摘要

人们对轮状病毒 (RV) 疫苗与儿童癫痫发作住院之间可能存在的关系越来越感兴趣。我们探讨了在接种 RV 疫苗之前和之后,在接种疫苗前 9 年针对加利西亚(西班牙西北部)<5 岁儿童的疫苗接种预防疾病期间,儿童癫痫发作住院率的变化。使用不同的统计方法,包括时间序列分析,比较了加利西亚儿童在 RV 疫苗接种前后(2007 年)癫痫发作住院率。我们的研究队列共有 7712 名<5 岁儿童因“各种儿童癫痫发作”于 2002 年至 2015 年住院,住院率稳步下降,降幅从 2008 年的 22.3%(95%CI:15.0-29.1)到 2014 年的 50.9%(95%CI:45.5-55.7)。与接种疫苗前相比,<1、1 和 2 岁儿童的住院率也显著下降。回归模型表明 RV 疫苗接种与所有类型癫痫发作的住院之间存在负相关。此外,时间序列分析也支持这一发现,并预测疫苗接种覆盖率将在 9 个月后影响“所有类型癫痫发作”的住院率。结果强烈支持 RV 疫苗接种显著降低了儿童癫痫发作的住院率。

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