Swartz Jackie, Aronsson Bernice, Lindblad Frank, Järnbert-Pettersson Hans, Scheynius Annika, Pershagen Göran, Alm Johan
Vidarkliniken, Järna, Sweden.
Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
EClinicalMedicine. 2018 Nov 6;4-5:92-98. doi: 10.1016/j.eclinm.2018.10.005. eCollection 2018 Oct-Nov.
The increasing incidence of allergic diseases highlights the importance of finding underlying mechanisms. Early vaccination has been suggested as one influential factor. However, it is difficult to find a study group with a large variation between subjects concerning compliance to the official vaccination program. The anthroposophic lifestyle is of interest in this context. Moreover, cohort studies show that children of families with this lifestyle run a lower risk of allergic sensitization and allergy-related disease.
From the prospective birth cohort ALADDIN we included one group from the anthroposophic community, with restrictive attitudes concerning vaccinations, and two other groups of age-matched children with more conventional parental lifestyles. In all, 466 children were followed from birth to five years of age. Detailed vaccination data and blood samples were collected at six months, one, two, and five years. Information was also obtained on risk factors for allergy. The outcome variable, allergic sensitization was defined as allergen-specific serum IgE levels ≥ 0.35 kU/L.
In a logistic regression model adjusted for socio-demographics and established allergy risk factors, vaccination at later age or having a lower number of injections or vaccines were associated with low OR for allergic sensitization during the first year of life. However, after adjustment for anthroposophic lifestyle, no statistically significant associations remained. The adjusted OR for sensitization at five years of age in children not receiving any vaccinations (n = 54) was 0.98 [95% CI 0.38-2.57].
We found no support for an association between early childhood vaccination and subsequent allergic sensitization. Our findings do not support scepticism towards early childhood vaccination motivated by allergy risk.
过敏性疾病发病率的不断上升凸显了寻找潜在机制的重要性。早期接种疫苗被认为是一个影响因素。然而,很难找到一个在遵守官方疫苗接种计划方面个体差异较大的研究群体。在这种背景下,人智学的生活方式受到关注。此外,队列研究表明,具有这种生活方式的家庭中的儿童发生过敏致敏和过敏相关疾病的风险较低。
从前瞻性出生队列“阿拉丁”中,我们纳入了一组来自人智学社区、对疫苗接种持限制态度的儿童,以及另外两组年龄匹配、父母生活方式更传统的儿童。总共466名儿童从出生到5岁被跟踪随访。在6个月、1岁、2岁和5岁时收集详细的疫苗接种数据和血样。还获取了过敏风险因素的信息。结局变量“过敏致敏”定义为过敏原特异性血清IgE水平≥0.35 kU/L。
在对社会人口统计学和既定过敏风险因素进行调整的逻辑回归模型中,较晚接种疫苗或接种针次或疫苗数量较少与生命第一年过敏致敏的低比值比相关。然而,在对人智学生活方式进行调整后,没有统计学上的显著关联。未接种任何疫苗的儿童(n = 54)在5岁时致敏的调整后比值比为0.98 [95%可信区间0.38 - 2.57]。
我们没有发现支持儿童早期接种疫苗与随后过敏致敏之间存在关联的证据。我们的研究结果不支持因过敏风险而对儿童早期接种疫苗产生的怀疑态度。