Hooker Brian S, Miller Neil Z
Department of Sciences and Mathematics, Simpson University, Redding, CA, USA.
Institute of Medical and Scientific Inquiry, Santa Fe, NM, USA.
SAGE Open Med. 2020 May 27;8:2050312120925344. doi: 10.1177/2050312120925344. eCollection 2020.
The aim of this study was to compare the health of vaccinated versus unvaccinated pediatric populations.
Using data from three medical practices in the United States with children born between November 2005 and June 2015, vaccinated children were compared to unvaccinated children during the first year of life for later incidence of developmental delays, asthma, ear infections and gastrointestinal disorders. All diagnoses utilized International Classification of Diseases-9 and International Classification of Diseases-10 codes through medical chart review. Subjects were a minimum of 3 years of age, stratified based on medical practice, year of birth and gender and compared using a logistic regression model.
Vaccination before 1 year of age was associated with increased odds of developmental delays (OR = 2.18, 95% CI 1.47-3.24), asthma (OR = 4.49, 95% CI 2.04-9.88) and ear infections (OR = 2.13, 95% CI 1.63-2.78). In a quartile analysis, subjects were grouped by number of vaccine doses received in the first year of life. Higher odds ratios were observed in Quartiles 3 and 4 (where more vaccine doses were received) for all four health conditions considered, as compared to Quartile 1. In a temporal analysis, developmental delays showed a linear increase as the age cut-offs increased from 6 to 12 to 18 to 24 months of age (ORs = 1.95, 2.18, 2.92 and 3.51, respectively). Slightly higher ORs were also observed for all four health conditions when time permitted for a diagnosis was extended from ⩾ 3 years of age to ⩾ 5 years of age.
In this study, which only allowed for the calculation of unadjusted observational associations, higher ORs were observed within the vaccinated versus unvaccinated group for developmental delays, asthma and ear infections. Further study is necessary to understand the full spectrum of health effects associated with childhood vaccination.
本研究旨在比较接种疫苗与未接种疫苗的儿童群体的健康状况。
利用美国三家医疗机构中2005年11月至2015年6月间出生儿童的数据,将接种疫苗的儿童与未接种疫苗的儿童在出生后第一年进行比较,以观察后期发育迟缓、哮喘、耳部感染和胃肠道疾病的发病率。所有诊断均通过病历审查使用国际疾病分类第9版和国际疾病分类第10版编码。受试者年龄至少为3岁,根据医疗机构、出生年份和性别进行分层,并使用逻辑回归模型进行比较。
1岁前接种疫苗与发育迟缓(比值比[OR]=2.18,95%置信区间[CI]1.47-3.24)、哮喘(OR=4.49,95%CI 2.04-9.88)和耳部感染(OR=2.13,95%CI 1.63-2.78)的几率增加相关。在四分位数分析中,根据出生后第一年接受的疫苗剂量数量对受试者进行分组。与第一四分位数相比,在考虑的所有四种健康状况下,第三和第四四分位数(接受更多疫苗剂量)的比值比更高。在时间分析中,随着年龄界限从6个月增加到12个月、18个月和24个月,发育迟缓呈线性增加(OR分别为1.95、2.18、2.92和3.51)。当诊断允许的时间从≥3岁延长到≥5岁时,在所有四种健康状况下也观察到略高的OR。
在本研究中,由于仅允许计算未经调整的观察性关联,在接种疫苗组与未接种疫苗组中,发育迟缓、哮喘和耳部感染的OR较高。有必要进行进一步研究以了解与儿童疫苗接种相关的健康影响的全貌。