Allergy Center, National Center for Child Health and Development, Tokyo, Japan.
Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan.
Environ Health Prev Med. 2020 Jul 7;25(1):27. doi: 10.1186/s12199-020-00864-7.
Adjuvants used in inactivated vaccines often upregulate type 2 immunity, which is dominant in allergic diseases. We hypothesised that cumulative adjuvant exposure in infancy may influence the development of allergies later in life by changing the balance of type 1/type 2 immunity. We examined the relationship between immunisation with different vaccine types and later allergic disease development.
We obtained information regarding vaccinations and allergic diseases through questionnaires that were used in The Japan Environment and Children's Study (JECS), which is a nationwide, multicentre, prospective birth cohort study that included 103,099 pregnant women and their children. We examined potential associations between the initial vaccination before 6 months of age and symptoms related to allergies at 12 months of age.
Our statistical analyses included 56,277 children. Physician-diagnosed asthma was associated with receiving three (aOR 1.395, 95% CI 1.028-1.893) or four to five different inactivated vaccines (aOR 1.544, 95% CI 1.149-2.075), compared with children who received only one inactivated vaccine. Similar results were found for two questionnaire-based symptoms, i.e. wheeze (aOR 1.238, 95% CI 1.094-1.401; three vaccines vs. a single vaccine) and eczema (aOR 1.144, 95% CI 1.007-1.299; four or five vaccines vs. a single vaccine).
Our results, which should be cautiously interpreted, suggest that the prevalence of asthma, wheeze and eczema among children at 12 months of age might be related to the amount of inactivated vaccine exposure before 6 months of age. Future work should assess if this association is due to cumulative adjuvant exposure. Despite this possible association, we strongly support the global vaccination strategy and recommend that immunisations continue.
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在灭活疫苗中使用的佐剂通常会上调 2 型免疫，而 2 型免疫在过敏疾病中占主导地位。我们假设，婴儿期累积的佐剂暴露可能通过改变 1 型/2 型免疫的平衡，影响生命后期过敏的发展。我们研究了不同疫苗类型的免疫接种与随后发生过敏疾病之间的关系。
我们通过日本环境与儿童研究（JECS）中的问卷调查获得了疫苗接种和过敏疾病的信息，JECS 是一项全国性的、多中心的、前瞻性的出生队列研究，纳入了 103099 名孕妇及其子女。我们研究了 6 个月龄前首次接种疫苗与 12 个月龄时与过敏相关症状之间的潜在关联。
我们的统计分析包括 56277 名儿童。与仅接种一种灭活疫苗的儿童相比，接受三种（优势比 1.395，95%置信区间 1.028-1.893）或四种至五种不同灭活疫苗的儿童患有医生诊断的哮喘（优势比 1.544，95%置信区间 1.149-2.075）的风险更高。对于两种基于问卷的症状，即喘息（优势比 1.238，95%置信区间 1.094-1.401；三种疫苗与单一疫苗相比）和湿疹（优势比 1.144，95%置信区间 1.007-1.299；四种或五种疫苗与单一疫苗相比），也得到了类似的结果。
我们的结果应谨慎解释，表明 12 个月龄儿童哮喘、喘息和湿疹的患病率可能与 6 个月龄前灭活疫苗暴露量有关。未来的工作应该评估这种关联是否是由于累积的佐剂暴露所致。尽管存在这种可能的关联，我们仍强烈支持全球疫苗接种策略，并建议继续进行免疫接种。
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