Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Copenhagen, Denmark; OPEN, Open Patient data Explorative Network, Odense University Hospital/Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
J Allergy Clin Immunol Pract. 2021 Apr;9(4):1520-1528.e8. doi: 10.1016/j.jaip.2020.09.024. Epub 2020 Oct 2.
An Australian study including 4433 children found that delayed Diphtheria-Tetanus-acellular Pertussis-containing vaccination was associated with reduced risk of developing atopic dermatitis (AD) before age 1 year.
We assessed whether delayed vaccination against diphtheria, tetanus, acellular pertussis, polio, and Haemophilus influenzae type b (Diphtheria, Tetanus, acellular Pertussis - Inactivated Polio vaccine - Haemophilus influenzae type b [DTaP]) was associated with a reduced risk of new cases of AD before age 1 year in Denmark.
We used nationwide registers to follow 883,160 children born in Denmark from 1997 to 2012. Binary regression models adjusting for potential confounding factors were applied to estimate relative risks (adjusted relative risks [aRRs]) of developing AD among children with delayed DTaP vaccination (defined as given 1 month or more after the recommended age) compared with timely vaccinated children.
Among 143,429 children with a delayed first dose of DTaP, 4,847 (3.4%) developed AD between age 4 months and 1 year, compared with 27,628 (3.7%) among 739,731 children not having delayed DTaP (aRR 0.94; 95% CI, 0.91-0.97). The aRR was 0.94 (95% CI, 0.90-0.99) for children with a delayed second dose, and the aRR was 0.88 (95% CI, 0.82-0.93) when comparing children with delayed first and second doses with all timely vaccinated children.
The results support the hypothesis that delayed vaccination with DTaP is associated with reduced risk of developing new cases of AD after age 4 months. The dose-dependent relationship strengthens the evidence of a causal relationship. Some countries are introducing maternal pertussis vaccination and delaying the first dose of DTaP, providing a possibility for further testing the hypothesis.
一项包含 4433 名儿童的澳大利亚研究发现，延迟接种含白喉、破伤风、无细胞百日咳的疫苗（DTaP）与 1 岁前发生特应性皮炎（AD）的风险降低有关。
我们评估了在丹麦，延迟接种白喉、破伤风、无细胞百日咳、脊髓灰质炎和流感嗜血杆菌 b 型（白喉、破伤风、无细胞百日咳-灭活脊髓灰质炎疫苗-流感嗜血杆菌 b 型[DTaP]）疫苗是否与 1 岁前新发 AD 病例风险降低有关。
我们使用全国性登记册，对 1997 年至 2012 年期间在丹麦出生的 883160 名儿童进行了随访。应用二元回归模型调整潜在混杂因素，估计延迟 DTaP 接种（定义为在推荐年龄后 1 个月或更长时间接种）儿童与及时接种儿童相比，发生 AD 的相对风险（调整后相对风险[aRR]）。
在 143429 名第一剂 DTaP 接种延迟的儿童中，4847 名（3.4%）在 4 月龄至 1 岁之间发生 AD，而在 739731 名未延迟 DTaP 接种的儿童中，有 27628 名（3.7%）发生 AD（aRR 0.94；95%CI，0.91-0.97）。第二剂延迟的 aRR 为 0.94（95%CI，0.90-0.99），第一剂和第二剂均延迟的儿童与所有及时接种的儿童相比，aRR 为 0.88（95%CI，0.82-0.93）。
结果支持延迟接种 DTaP 与 4 月龄后新发 AD 风险降低相关的假设。剂量依赖性关系加强了因果关系的证据。一些国家正在引入母体百日咳疫苗接种并延迟 DTaP 的第一剂，为进一步检验该假说提供了可能。
