Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, Australia.
Illawarra Medical Centre, Ballajura, Western Australia, Australia.
Expert Rev Vaccines. 2022 Mar;21(3):415-422. doi: 10.1080/14760584.2022.2021075. Epub 2022 Jan 2.
Reduction of adverse events following immunization (AEFI) could improve vaccine uptake. Evidence suggests sex and age affect AEFI rates but, with limited understanding of their interaction, groups at higher risk for adverse reaction cannot be identified.
Using deidentified data (n = 308,481) from Australians receiving influenza vaccinations in the 2020 calendar year, we analyzed the effects of independent predictors (i.e. age and sex), on experiencing an AEFI using logistic regression generalized additive modeling to capture any nonlinear relationships and adjusting for vaccine brand and concomitant vaccination.
The overall reaction rate was 5.5%. Modeling revealed significant effects of age (p < 0.001), sex (p < 0.001), and age × sex (p < 0.001). Females were more likely than males to experience AEFIs between 7.5 and 87.5 years of age and exhibited peak odds at about 53 years, while peak odds for males occurred in infancy.
The results suggest there is a need for targeting AEFI reduction in females, particularly in 30-70-year-olds, to improve the vaccination experience. The results further suggest that reducing concomitant vaccination and choosing less reactogenic vaccine brands could reduce risk of AEFI, however, retaining concomitant vaccination may optimize vaccine uptake.
减少接种疫苗后的不良反应（AEFI）可以提高疫苗接种率。有证据表明，性别和年龄会影响 AEFI 发生率，但由于对其相互作用的了解有限，无法确定不良反应风险更高的人群。
利用 2020 年澳大利亚人接种流感疫苗的匿名数据（n=308481），我们使用逻辑回归广义加性模型分析了独立预测因子（即年龄和性别）对 AEFI 发生的影响，以捕捉任何非线性关系，并调整疫苗品牌和同时接种疫苗的影响。
总体反应率为 5.5%。模型显示年龄（p<0.001）、性别（p<0.001）和年龄×性别（p<0.001）均有显著影响。女性在 7.5 至 87.5 岁之间发生 AEFI 的可能性高于男性，而男性的峰值概率出现在婴儿期。
结果表明，需要针对女性，特别是 30-70 岁女性，减少 AEFI，以改善接种体验。结果进一步表明，减少同时接种疫苗和选择较少反应原性疫苗品牌可以降低 AEFI 的风险，但保留同时接种疫苗可能会优化疫苗接种率。
