Kaiser Permanente Vaccine Study Center, Oakland, CA, United States.
Kaiser Permanente Vaccine Study Center, Oakland, CA, United States.
Vaccine. 2022 Apr 20;40(18):2568-2573. doi: 10.1016/j.vaccine.2022.03.031. Epub 2022 Mar 18.
To determine whether children aged 4-7 years with a diagnosis of autism spectrum disorders (ASD) were at increased risk of fever, febrile seizures, or emergency department (ED) visits following measles- or pertussis-containing vaccines compared with children without ASD.
The study included children born between 1995-2012, aged 4-7 years at vaccination, and members of six healthcare delivery systems within Vaccine Safety Datalink. We conducted self-controlled risk interval analyses comparing rates of outcomes in risk and control intervals within each group defined by ASD status, and then compared outcome rates between children with and without ASD, in risk and control intervals, by estimating difference-in-differences using logistic regressions.
The study included 14,947 children with ASD and 1,650,041 children without ASD. After measles- or pertussis-containing vaccination, there were no differences in association between children with and without ASD for fever (ratio of rate ratio for measles-containing vaccine = 1.07, 95% CI 0.58-1.96; for pertussis-containing vaccine = 1.16, 95% CI 0.63-2.15) or ED visits (ratio of rate ratio for measles-containing vaccine = 1.11, 95% CI 0.80-1.54; for pertussis-containing vaccine = 0.87, 95% CI 0.59-1.28). Febrile seizures were rare. Pertussis-containing vaccines were associated with small increased risk of febrile seizures in children without ASD.
Children with ASD were not at increased risk for fever or ED visits compared with children without ASD following measles- or pertussis-containing vaccines. These results may provide further reassurance that these vaccines are safe for all children, including those with ASD.
确定与没有自闭症谱系障碍(ASD)的儿童相比,4-7 岁被诊断为自闭症谱系障碍的儿童在接种麻疹或百日咳疫苗后是否有更高的发热、热性惊厥或急诊就诊(ED)风险。
本研究纳入了 1995 年至 2012 年期间出生、接种疫苗时年龄为 4-7 岁且来自疫苗安全数据链内 6 个医疗保健提供系统的儿童。我们通过 ASD 状态定义的风险和对照间隔内的每个组内进行自我对照风险间隔分析,比较结果发生率,然后通过使用逻辑回归估计差异差异来比较有和没有 ASD 的儿童在风险和对照间隔内的结果发生率。
该研究共纳入 14947 名患有 ASD 的儿童和 1650041 名没有 ASD 的儿童。接种麻疹或百日咳疫苗后,有和没有 ASD 的儿童之间在发热(麻疹疫苗接种的率比为 1.07,95%CI 0.58-1.96;百日咳疫苗接种的率比为 1.16,95%CI 0.63-2.15)或 ED 就诊(麻疹疫苗接种的率比为 1.11,95%CI 0.80-1.54;百日咳疫苗接种的率比为 0.87,95%CI 0.59-1.28)方面没有差异。热性惊厥罕见。百日咳疫苗接种与无 ASD 儿童热性惊厥风险略有增加相关。
与没有 ASD 的儿童相比,接种麻疹或百日咳疫苗后,患有 ASD 的儿童发热或 ED 就诊的风险没有增加。这些结果可能进一步证明这些疫苗对所有儿童,包括 ASD 儿童都是安全的。