Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.
Faculty of Health Science, Curtin School of Population Health, Curtin University, Bentley, Western Australia, Australia.
PLoS One. 2023 Oct 4;18(10):e0291483. doi: 10.1371/journal.pone.0291483. eCollection 2023.
Asthma is among the commonest noncommunicable diseases of childhood and often occurs with other atopic comorbidities. A previous case-control study found evidence that compared to children who received acellular pertussis (aP) vaccines in early infancy, children who received one or more doses of whole-cell pertussis (wP) vaccine had lower risk of developing IgE-mediated food allergy. We hypothesized that wP vaccination in early infancy might protect against atopic asthma in childhood.
Retrospective record-linkage cohort study of children between 5 and < 15 years old and born between January 1997, and December 1999, in the Australian states of Western Australia (WA) and New South Wales (NSW), receiving wP versus aP vaccine as the first pertussis vaccine dose. The main outcome and measures were first and recurrent hospitalizations for asthma; hazard ratios (HRs) and 95% confidence intervals (CIs) were computed by means of Cox and Andersen and Gill models.
274,405 children aged between 5 and < 15 years old (78.4% NSW-born) received a first dose of either wP (67.8%) or aP vaccine before 4 months old. During the follow-up period, there were 5,905 hospitalizations for asthma among 3,955 children. The incidence rate for first hospitalization was 1.5 (95% CI 1.4-1.5) per 1,000 child-years among children receiving wP vaccine as a first dose, and 1.5 (95% CI 1.4-1.6) among those vaccinated with aP vaccine as a first dose. The adjusted HRs for those who received wP vaccine versus aP vaccine as the first dose were 1.02 (95% CI 0.94-1.12) for first hospitalizations and 1.07 (95% CI 0.95-1.2) for recurrent hospitalizations for asthma.
We found no convincing evidence of a clinically relevant association between receipt of wP versus aP vaccines in early infancy and hospital presentations for asthma in childhood.
哮喘是儿童中最常见的非传染性疾病之一，常伴有其他特应性合并症。一项先前的病例对照研究发现，与婴儿早期接受无细胞百日咳（aP）疫苗相比，接受全细胞百日咳（wP）疫苗一剂或多剂的儿童发生 IgE 介导的食物过敏的风险较低。我们假设婴儿早期接种 wP 疫苗可能会预防儿童特应性哮喘。
对 1997 年 1 月至 1999 年 12 月期间在澳大利亚西澳大利亚州（WA）和新南威尔士州（NSW）出生的 5 岁至<15 岁儿童进行回顾性记录链接队列研究，他们接受 wP 或 aP 疫苗作为第一剂百日咳疫苗。主要结局和措施是首次和反复因哮喘住院；使用 Cox 和 Andersen 和 Gill 模型计算危害比（HR）和 95%置信区间（CI）。
274405 名 5 岁至<15 岁的儿童（78.4%出生于 NSW）在 4 个月前接受了第一剂 wP（67.8%）或 aP 疫苗。在随访期间，有 3955 名儿童中有 5905 次因哮喘住院。接受 wP 疫苗作为首剂的儿童首次住院的发病率为每 1000 人年 1.5（95%CI 1.4-1.5），而接受 aP 疫苗作为首剂的儿童为 1.5（95%CI 1.4-1.6）。接受 wP 疫苗与 aP 疫苗作为首剂的儿童，首次住院的调整 HR 分别为 1.02（95%CI 0.94-1.12）和 1.07（95%CI 0.95-1.2）。
我们没有发现婴儿早期接受 wP 与 aP 疫苗接种与儿童哮喘住院治疗之间存在临床相关关联的令人信服的证据。
