Cao Feng, Xu Long-Wei, Zhang Ying-Hui
Department of Nephrology and Rheumatology, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou 450000, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2023 Nov 15;25(11):1137-1142. doi: 10.7499/j.issn.1008-8830.2303129.
To study the effect of vaccination on the short-term risk of immunoglobulin A vasculitis (IgAV) in children.
A retrospective analysis was conducted on the general data and the vaccination history within one year prior to onset in children with IgAV hospitalized in the Children's Hospital Affiliated to Zhengzhou University from November 2021 to January 2023. Vaccine exposure rates in the risk period (3 months prior to IgAV onset) and the control period were compared by autocontrol-case crossover analysis, and the odds ratio and 95% confidence interval (95%) were calculated. A sensitivity analysis for the one-month and two-month risk periods was conducted.
A total of 193 children with IgAV were included, with a median age of 7.0 years. Among the 193 children, 36 (18.7%) received at least one dose of the vaccine within 1 year prior to IgAV onset, and 14 (7.3%) received at least one dose of the vaccine during the 3-month risk period. Compared to the unvaccinated IgAV group, the vaccinated IgAV group had a significantly younger age of onset (<0.05). There were no significant differences in the proportions of children with gastrointestinal involvement, renal involvement, and joint involvement between the two groups (>0.05). The odds ratio for developing IgAV after receiving any type of vaccine within 3 months prior to IgAV onset was 2.08 (95%: 0.82-5.27, >0.05). Further sensitivity analysis for the 1-month and 2-month risk periods demonstrated that the odds ratios for developing IgAV after receiving any type of vaccine were 2.74 (95%: 0.72-10.48, >0.05) and 2.72 (95%: 0.95-7.77, >0.05), respectively.
Vaccination dose not increase the risk of IgAV, nor does it exacerbate clinical symptoms in children with IgAV.
研究疫苗接种对儿童免疫球蛋白A血管炎（IgAV）短期风险的影响。
对2021年11月至2023年1月在郑州大学附属儿童医院住院的IgAV患儿的一般资料及发病前一年内的疫苗接种史进行回顾性分析。采用自身对照病例交叉分析比较风险期（IgAV发病前3个月）和对照期的疫苗暴露率，并计算比值比和95%置信区间（95%CI）。对1个月和2个月风险期进行敏感性分析。
共纳入193例IgAV患儿，中位年龄7.0岁。193例患儿中，36例（18.7%）在IgAV发病前1年内至少接种过一剂疫苗，14例（7.3%）在3个月风险期内至少接种过一剂疫苗。与未接种疫苗的IgAV组相比，接种疫苗的IgAV组发病年龄显著更小（P<0.05）。两组胃肠道受累、肾脏受累及关节受累患儿比例差异无统计学意义（P>0.05）。IgAV发病前3个月内接种任何类型疫苗后发生IgAV的比值比为2.08（95%CI：0.82-5.27，P>0.05）。对1个月和2个月风险期的进一步敏感性分析表明，接种任何类型疫苗后发生IgAV的比值比分别为2.74（95%CI：0.72-10.48，P>0.05）和2.72（95%CI：0.95-7.77，P>0.05）。
疫苗接种不会增加IgAV的风险，也不会加重IgAV患儿的临床症状。
