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1968 - 2024年疫苗相关雷诺现象的全球负担:药物警戒数据库的综合分析

Global burden of vaccine-associated Raynaud's phenomenon, 1968-2024: A comprehensive analysis of the pharmacovigilance database.

作者信息

Jeong Jinyoung, Kim Hyunjee, Jo Hyesu, Park Jaeyu, Cho Jaehyeong, Lee Hayeon, Cho Hanseul, Rahmati Masoud, Woo Ho Geol, Yon Dong Keon

机构信息

Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.

Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.

出版信息

Eur J Clin Pharmacol. 2025 Jun 6. doi: 10.1007/s00228-025-03854-2.

Abstract

PURPOSE

Reports of Raynaud's phenomenon following vaccination have been steadily increasing; however, research on vaccine-associated Raynaud's phenomenon remains limited. This study aims to provide a comprehensive analysis of the association between Raynaud's phenomenon and various vaccines.

METHOD

This study used data from international pharmacovigilance, which contains over 35 million adverse event cases from more than 140 countries. Two established pharmacovigilance indicators, the information component (IC) and reporting odds ratio (ROR), were employed in the analysis with 95% confidence interval (CI). The IC was derived using a Bayesian methodology to compare the reporting and non-reporting groups, while the ROR, a frequentist measure of association, was calculated using contingency tables based on the number of adverse events.

RESULTS

The signal with Raynaud's phenomenon was highest for papillomavirus vaccines (ROR: 11.49 [95% CI, 9.66-13.67]; IC: 3.45 [IC, 3.16]), followed in order by typhoid (5.86 [2.93-11.72]), hepatitis B (5.63 [4.25-7.45]; 2.42 [1.95]), COVID-19 mRNA (5.00 [4.70-5.31]; 2.00 [1.91]), and hepatitis A vaccines (4.35 [2.87-6.62]; 2.02 [1.30]). The signal was higher in females (ROR: 3.74 [95% CI, 3.54-3.95]; IC: 1.67 [IC, 1.59]) compared to males (3.44 [3.12-3.78]; 1.57 [1.43]), and it increased monotonically with age (0-11 years: IC [IC] 0.03 [-0.56]; 12-17 years: 1.54 [1.25]; 18-44 years: 1.64 [1.52]; 45-64 years: 2.00 [1.87]; ≥ 65 years: 2.12 [1.91]).

CONCLUSION

This study suggests the potential signal association between various vaccines and Raynaud's phenomenon. Although our study does not imply causality, we propose the need to strengthen post-vaccination monitoring and establish support policies to address such adverse events.

摘要

目的

接种疫苗后出现雷诺现象的报告一直在稳步增加;然而,关于疫苗相关雷诺现象的研究仍然有限。本研究旨在全面分析雷诺现象与各种疫苗之间的关联。

方法

本研究使用了来自国际药物警戒的数据,其中包含来自140多个国家的超过3500万例不良事件病例。在分析中采用了两个既定的药物警戒指标,即信息成分(IC)和报告比值比(ROR),并给出95%置信区间(CI)。IC是使用贝叶斯方法得出的,用于比较报告组和非报告组,而ROR是一种基于频率的关联度量,使用基于不良事件数量的列联表进行计算。

结果

乳头瘤病毒疫苗出现雷诺现象的信号最高(ROR:11.49 [95% CI,9.66 - 13.67];IC:3.45 [IC,3.16]),其次依次是伤寒疫苗(5.86 [2.93 - 11.72])、乙肝疫苗(5.63 [4.25 - 7.45];2.42 [1.95])、新冠mRNA疫苗(5.00 [4.70 - 5.31];2.00 [1.91])和甲肝疫苗(4.35 [2.87 - 6.62];2.02 [1.30])。女性出现该信号的比例高于男性(ROR:3.74 [95% CI,3.54 - 3.95];IC:1.67 [IC,1.59])(男性为3.44 [3.12 - 3.78];1.57 [1.43]),并且该信号随年龄单调增加(0 - 11岁:IC [IC] 0.03 [-0.56];12 - 17岁:1.54 [1.25];18 - 44岁:1.64 [1.52];45 - 64岁:2.00 [1.87];≥65岁:2.12 [1.91])。

结论

本研究表明各种疫苗与雷诺现象之间可能存在信号关联。虽然我们的研究并不意味着存在因果关系,但我们建议有必要加强疫苗接种后的监测,并制定支持政策以应对此类不良事件。

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