甲型肝炎灭活疫苗和乙型肝炎(重组)疫苗的真实世界药物警戒报告:来自疫苗不良事件报告系统不成比例分析的见解

Real-world pharmacovigilance reports of hepatitis A inactivated and hepatitis B (recombinant) vaccine: insights from disproportionality analysis of the vaccine adverse event reporting system.

作者信息

Zhou Yuhang, Wang Yue, Feng Yun, Zhang Huiyue, Sun Tao, Xu Junnan

机构信息

Department of Breast Medicine 1, Cancer Hospital of China Medical University, Liaoning Cancer Hospital, Shenyang, China.

Department of Pharmacology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital, Shenyang, China.

出版信息

Front Cell Infect Microbiol. 2025 Jun 10;15:1609409. doi: 10.3389/fcimb.2025.1609409. eCollection 2025.

Abstract

BACKGROUND

Hepatitis A Inactivated and Hepatitis B (Recombinant) Vaccine (Hep AB) was approved for use in 2001. Hep AB demonstrates satisfactory efficacy in protecting the public from hepatitis virus infections. However, there is a lack of recent real-world report on its adverse events (AEs).

METHODS

We retrieved US AE reports related to Hep AB vaccination from VAERS for the period 2020-2024. We used four algorithms: Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN) and Multi-Item Gamma-Poisson Shrinkage (MGPS) to examine AE signals. The ROR and PRR algorithms have higher sensitivity but lower specificity. However, BCPNN and MGPS compensate for this limitation. Combining all four algorithms helps reduce false-positive signals. In addition to the general population, we also focused on reports stratified by gender.

RESULTS

We retrieved 1,640 eligible reports from VAERS. In the general population, we identified two AE signals at the System Organ Classification (SOC) level. Additionally, we found 39 AE signals at the Preferred Term (PT) level. Among these, endocrine disorders were identified for the first time as AE signals. In the subsequent gender stratified analysis, more AE signals were identified in females compared to males. Notably, signals for endocrine disorders (autoimmune thyroiditis and Graves' disease) were detected in females, whereas no such signals were found in males.

CONCLUSIONS

We conducted a comprehensive examination of the recent AE reports for Hep AB and identified unexpected AEs, particularly in females. These findings will provide valuable insights into future evidence-based surveillance strategies of Hep AB.

摘要

背景

甲型肝炎灭活和乙型肝炎(重组)疫苗(甲乙肝疫苗)于2001年获批使用。甲乙肝疫苗在保护公众免受肝炎病毒感染方面显示出令人满意的效果。然而,目前缺乏关于其不良事件(AE)的近期真实世界报告。

方法

我们从疫苗不良事件报告系统(VAERS)中检索了2020 - 2024年期间与甲乙肝疫苗接种相关的美国不良事件报告。我们使用了四种算法:报告比值比(ROR)、比例报告比值比(PRR)、贝叶斯置信传播神经网络(BCPNN)和多项目伽马 - 泊松收缩法(MGPS)来检查不良事件信号。ROR和PRR算法灵敏度较高但特异性较低。然而,BCPNN和MGPS弥补了这一局限性。综合使用这四种算法有助于减少假阳性信号。除了普通人群,我们还重点关注了按性别分层的报告。

结果

我们从VAERS中检索到1640份合格报告。在普通人群中,我们在系统器官分类(SOC)级别识别出两个不良事件信号。此外,我们在首选术语(PT)级别发现了39个不良事件信号。其中,内分泌紊乱首次被识别为不良事件信号。在随后的性别分层分析中,女性比男性识别出更多的不良事件信号。值得注意的是,在女性中检测到内分泌紊乱(自身免疫性甲状腺炎和格雷夫斯病)的信号,而在男性中未发现此类信号。

结论

我们对甲乙肝疫苗近期的不良事件报告进行了全面检查,并识别出了意外的不良事件,尤其是在女性中。这些发现将为未来甲乙肝疫苗基于证据的监测策略提供有价值的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0854/12185504/460129196a1d/fcimb-15-1609409-g001.jpg

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