新生儿乙型肝炎疫苗接种:重新评估接种时间和佐剂以提高安全性和有效性。

Neonatal hepatitis B vaccination: Reevaluating timing and adjuvants for enhanced safety and effectiveness.

作者信息

Cirovic Aleksandar, Cirovic Ana, Ivanovski Ana, Ivanovski Petar

机构信息

Institute of Anatomy Faculty of Medicine University of Belgrade Belgrade Serbia.

Faculty of Medicine University of Belgrade Belgrade Serbia.

出版信息

Pediatr Discov. 2023 Dec 11;1(3):e47. doi: 10.1002/pdi3.47. eCollection 2023 Dec.

Abstract

Our aim is an achievement of a 100 percent vaccination rate without toxic vaccine effects. We did a comprehensive literature review on aluminum neurotoxicity and early neonatal hepatitis B vaccination. We analyzed indications for introduction of early neonatal hepatitis B vaccination and the data on experimental and clinical aluminum-induced neurotoxicity. It is justified very early hepatitis B vaccination to be carried out in high-risk endemic areas. In those countries there is a large number of hepatitis B positive individuals, including pregnant women, which leads to a great number of vertical, mother-to-child, transmissions of the virus during pregnancy. There is also a serious risk of perinatal Hepatitis B virus infections in such countries. Early neonatal hepatitis B vaccination is also carried out in low-risk countries, where the number of hepatitis B positive pregnant women is extremely small, making the number of newborns who require the prevention of hepatitis B infection extremely small as well. It is necessary for all vaccines which contain aluminum as an adjuvant to be immediately suspended as children vaccination until they start walking and until aluminum is replaced with calcium, zinc or a nonmetallic adjuvant such as microcrystalline tyrosine or monosodium urate. Meanwhile sustained efforts should be made to create the so-called mucosal vaccines against diphtheria, pertussis, measles, mumps and rubella. At the same time, all the children born to hepatitis B positive mothers, regardless of their place of birth must be vaccinated against hepatitis B as the benefits from vaccines by far outweigh potential harm caused by adjuvant aluminum.

摘要

我们的目标是实现100%的疫苗接种率且无疫苗毒性作用。我们对铝的神经毒性和新生儿早期乙肝疫苗接种进行了全面的文献综述。我们分析了引入新生儿早期乙肝疫苗接种的指征以及铝诱导的实验性和临床神经毒性数据。在高流行风险地区尽早开展乙肝疫苗接种是合理的。在这些国家,有大量乙肝阳性个体,包括孕妇,这导致孕期大量病毒垂直母婴传播。在这些国家,围产期感染乙肝病毒的风险也很高。在低风险国家也开展新生儿早期乙肝疫苗接种,这些国家乙肝阳性孕妇数量极少,因此需要预防乙肝感染的新生儿数量也极少。所有含铝佐剂的疫苗必须立即暂停用于儿童接种,直至儿童开始学步,并且直到铝被钙、锌或诸如微晶酪氨酸或尿酸钠等非金属佐剂替代。与此同时,应持续努力研发针对白喉、百日咳、麻疹、腮腺炎和风疹的所谓黏膜疫苗。同时,所有乙肝阳性母亲所生的儿童,无论其出生地在哪里,都必须接种乙肝疫苗,因为疫苗带来的益处远远超过铝佐剂可能造成的潜在危害。

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