Sacks H S, Rose D N, Chalmers T C
JAMA. 1984 Dec 28;252(24):3375-7.
The current epidemic of acquired immunodeficiency syndrome (AIDS) and fear that its causative agent contaminates the currently available hepatitis B vaccine may have deterred vaccine use. We formulated a decision-analytic model that compares the risk of death from hepatitis B and AIDS in those vaccinated with the risk of death from hepatitis B alone in those who wait two years for a synthetic vaccine. For individuals with 5% annual risk of hepatitis B, the best current estimate is that vaccination now would save 25 lives per 100,000. The best current estimate of the rate of vaccine-induced AIDS is zero, and one can be 95% confident that the rate is less than eight per 100,000. The rate would have to be considerably higher before postponement of vaccination would be rational for those for whom vaccination has been recommended.
当前的获得性免疫缺陷综合征（艾滋病）疫情以及对其病原体污染现有乙肝疫苗的担忧可能阻碍了疫苗的使用。我们构建了一个决策分析模型，比较了接种疫苗者中因乙肝和艾滋病死亡的风险与等待两年使用合成疫苗者中仅因乙肝死亡的风险。对于每年有5%感染乙肝风险的个体，目前最佳估计是现在接种疫苗每10万人可挽救25条生命。目前对疫苗诱发艾滋病发生率的最佳估计为零，并且有95%的把握确定该发生率低于每10万人8例。对于已被建议接种疫苗的人群，在疫苗诱发艾滋病的发生率大幅更高之前，推迟接种疫苗才是合理的。
