Littenberg B, Ransohoff D F
Am J Med. 1984 Dec;77(6):1023-6. doi: 10.1016/0002-9343(84)90182-7.
Three strategies regarding hepatitis B virus vaccination were compared by decision analysis: no vaccination, immediate vaccination, and vaccination after two years. The potential advantage of waiting two years is to learn whether serious side effects of the vaccine will become evident. For example, it was found that immediate hepatitis B vaccination of 100,000 surgical house officers with a 5 percent annual attack rate for five years would, compared with no vaccination, prevent 4,092 cases of icteric hepatitis, 335 cases of chronic active hepatitis, and 15 deaths from fulminant hepatitis. For a strategy of waiting two years, the number of cases prevented would decrease by about 40 percent. Persons in groups with an annual attack rate lower than 5 percent appear to benefit from vaccination. The known health risks of hepatitis B virus vaccination are low, and the hypothesized risks would have to be frequent to justify delay in vaccination. From an individual perspective, even persons at low risk of hepatitis B virus infection should seriously consider immediate vaccination.
不接种、立即接种和两年后接种。等待两年的潜在优势在于了解疫苗的严重副作用是否会显现出来。例如，研究发现，对于每年发病率为5%的10万名外科住院医生，立即接种乙肝疫苗，持续五年，与不接种相比，可预防4092例黄疸型肝炎、335例慢性活动性肝炎以及15例暴发性肝炎死亡。对于等待两年的策略，预防的病例数将减少约40%。年发病率低于5%的人群似乎能从接种疫苗中受益。已知的乙肝病毒疫苗接种健康风险较低，而假设的风险必须频繁发生才能证明延迟接种是合理的。从个人角度来看，即使是乙肝病毒感染风险较低的人也应认真考虑立即接种疫苗。
