Hofmann H
Abteilung für Klinische Virologie am AKH-Wien.
Wien Klin Wochenschr. 1995;107(17):509-15.
In Austria at present more than 5 million people are vaccinated against tick-borne encephalitis (TBE), some of whom have received up to 8 vaccinations. Since introduction of the mass vaccination programme an estimated 18 million TBE vaccinations have been given in this country. Hence, the change coincidental occurrence of various illnesses which might be interpreted as possible vaccination complications is inevitable. However, the appearance of true vaccination complications in addition to chance concurrent disease cannot be ruled out a priori. In any given case it is very difficult, indeed virtually impossible, to differentiate between these two possibilities since there is no available test for confirmation or exclusion of vaccine complications. Mainly disturbances of the nervous system have been ascribed to preceding TBE vaccination. From the incidence of such diseases we calculated how often their occurrence should inevitably be expected during a two-month observation period after vaccination; only significantly higher figures can be accepted as representing vaccination complications. Very large controlled field studies would be required to provide unequivocal results. This enormous expense is barely justifiable and the required money could be better spent on other projects in the public health system. All studies to date and theoretical considerations show that the potential risk of TBE vaccination is extremely low. Experts of the Paul Ehrlich Institute (Germany) came to the conclusion that one certain case of neuritis arises after 1 million TBE vaccinations. Virological investigations show that virologically unclarified (and, hence, vaccine-induced) neurological disturbances do not occur more frequently in TBE vaccines than in unvaccinated persons.(ABSTRACT TRUNCATED AT 250 WORDS)
目前在奥地利,超过500万人接种了蜱传脑炎(TBE)疫苗,其中一些人接种次数多达8次。自大规模疫苗接种计划实施以来,该国估计已进行了1800万次TBE疫苗接种。因此,各种疾病巧合同时出现,而这些疾病可能被解释为潜在的疫苗接种并发症,这是不可避免的。然而,除了偶然并发的疾病外,真正的疫苗接种并发症的出现也不能被先验地排除。在任何特定情况下,很难,实际上几乎不可能区分这两种可能性,因为没有可用的检测方法来确认或排除疫苗并发症。主要是神经系统紊乱被归因于先前的TBE疫苗接种。根据这些疾病的发病率,我们计算了在接种疫苗后的两个月观察期内,它们不可避免地出现的频率;只有明显更高的数字才能被视为代表疫苗接种并发症。需要非常大规模的对照实地研究才能提供明确的结果。这笔巨大的费用几乎没有正当理由,所需资金可以更好地用于公共卫生系统的其他项目。迄今为止的所有研究和理论考虑都表明,TBE疫苗接种的潜在风险极低。德国保罗·埃利希研究所的专家得出结论,每100万次TBE疫苗接种后会出现1例神经炎病例。病毒学调查表明,TBE疫苗中病毒学上未明确(因此是疫苗诱导)的神经紊乱并不比未接种疫苗的人更频繁地发生。