Nilsson L, Kjellman N I, Björkstén B
Department of Health and Environment, Faculty of Health Sciences, University Hospital, Linköping, Sweden.
Arch Pediatr Adolesc Med. 1998 Aug;152(8):734-8. doi: 10.1001/archpedi.152.8.734.
Pertussis vaccination in infancy has been suggested to increase the risk for development of asthma and allergy.
To assess sensitization rates and development of atopic diseases in a prospective randomized controlled trial of pertussis vaccine.
A total of 669 children were randomized to 1 of 4 vaccine groups (2-component acellular pertussis, 5-component acellular pertussis, whole-cell pertussis vaccines, and placebo [diphtheria and tetanus toxoids]). Diphtheria and tetanus toxoids were also given to the children in the pertussis vaccine groups. The children were evaluated by means of questionnaires at age 2 months, 7 months, and 2 1/2 years; skin prick tests at age 7 months and 2 1/2 years; and blinded clinical investigation at age 2 1/2 years. The families were contacted at regular intervals to assess possible adverse effects after the vaccinations and symptoms of whooping cough.
The cumulative incidence of atopic diseases was 30% and incidence rates were similar in the 4 groups after adjusting for family history. Exposure to environmental tobacco smoke and home dampness did not confound these results. The frequency of adverse effects did not differ appreciably between atopic and nonatopic children, with the exception that a nodule at the vaccination site was more frequent after whole-cell pertussis vaccination in the nonatopic children. Among 47 children with proven pertussis, atopic disease appeared in 19 (40%). Of these 47 children, 9 (19%) developed asthma, as compared with 58 (9%) noninfected children (P=.03).
We found no support for a drastic increase in allergic manifestations after pertussis vaccination. There was a positive association between whooping cough and asthma by 2 1/2 years of age. There seems to be little reason to withhold pertussis vaccination from infants, irrespective of family history of allergy.
有研究表明婴儿期接种百日咳疫苗会增加患哮喘和过敏的风险。
在一项百日咳疫苗的前瞻性随机对照试验中评估致敏率和特应性疾病的发生情况。
总共669名儿童被随机分为4个疫苗组之一（2组分无细胞百日咳疫苗、5组分无细胞百日咳疫苗、全细胞百日咳疫苗和安慰剂[白喉和破伤风类毒素]）。百日咳疫苗组的儿童也接种了白喉和破伤风类毒素。通过问卷在2个月、7个月和2岁半时对儿童进行评估；在7个月和2岁半时进行皮肤点刺试验；在2岁半时进行盲法临床检查。定期与家庭联系以评估接种疫苗后可能出现的不良反应和百日咳症状。
调整家族史后，特应性疾病的累积发病率为30%，4组的发病率相似。接触环境烟草烟雾和家庭潮湿并未混淆这些结果。特应性儿童和非特应性儿童之间不良反应的频率没有明显差异，唯一的例外是全细胞百日咳疫苗接种后，非特应性儿童接种部位出现结节的频率更高。在47名确诊为百日咳的儿童中，19名（40%）出现了特应性疾病。在这47名儿童中，9名（19%）患了哮喘，而未感染的儿童中有58名（9%）患哮喘（P = 0.03）。
我们没有发现百日咳疫苗接种后过敏表现急剧增加的证据。到2岁半时，百日咳与哮喘之间存在正相关。无论家族过敏史如何，似乎没有什么理由不给婴儿接种百日咳疫苗。
