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麻疹疫苗:不良事件综述

Measles vaccines: a review of adverse events.

作者信息

Duclos P, Ward B J

机构信息

Division of Immunisation, Bureau of Infectious Diseases, Laboratory Centre for Disease Control, Health Canada, Ottawa, Ontario.

出版信息

Drug Saf. 1998 Dec;19(6):435-54. doi: 10.2165/00002018-199819060-00002.

Abstract

A great deal of controversy has recently been generated over the publication of several articles implicating measles vaccine in the induction of Crohn's disease and autism. The publication of this work has already had a negative impact on measles vaccine acceptance in the UK. These allegations are particularly troubling because they arise in the context of increased use of measles vaccine as global control of measles nears and the international community considers strategies for a drive towards eradication. In 1994, the US Institute of Medicine reviewed the world literature and published a comprehensive review of adverse events associated with measles-containing vaccines. Reviewing the literature published between 1994 and the present day, reveals that there is considerable new data suggesting that modified gelatin rather than egg proteins is responsible for most episodes of anaphylaxis following measles vaccination. New work weakens the possible links between measles vaccine and subacute sclerosing panencephalitis and Guillain-Barré syndrome, but strengthens the rare association of measles-containing vaccines with post infectious encephalomyelitis. The alleged associations between measles vaccination and Crohn's disease and autism are based upon weak science and have largely been refuted by a large volume of stronger work. A review of the data generated in the last 4 years amply demonstrates the continued efforts of the scientific community to monitor and understand true measles vaccine-associated adverse events. The rapidity and clarity of this same community's debunking of the spurious associations with Crohn's disease and autism suggests that those charged with vaccination programmes have learned from past mistakes. During 30 years of worldwide use, measles vaccination has proven to be one of the safest and most successful health interventions in the history of mankind. It is not a 'perfect' vaccine, but the benefits of measles vaccination far outweigh the risks even in countries with low incidence of measles and high rates of measles vaccine coverage.

摘要

最近,几篇文章暗示麻疹疫苗可诱发克罗恩病和自闭症,这引发了大量争议。这些文章的发表已经对英国的麻疹疫苗接种率产生了负面影响。这些指控尤其令人不安,因为它们出现在全球麻疹控制接近尾声、国际社会考虑根除麻疹策略之际,而此时麻疹疫苗的使用却在增加。1994年,美国医学研究所审查了世界文献,并发表了一篇关于含麻疹疫苗相关不良事件的全面综述。回顾1994年至今发表的文献发现,有大量新数据表明,麻疹疫苗接种后大多数过敏反应是由改良明胶而非鸡蛋蛋白引起的。新的研究削弱了麻疹疫苗与亚急性硬化性全脑炎和格林-巴利综合征之间可能存在的联系,但加强了含麻疹疫苗与感染后脑脊髓炎之间罕见的关联。麻疹疫苗接种与克罗恩病和自闭症之间所谓的关联缺乏科学依据,大量更有力的研究已基本予以驳斥。对过去4年产生的数据进行回顾充分表明,科学界一直在持续努力监测和了解真正与麻疹疫苗相关的不良事件。科学界迅速且明确地揭穿了与克罗恩病和自闭症的虚假关联,这表明负责疫苗接种计划的人员已从过去的错误中吸取了教训。在全球使用的30年里,麻疹疫苗已被证明是人类历史上最安全、最成功的健康干预措施之一。它并非一种“完美”的疫苗,但即使在麻疹发病率低、麻疹疫苗接种率高的国家,麻疹疫苗接种的益处也远大于风险。

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