摘要
背景:最近,我们报告了一个在哮喘儿童中疫苗诱导的体液免疫(麻疹疫苗)的更快速的减弱。哮喘是否影响疫苗可预防疾病的易感性还是未知的。
目的:要确定哮喘是否与疫苗可预防疾病的风险增加有关,如爆发性水痘感染。
方法:这是一个基于群体的回顾性病例对照研究,研究2005和2011年之间的儿童爆发性水痘病例。在2005和2011年,明尼苏达奥姆斯特德县,诊断为爆发性水痘感染(接种疫苗后感染>42天)的儿童,以及两个年龄和性别匹配的对照组被纳入研究。哮喘的状态是通过使用预定的标准确定。条件的逻辑回归模型被用来计算匹配的比值比(OR)和他们相应的95%可信区间(CI)。
结果:在165个病例和330个匹配的对照中,48%为男生,病例和对照的平均年龄(标准差)为岁6.6± 3.5岁。330个对照孩子中,80个(24%)打过两次的水痘疫苗,165个病例中只有23个(14%)打过两次水痘疫苗(OR 0.29 [ 95% CI,0.14-0.61 ];P = 0.001)。当调整第一次水痘疫苗的时间和水痘疫苗接种次数之后,与那些没有哮喘史的孩子相比,有哮喘病史的孩子有较高风险患爆发性水痘(调整过的OR 1.63 [ 95% CI,1.04-2.55 ];P = 0.032)。
结论:哮喘病史可能是爆发性水痘感染无法识别的一个风险因素。哮喘患儿应遵循两次水痘疫苗政策。
(杨冬 审校)
Allergy Asthma Proc. 2016 May;37(3):207-15. doi: 10.2500/aap.2016.37.3951.
Asthma and risk of breakthrough varicella infection in children.
Umaretiya PJ1, Swanson JB, Kwon HJ, Grose C, Lohse CM, Juhn YJ.
Author information
Abstract
BACKGROUND:We recently reported a more rapid waning of vaccine-induced humoral immunity (measles vaccine) in children with asthma. It is unknown if asthma affects susceptibility to vaccine-preventable diseases.
OBJECTIVE:To determine whether asthma is associated with an increased risk of vaccine-preventable disease, e.g., breakthrough varicella infection.
METHODS:This was a retrospective population-based case-control study that examined cases of breakthrough varicella among children between 2005 and 2011. Children with a diagnosis of breakthrough varicella infection in Olmsted County, Minnesota (infection of >42 days after vaccination) between 2005 and 2011 and two age- and sex-matched controls were enrolled for each case. Asthma status was determined by using predetermined criteria. Conditional logistic regression models were used to calculate matched odds ratios (OR) and their corresponding 95% confidence intervals (CI).
RESULTS:Of the 165 cases and their 330 matched controls, 48% were boys and the mean (standard deviation) age at the index date was 6.6 ± 3.5 years for both cases and controls. Of the 330 controls, 80 (24%) had two doses of the varicella vaccine compared with only 23 (14%) of the 165 cases (OR 0.29 [95% CI, 0.14-0.61]; p = 0.001). Children with a history of asthma ever had a higher risk of developing breakthrough varicella compared with those without a history of asthma (adjusted OR 1.63 [95% CI, 1.04-2.55]; p = 0.032) when adjusting for elapsed time since the first varicella vaccination and the number of varicella vaccine doses.
CONCLUSIONS:A history of asthma might be an unrecognized risk factor for breakthrough varicella infection. Children with asthma should follow the two-dose varicella vaccine policy.
Allergy Asthma Proc. 2016 May;37(3):207-15. doi: 10.2500/aap.2016.37.3951.