Risks of serious complications and death from smallpox vaccination: a systematic review of the United States experience, 1963-1968.
Risks of serious complications and death from smallpox vaccination: a systematic review of the United States experience, 1963-1968.
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DOI：
10.1186/1471-2458-3-26
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发表时间：
2003-08-11
影响因子：
4.5
通讯作者：
Rutherford, GW
中科院分区：
文献类型：
--
作者：
Arag贸n, TJ;Ulrich, S;Fernyak, S;Rutherford, GW
美国已重新实施天花疫苗接种，为故意将天花病毒释放到平民人口中做准备。在疫情中，所有年龄段的人都将接种疫苗。为了应对大规模环种和大规模接种的影响，我们对天花疫苗接种的并发症和死亡风险进行了系统的审查。我们总结了疫苗接种后脑炎、牛痘坏死症(进行性牛痘)、湿疹牛痘、全身性牛痘和意外感染(无意自身接种)的风险。使用MEDLINE搜索策略，我们确定了348篇文章，其中7项研究符合我们的纳入标准(报告了初次接种和再次接种的数量，提供了足够的数据来计算并发症或病例死亡风险，并使用了可比的病例定义)。对于每个并发症，我们估计了并发症、死亡和病例死亡风险。疫苗接种后脑炎和牛痘坏死症的危及生命的并发症分别为至少每百万次初级疫苗接种3次和1次。29%的接种后脑炎疫苗接种者死亡，15%的牛痘坏死症患者死亡。接种湿疹疫苗的人中没有人死亡；然而，未接种疫苗的湿疹接触者中有2.3%死亡。在重新接种疫苗的人中，接种疫苗后脑炎的风险降低了26%，全身性牛痘的风险降低了29%，湿疹疫苗的风险降低了12%。然而，意外感染和牛痘坏死症的风险降低幅度不大(分别为3.8倍和1.5倍)。
The United States (US) has re-instituted smallpox vaccinations to prepare for an intentional release of the smallpox virus into the civilian population. In an outbreak, people of all ages will be vaccinated. To prepare for the impact of large-scale ring and mass vaccinations, we conducted a systematic review of the complication and mortality risks of smallpox vaccination. We summarized these risks for post-vaccinial encephalitis, vaccinia necrosum (progressive vaccinia), eczema vaccinatum, generalized vaccinia, and accidental infection (inadvertant autoinoculation). Using a MEDLINE search strategy, we identified 348 articles, of which seven studies met our inclusion criteria (the number of primary vaccinations and re-vaccinations were reported, sufficient data were provided to calculate complication or case-fatality risks, and comparable case definitions were used). For each complication, we estimated of the complication, death, and case-fatality risks. The life-threatening complications of post-vaccinial encephalitis and vaccinia necrosum were at least 3 and 1 per million primary vaccinations, respectively. Twenty-nine percent of vaccinees with post-vaccinial encephalitis died and 15% with vaccinia necrosum died. There were no deaths among vaccinees that developed eczema vaccinatum; however, 2.3% of non-vaccinated contacts with eczema vaccinatum died. Among re-vaccinees, the risk of post-vaccinial encephalitis was reduced 26-fold, the risk of generalized vaccinia was reduced 29-fold, and the risk of eczema vaccinatum was reduced 12-fold. However, the risk reductions of accidental infection and vaccinia necrosum were modest (3.8 and 1.5 fold respectively).
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影响因子：
1.2
作者：
Haim, M;Gdalevich, M;Shemer, J
通讯作者：
Shemer, J
影响因子：
--
作者：
COPEMAN, PWM;WALLACE, HJ
通讯作者：
WALLACE, HJ
影响因子：
11.4
作者：
FEERY, BJ
通讯作者：
FEERY, BJ
影响因子：
11.8
作者：
Bartlett, J;Borio, L;Inglesby, TV
通讯作者：
Inglesby, TV
影响因子：
14.2
作者：
Engler, RJM;Kenner, J;Leung, DYM
通讯作者：
Leung, DYM