Estimating the Size of the US Population at Risk of Severe Adverse Events from Replicating Smallpox Vaccine
Estimating the Size of the US Population at Risk of Severe Adverse Events from Replicating Smallpox Vaccine
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DOI：
10.1111/phn.12291
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发表时间：
2017-05-01
影响因子：
2.1
通讯作者：
Katz, Rebecca
中科院分区：
文献类型：
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作者：
Carlin, Ellen P.;Giller, Nichole;Katz, Rebecca
目的通过疾病控制和预防中心的规划文件、其他联邦出版物和同行评议文献，确定复制型天花疫苗的严重不良反应风险人群。确定的疾病被归类为历史上公认的风险或最近公认的可能构成风险的免疫功能低下状态。主要历史风险因素如下：湿疹/特应性皮炎、妊娠、HIV和原发性免疫缺陷。最近确定的国家如下：类风湿性关节炎、炎症性肠病、透析、移植后24个月内的骨髓移植受者、移植后3个月内的实体器官移植受者、1岁以下的年龄和系统性红斑狼疮。结果估计有48，121，280至50，028，045人（占美国人口的15.2-15.8%）可能禁忌复制天花疫苗。这上升到119，244，531至123，669，327（37.4-38.8%），如果家庭接触包括在内。了解这一数字有助于提高临床利用率，公平关注弱势群体的健康需求，并进行战略性疫苗储备。
ObjectiveTo quantify the population at risk of serious adverse reactions to replicating smallpox vaccine.Design and SampleConditions known or suspected to carry risk were identified via Centers for Disease Control and Prevention planning documents, other federal publications, and peer-reviewed literature. Conditions identified were categorized as historically recognized risks or more recently recognized immunocompromised states that may pose risk. Major historical risk factors were as follows: eczema/atopic dermatitis, pregnancy, HIV, and primary immunodeficiency. More recently identified states were as follows: rheumatoid arthritis, inflammatory bowel disease, dialysis, bone marrow transplant recipients within 24months post-transplant, solid-organ transplant recipients within 3months post-transplant, age under 1year, and systemic lupus erythematosus.MeasuresThe estimated prevalence or absolute number of affected individuals for each condition was ascertained from peer-reviewed studies, vital statistics, and registry databases.ResultsAn estimated 48,121,280 to 50,028,045 individuals (15.2-15.8% of the U.S. population) are potentially contraindicated to replicating smallpox vaccine. This rises to 119,244,531 to 123,669,327 (37.4-38.8%) if household contacts are included.ConclusionsThese figures are significant and larger than the only previously published study. Understanding this number allows for improved clinical utilization, equitable attention to the health needs of a vulnerable population, and strategic vaccine stockpiling.